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After identifying a potential case for the registry
from a casefinding source, the registrar assesses
whether the case is reportable, is already reported
(and is already in the registry database), or could
potentially be recorded in a file of non-reportable
cases.
The suspense file contains information on cases that
are potentially reportable. The suspense file can
be maintained in at least two ways:
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- By entering the case into a computerized registry data
base, which has a suspense file designed into it
- By filling out brief identifying information on a paper
abstract, and filing it in alphabetical order.
The suspense file should be reviewed periodically to ensure
that cases are completed promptly. Cases entered into the
suspense file but later determined not to be reportable are
moved to the history file of non-reportable cases. Reportable
cases are eventually moved to the master patient index file.
When entering a case into the suspense file, registry personnel
should include data elements required by the governing body.
Hospitals participating in the approvals process by the Commission
on Cancer of the American College of Surgeons must include
the patient name, patient identifier, date of diagnosis, and
primary site. Another option is to also include an identifier
to indicate the location of the source document. This enables
the registrar to more accurately record necessary identifying
information in the suspense file as the patient moves through
various hospital departments and is identified in multiple
casefinding sources.
During the review of source document information, the registrar
may discover that the patient is already in the registry's
patient index file for the same primary cancer. If the source
document indicates that this is a new primary, the case should
be added to the suspense file so that the patient's health
record can be reviewed to complete the documentation on the
newly identified subsequent primary.
If, after review of the health record documentation, the
registrar determines a case to be either a history case (i.e.,
no active disease or treatment) or a non-reportable case (for
example, if the health record does not support the malignant
disease code found on the hospital's disease index), the case
should be maintained in the file of non-reportable cases to
prevent repeated pulling and review of the same health record.
Registries that can not maintain the file of non-reportable
cases in their computerized registry system can use a separate
database, spreadsheet, or word-processing program. These programs
should allow the registrar to search the file by name, health
record number, or social security number.
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