Research on Biomedical Engineering
http://www.rbejournal.periodikos.com.br/article/doi/10.1590/2446-4740.08117
Research on Biomedical Engineering
Original Article

AD-SISCOLO: a decision-support tool to aid the management of a cervical cancer screening program

Sulafa Yacoub Mohammed Ahmed; Sergio Miranda Freire; Tereza Maria Piccinini Feitosa; Lucilia Maria Gama Zardo; Rosimary Terezinha de Almeida

Abstract

Abstract Introduction: This paper aims to develop a data warehouse (AD-SISCOLO) in order to support the management of the cervical cancer screening program in the municipality of Rio de Janeiro/Brazil. As a part of the management process, the program managers of the municipality perform tedious manual work in order to calculate a series of performance indicators and then take decisions based on them.

Methods: AD-SISCOLO was implemented using the Pentaho BI Suite Business Intelligence Platform and the MySQL database management system. The indicators to be calculated and visualized in the tool were based on the municipal data of the cytopathology and histopathology tests from January 2012 until December 2014, which was obtained from the Information System of Cervical Cancer (SISCOLO) after a record linkage process. The follow-up indicators were based on a simplified version of the Brazilian guidelines for the cervical cancer screening.

Results: AD-SISCOLO allows the visualization of a set of test-based and follow-up indicators from different views and dimensions, which enable managers to monitor all the phases of the screening process and to identify the process’ failures.

Conclusions: Compared with the current available environments in Brazil, AD-SISCOLO is unique in its visualization of the follow-up indicators of groups of women, according to their test results and age. Thereby it provides presentation flexibility to suit the program manager's needs.

Keywords

Decision-support tools, Data visualization, Data warehouse, Cervical cancer screening, Performance indicators, Healthcare management

References

Agency for Healthcare Research and Quality – AHRQ. Decision support tools for screening and treatment decisions in early cancer. Rockville: AHRQ; 2013 [cited 2017 Dec 9]. Available from: https://effectivehealthcare.ahrq.gov/ehc/products/529/1749/cancer-decision-support-tools-protocol-131112.pdf

Agência Nacional de Saúde Suplementar – ANS. Beneficiários de planos privados de saúde, por cobertura assistencial (Brasil - 2003-2011). Rio de Janeiro: ANS; 2015 [cited 2017 Dec 9]. Available from: http://www.ans.gov.br/images/stories/Materiais_para_pesquisa/Perfil_setor/Caderno_informacao_saude_suplementar/2015_mes12_caderno_informacao.pdf

Ahmed SYM, Almeida RT. A review of performance indicators for evaluation of cervical cancer screening programs. In: Anais do XXIV Congresso Brasileiro de Engenharia Biomédica; 2014; Uberlândia, Brasil. Rio de Janeiro: SBEB; 2014 [cited 2017 Dec 9]. Available from: http://www.canal6.com.br/cbeb/2014/artigos/cbeb2014_submission_207.pdf

Ahmed SYM, Freire SM, Almeida RT. Indicadores de eficácia para a avaliação das ações de um programa de rastreamento do câncer do colo de útero. Rio de Janeiro: UERJ; 2017 [cited 2017 Dec 9]. Available from: http://www.lampada.uerj.br/adsiscolo

Araujo MLC Jr, Santana DA, Almeida LB, Quintana SBS, Silva GRF, Fonseca RCSP. Quality in cytopathology: an analysis of the internal quality monitoring indicators of the Instituto Nacional de Câncer. J Bras Patol E Med Lab. 2015; 51(2):102-7. http://dx.doi.org/10.5935/1676-2444.20150018.

Bastos EA. Estimativa da Efetividade do Programa de Rastreamento do Câncer do Colo do Útero no Estado do Rio de Janeiro [dissertation]. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 2011 [cited 2017 Dec 9]. Available from: http://www.peb.ufrj.br/teses/Tese0143_2011_08_12.pdf

Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva – INCA. Coordenação de Prevenção e Vigilância. Nomenclatura brasileira para laudos cervicais e condutas preconizadas: recomendações para profissionais de saúde. 2nd ed. Rio de Janeiro: INCA; 2006a [cited 2017 Dec 9]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/Nomenclaturas_2_1705.pdf

Brasil. Ministério da Saúde. Gabinete do Ministro. Portaria nº 399/GM de 22 de fevereiro de 2006. Divulga o Pacto pela Saúde 2006 – Consolidação do SUS e aprova as Diretrizes Operacionais do Referido Pacto. Diário Oficial da República Federativa do Brasil, Brasília, fev. 2006b [cited 2017 Dec 9]. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2006/prt0399_22_02_2006.html

Brasil. Ministério da Saúde. Departamento de Informática do Sistema Único de Saúde – DATASUS. Sistema de informação do câncer do colo do útero e mama: informações estatísticas. Brasília; 2008a [cited 2017 Dec 9]. Available from: http://w3.datasus.gov.br/siscam/index.php?area=0401

Brasil. Ministério da Saúde. Departamento de Informática do Sistema Único de Saúde – DATASUS. Tab para Windows – TabWin. Brasília; 2008b [cited 2017 Dec 9]. Available from: http://www2.datasus.gov.br/DATASUS/index.php?area=060805

Brasil. Ministério da Saúde. Instituto Nacional de Câncer – INCA. Sistemas de informação do controle do câncer de mama e do colo do útero: manual gerencial. Rio de Janeiro: INCA; 2011 [cited 2017 Dec 9]. Available from: http://www1.inca.gov.br/inca/Arquivos/manual_gerencial_2011.pdf

Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva – INCA. Sistema de informação do câncer: manual preliminar para apoio à implantação. Rio de Janeiro: INCA; 2013 [cited 2017 Dec 9]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/inca/siscan_manual_preliminar.pdf

Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva – INCA. Câncer do colo do útero. Rio de Janeiro: INCA; 2015a [cited 2017 Dec 9]. Available from: http://www2.inca.gov.br/wps/wcm/connect/tiposdecancer/site/home++/colo_utero/definicao

Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva – INCA. Controle do câncer do colo do útero, histórico das ações. Rio de Janeiro: INCA; 2015b [cited 2017 Dec 9]. Available from: http://www2.inca.gov.br/wps/wcm/connect/acoes_programas/site/home/nobrasil/programa_nacional_controle_cancer_colo_utero/historico_acoes

Brasil. Ministério da Saúde. Departamento de Informática do SUS. Cadastro Nacional de Estabelecimentos de Saúde. Brasília; 2015c [cited 2017 Dec 9]. Available from: http://cnes.datasus.gov.br/

Brasil. Ministério da Saúde. Departamento de Informática do SUS. Tabelas nacionais. Brasília; 2015d [cited 2017 Dec 9]. Available from: ftp://ftp.datasus.gov.br/territorio/tabelas

Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva – INCA. Atlas de Mortalidade por Câncer. Rio de Janeiro: INCA; 2016a [cited 2017 Dec 9]. Available from: http://www1.inca.gov.br/vigilancia/mortalidade.asp

Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva – INCA. Coordenação de Prevenção e Vigilância – Conprev. Divisão de Detecção Precoce e Apoio à Organização de Rede. Diretrizes brasileiras para o rastreamento do câncer do colo do útero. 2nd ed. Rio de Janeiro: INCA; 2016b [cited 2017 Dec 9]. Available from: http://www1.inca.gov.br/inca/Arquivos/Diretrizes_para_o_Rastreamento_do_cancer_do_colo_do_utero_2016_corrigido.pdf

Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva – INCA. Painel de indicadores do câncer do colo de útero. Rio de Janeiro: INCA; 2017a [cited 2017 Dec 9]. Available from: http://www2.inca.gov.br/wps/wcm/connect/acoes_programas/site/home/nobrasil/programa_nacional_controle_cancer_colo_utero/indicadores/

Brasil. Ministério da Saúde. Sala de Apoio a Gestão Estratégica – SAGE. Prevenção e tratamento de câncer de colo e mama. Brasília; 2017b [cited 2017 Dec 9]. Available from: http://sage.saude.gov.br/

Canadian Institute for Health Information – CIHI. CIHI Health Indicators. Canada; 2017 [cited 2017 Dec 9]. Available from: https://www.cihi.ca/en/cihi-health-indicators

Clark I, Whiting P, Twin J, Docker J, Ferguson J. Pathology handbook. 5th ed. Canberra: Buckner Printing Company; 2012.

Drummond JL, Were MC, Arrossi S, Wools-Kaloustian K. Cervical cancer data and data systems in limited-resource settings: challenges and opportunities. Int J Gynaecol Obstet. 2017; 138(Suppl 1):33-40. PMid:28691330. http://dx.doi.org/10.1002/ijgo.12192.

Feitosa TMP, Almeida RT. Pap smear screening for the control of cervical cancer in Minas Gerais State, Brazil, 2002. Cad Saude Publica. 2007; 23(4):907-17. PMid:17435888. http://dx.doi.org/10.1590/S0102-311X2007000400018.

Fellegi IP, Sunter AB. A theory for record linkage. J Am Stat Assoc. 1969; 64(328):1183-210. http://dx.doi.org/10.1080/01621459.1969.10501049.

Forsmo S, Buhaug H, Skjeldestad F, Haugen O. Treatment of pre-invasive conditions during opportunistic screening and its effectiveness on cervical cancer incidence in one Norwegian county. Int J Cancer. 1997; 71(1):4-8. PMid:9096657. http://dx.doi.org/10.1002/(SICI)1097-0215(19970328)71:1<4::AID-IJC2>3.0.CO;2-Y.

Freire SM, Almeida RT, Cabral MDB, Bastos EA, Souza RC, Silva MGP. A record linkage process of a cervical cancer screening database. Comput Methods Programs Biomed. 2012; 108(1):90-101. PMid:22341207. http://dx.doi.org/10.1016/j.cmpb.2012.01.007.

Girianelli VR, Thuler LCS, Silva GA. Qualidade do sistema de informação do câncer do colo de útero no estado do Rio de Janeiro. Rev Saude Publica. 2009; 43(4):580-8. PMid:19618027. http://dx.doi.org/10.1590/S0034-89102009005000043.

Hitachi Vantara Community. Pentaho Schema Workbench. 2015 [cited 2017 Dec 9]. Available from: https://sourceforge.net/projects/mondrian/files/schema%20workbench/

Hitachi Vantara Community. Pentaho Report Designer. 2017 [cited 2017 Dec 9]. Available from: https://sourceforge.net/projects/pentaho/files/Report%20Designer/

International Agency for Research on Cancer – IARC. Cervix cancer screening: IARC Handbook of Cancer Prevention. 1st ed. Lyon: IARC Press; 2005 [cited 2017 Dec 9]. Available from: http://www.iarc.fr/en/publications/pdfs-online/prev/handbook10/

Kimball R, Ross M. The data warehouse took kit: the complete guide to dimensional modeling. 2nd ed. New York: John Wiley & Sons; 2011.

Meteorite.bi Company. Saiku analytics. 2016 [cited 2017 Dec 9]. Available from: http://www.meteorite.bi/products/saiku

Oracle Corporation. MySQL WorkBench. 2016a [cited 2017 Dec 9]. Available from: https://dev.mysql.com/downloads/workbench/

Oracle Corporation. MySQL database. 2016b [cited 2017 Dec 9]. Available from: http://www.mysql.com

Pentaho Corporation. Pentaho Suite Business Intelligence. 2017 [cited 2017 Dec 9]. Available from: http://www.pentaho.com

Public Health Agency of Canada – PHAC. Performance monitoring for cervical cancer screening programs in Canada. Canada; 2009 [cited 2017 Dec 9]. Available from: https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/cd-mc/cancer/pmccspc-srpdccuc/pdf/cervical-eng.pdf

Sellors JW, Sankaranarayanan R. Colposcopy and treatment of cervical intraepithelial neoplasia: a beginners’ manual Lyon: IARC Press; 2003.

The National Cervical Screening Programme of Republic of Ireland – NCSP. Guidelines for quality assurance in cervical screening. 2nd ed. Limerick; 2013 [cited 2017 Dec 9]. Available from: https://www.cervicalcheck.ie/_fileupload/QualityAssurance/NCSS-PUB-Q-1%20Guidelines%20for%20Quality%20Assurance%20in%20Cervical%20Screening.pdf

Thuler LCS, Zardo LMG, Zeferino LC. Perfil dos laboratórios de citopatologia do Sistema Único de Saúde. J Bras Patol E Med Lab. 2007; 43(2):103-14. http://dx.doi.org/10.1590/S1676-24442007000200006.

Tobias AHG, Amaral RG, Diniz EM, Carneiro CM. Quality indicators of cervical cytopathology tests in the public service in Minas Gerais, Brazil. Rev Bras Ginecol Obstet. 2016; 38(2):65-70. PMid:26883863. http://dx.doi.org/10.1055/s-0035-1571175.

Universidade do Estado do Rio de Janeiro – UERJ. AD-SISCOLO: rastreamento do câncer de colo de útero: indicadores de desempenho. Rio de Janeiro; 2017 [cited 2017 Dec 9]. Available from: http://pentaho.lampada.uerj.br:8080/pentaho/Login

World Health Organization – WHO. Cervical cancer screening in developing countries. Geneve; 2002 [cited 2017 Dec 9]. Available from: http://apps.who.int/iris/bitstream/10665/42544/1/9241545720.pdf

World Health Organization – WHO. Monitoring national cervical cancer prevention and control programmes: quality control and quality assurance for visual inspection with acetic acid (VIA)-based programmes. Geneve; 2013a [cited 2017 Dec 9]. Available from: http://apps.who.int/iris/bitstream/10665/79316/1/9789241505260_eng.pdf

World Health Organization – WHO. Compendium of innovative health technologies for low-resource settings: assistive devices: ehealth solutions: medical devices. Geneve; 2013b [cited 2017 Dec 9]. Available from: http://apps.who.int/iris/bitstream/10665/202537/2/9789241509992_eng.pdf

World Health Organization – WHO. Comprehensive cervical cancer control, a guide to essential practice. 2nd ed. Geneve; 2014 [cited 2017 Dec 9]. Available from: http://apps.who.int/iris/bitstream/10665/144785/1/9789241548953_eng.pdf

World Health Organization – WHO. Screening as well as vaccination is essential in the fight against cervical cancer. Geneve; 2016 [cited 2017 Dec 9]. Available from: http://www.who.int/reproductivehealth/topics/cancers/fight-cervical-cancer/en/
 

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