Download radiotherapy hrg treatment course

DSC Notice: 10/2002
Date of Issue:
March
2002
Subject:
NHS Information
Standards Board
Data Standards:
Radiotherapy treatments
Implementation Date: 1st October 2002
DATA SET CHANGE CONTROL PROCEDURE
This paper gives notification of changes to be included in the NHS Data Dictionary & Manual and the
NHS CDS Manual as appropriate. These will be consolidated into the publications in due course.
Summary of Changes:
Changes to NHS data standards to integrate Radiotherapy HRGs and the Radiotherapy element
of the National Cancer Dataset with other existing radiotherapy elements in the NHS Data
Dictionary & Manual.
Change Proposal
Reference No: CP 08/02
The NHS Information Standards Board (NHS ISB) is responsible for approving information standards. The NHS
ISB is supported by the Management Information Standards Board, the Clinical Information Standards Board and
the Technical Standards Board.
The packaging of standards document is under review. Any changes will be notified in due course.
Please note that the website address has changed, and that Data Set Change Notices are now located at:
http://www.nhsia.nhs.uk/dscn/pages/default.asp and on the NHSnet at:
http://nww.nhsia.nhs.uk/dscn/pages/default.asp
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DATA SET CHANGE NOTICE 10/2002
Reference:
CP08/02 - DG1038/02/02 (v 1.4)
Subject:
Radiotherapy treatments
Type of Change:
Changes to NHS data standards
Effective Date:
01 October 2002
Reason for Change:
Integrating Reference Costs for Radiotherapy Services into the NHS
Data Standards
Background:
DSCN 33/98/P24 implemented the data standards for the Reference Costs for Radiotherapy
Services, which became mandatory on the 1st April 1999. These data standards were an interim
solution to support the collection of data, which is based upon Radiotherapy Healthcare
Resource Groups (HRGs).
Also, the National Cancer Data Set Project, run by the NHS Information Authority, has
produced a set of core data items relating to the diagnosis and management of cancer including
Radiotherapy.
This DSCN details changes to the NHS data standards to support the integration of the
Radiotherapy HRGs, together with the Radiotherapy element of the National Cancer Data Set,
into the NHS data standards.
Summary of Changes:
Entity Definitions
BRACHYTHERAPY HRG TREATMENT COURSE
Change entity type name,
description and attributes
EXPOSURE
Change entity type relationships
FRACTION
Change entity type relationships
PATIENT
Change entity type relationships
RADIOTHERAPY DEPARTMENT
Change entity type relationships
RADIOTHERAPY TREATMENT COURSE
Change entity type description,
attributes and relationships
RADIOTHERAPY HRG TREATMENT COURSE
Delete entity type
TELETHERAPY HRG TREATMENT COURSE
Change entity type name,
description and attributes
UNSEALED SOURCE HRG TREATMENT COURSE Change entity type name,
description and attributes
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Attribute Definitions
BRACHYTHERAPY HRG DELIVERY TYPE
BRACHYTHERAPY HRG DOSE
BRACHYTHERAPY HRG FRACTIONS
BRACHYTHERAPY HRG ISOTOPE TYPE
BRACHYTHERAPY PRESCIBED FRACTIONS
BRACHYTHERAPY TYPE
RADIOTHERAPY ACTUAL DOSE
RADIOTHERAPY HRG ANAESTHETIC
RADIOTHERAPY PRESCIBED DOSE
RADIOTHERAPY PRESCRIBED DURATION
TELETHERAPY HRG BEAM TYPE
TELETHERAPY HRG COMPLEXITY GROUP
TELETHERAPY HRG ELECTRON ENERGY
TELETHERAPY HRG FIELDS
TELETHERAPY HRG FRACTIONS
TELETHERAPY HRG MULTIPLE PLANNING
TELETHERAPY HRG PHOTON ENERGY
TELETHERAPY PRESCRIBED FRACTIONS
TREATMENT COURSE STATUS
UNSEALED SOURCE HRG ISOTOPE TYPE
UNSEALED SOURCE HRG PATIENT TYPE
Change attribute name and description
Change attribute name and description
Delete attribute
Change attribute name and description
New attribute
New attribute
New attribute
Change attribute name and description
New attribute
New attribute
Change attribute name and description
Change attribute name and description
Change attribute name and description
Change attribute name and description
Delete attribute
Change attribute name and description
Change attribute name and description
New attribute
New attribute
Change attribute name and description
Change attribute name and description
Model View Diagrams
HP190 Radiotherapy Departments
Change model view diagram and
overview text
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CHANGES
Change Type:
Change entity type name, description and attributes
BRACHYTHERAPY HRG TREATMENT COURSE
A type of RADIOTHERAPY HRG TREATMENT COURSE.
A prescribed course of radiotherapy brachytherapy treatment for a PATIENT which is recorded
by the RADIOTHERAPY DEPARTMENT for the purposes of deriving Reference Costs for
radiotherapy services based upon Healthcare Resource Groups (HRGs).
UNSEALED SOURCE TREATMENT COURSE is a type of BRACHYTHERAPY
TREATMENT COURSE.
Attributes of this entity type are:
BRACHYTHERAPY HRG DELIVERY TYPE
BRACHYTHERAPY HRG DOSE RATE
BRACHYTHERAPY HRG FRACTIONS
O BRACHYTHERAPY HRG ISOTOPE TYPE
if not unsealed source
BRACHYTHERAPY PRESCRIBED FRACTIONS
BRACHYTHERAPY TYPE
RADIOTHERAPY HRG ANAESTHETIC
This entity type has no relationships.
Change Type:
Change entity type relationships
EXPOSURE
The description and attributes are unchanged.
Each EXPOSURE
may be related to one and only one RADIOTHERAPY TREATMENT COURSE
The remaining relationships are unchanged.
Change Type:
Change entity type relationships
FRACTION
The description and attributes are unchanged.
Each FRACTION
K must be related to one and only one PATIENT
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K must be related to one and only one RADIOTHERAPY DEPARTMENT
K must be related to one and only one RADIOTHERAPY TREATMENT COURSE
The remaining relationships are unchanged.
Change Type:
Change entity type relationships
PATIENT
The description and attributes are unchanged.
Each PATIENT
may be related to one or more FRACTIONS
may be subject to one or more RADIOTHERAPY HRG TREATMENT COURSES
The remaining relationships are unchanged.
Change Type:
Change entity type relationships
RADIOTHERAPY DEPARTMENT
The description and attributes are unchanged.
Each RADIOTHERAPY DEPARTMENT
may be responsible for one or more RADIOTHERAPY HRG TREATMENT COURSES
may be related to one or more FRACTIONS
The remaining relationships are unchanged.
Change Type:
Change entity type description, attributes and relationships
RADIOTHERAPY TREATMENT COURSE
A set of FRACTIONS for an individual PATIENT which have been planned and prescribed as a
whole. It should be noted that the following all constitute one course of treatment:
a. Set of FRACTIONS planned and prescribed as a whole and using one or more different
machines,
b. Set of FRACTIONS planned and prescribed as a whole with a period of no treatment during
them (split course),
c. Set of FRACTIONS planned and prescribed as a whole involving machines located on two
or more sites (exceptionally a patient may be transferred between sites possibly due to
machine failure).
If a PATIENT has two unrelated diseases both of which require radiotherapy, each course of
treatment should be recorded as a primary course. Similarly if a PATIENT has two primary
DSCN 10/2002
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lesions of the same disease, eg two rodent ulcers, the treatment of these comprises two primary
courses, unless the lesions are in such close proximity that they are to be treated together. If
during a course of treatment, a PATIENT starts a further course, the second course should be
separately identified.
Each RADIOTHERAPY TREATMENT COURSE has a sub-type of BRACHYTHERAPY
TREATMENT COURSE or TELETHERAPY TREATMENT COURSE or UNSEALED
SOURCE TREATMENT COURSE
Attributes of this entity type are:
K
START DATE
O END DATE
PRIMARY OR SUBSEQUENT COURSE
O RADIOTHERAPY ACTUAL DOSE
RADIOTHERAPY HRG ANAESTHETIC
O RADIOTHERAPY PRESCRIBED DOSE
RADIOTHERAPY PRESCRIBED DURATION
O TREATMENT COURSE STATUS
O RADIOTHERAPY PRESCRIBED DOSE
Each RADIOTHERAPY TREATMENT COURSE
K must be related to one and only one PATIENT
may be related to one or more EXPOSURES
may be a set of one or more FRACTIONS
maymust be related topart of one and only one SERVICE PROVIDED
must be the responsibility of one and only one RADIOTHERAPY DEPARTMENT
Change Type:
Delete entity type
RADIOTHERAPY HRG TREATMENT COURSE
Change Type:
Change entity type name, description and attributes
TELETHERAPY HRG TREATMENT COURSE
A type of RADIOTHERAPY HRG TREATMENT COURSE.
A prescribed course of radiotherapy teletherapy treatment for a PATIENT which is recorded by
the RADIOTHERAPY DEPARTMENT for the purposes of deriving Reference Costs for
radiotherapy services based upon Healthcare Resource Groups (HRGs).
Attributes of this entity type are:
RADIOTHERAPY HRG ANAESTHETIC
TELETHERAPY HRG BEAM TYPE
TELETHERAPY HRG COMPLEXITY GROUP
TELETHERAPY HRG ELECTRON ENERGY
TELETHERAPY HRG FIELDS
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TELETHERAPY HRG FRACTIONS
TELETHERAPY HRG MULTIPLE PLANNING
TELETHERAPY HRG PHOTON ENERGY
TELETHERAPY PRESCRIBED FRACTIONS
This entity type has no relationships
Change Type:
Change entity name, description and attributes
UNSEALED SOURCE HRG TREATMENT COURSE
A type of RADIOTHERAPY HRG BRACHYTHERAPY TREATMENT COURSE.
A prescribed course of radiotherapy treatment for a PATIENT where an unsealed source of
radiation is used. which is recorded by the RADIOTHERAPY DEPARTMENT for the purposes
of deriving Reference Costs for radiotherapy services based upon Healthcare Resource Groups
(HRGs).
Attributes of this entity type are:
UNSEALED SOURCE HRG ISOTOPE TYPE
UNSEALED SOURCE HRG PATIENT TYPE
This entity type has no relationships
Change Type:
Change attribute name and description
BRACHYTHERAPY HRG DELIVERY TYPE
The prescribed type of delivery system of a BRACHYTHERAPY HRG TREATMENT
COURSE.
The remainder of the description is unchanged.
Change Type:
Change attribute name and description
BRACHYTHERAPY HRG DOSE RATE
The prescribed dose rate of a BRACHYTHERAPY HRG TREATMENT COURSE.
The remainder of the description is unchanged.
Change Type:
Delete attribute
BRACHYTHERAPY HRG FRACTIONS
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Change Type:
Change attribute name and description
BRACHYTHERAPY HRG ISOTOPE TYPE
The prescribed type of isotope of a BRACHYTHERAPY HRG TREATMENT COURSE.
The remainder of the description is unchanged.
Change Type:
New attribute
BRACHYTHERAPY PRESCRIBED FRACTIONS
The prescribed number of fractions of a BRACHYTHERAPY TREATMENT COURSE.
References:
National Cancer Data Set Version1.1_ISB October 2001
Reference Costs for Radiotherapy Services based on Healthcare Resource Groups
Change Type:
New attribute
BRACHYTHERAPY TYPE
The type of BRACHYTHERAPY TREATMENT COURSE being used.
National Codes:
BI
Interstitial
BC
Intra-cavity
BT
Not otherwise specified
US
Unsealed Source
References:
National Cancer Data Set Version1.1_ISB October 2001
Change Type:
New attribute
RADIOTHERAPY ACTUAL DOSE
The total actual absorbed radiation dose given in Grays.
References:
National Cancer Data Set Version1.1_ISB October 2001
Change Type:
Change attribute name and description
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RADIOTHERAPY HRG ANAESTHETIC
An indication of whether anaesthetic is required during a TELETHERAPY HRG TREATMENT
COURSE or a BRACHYTHERAPY HRG TREATMENT COURSE.
The remainder of the description is unchanged.
Change Type:
New attribute
RADIOTHERAPY PRESCRIBED DOSE
The total prescribed absorbed radiation dose in Grays.
References:
National Cancer Data Set Version1.1_ISB October 2001
Change Type:
New attribute
RADIOTHERAPY PRESCRIBED DURATION
The prescribed number of days over which the RADIOTHERAPY TREATMENT COURSE is
planned to be given.
References:
National Cancer Data Set Version1.1_ISB October 2001
Change Type:
Change attribute name and description
TELETHERAPY HRG BEAM TYPE
The prescribed type of beam of a TELETHERAPY HRG TREATMENT COURSE.
The remainder of the description is unchanged.
Change Type:
Change attribute name and description
TELETHERAPY HRG COMPLEXITY GROUP
The grouping which classifies the complexity of a TELETHERAPY HRG TREATMENT
COURSE.
The remainder of the description is unchanged.
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Change Type:
Change attribute name and description
TELETHERAPY HRG ELECTRON ENERGY
The prescribed electron energy of a TELETHERAPY HRG TREATMENT COURSE.
The remainder of the description is unchanged.
Change Type:
Change attribute name and description
TELETHERAPY HRG FIELDS
The prescribed number of fields of a TELETHERAPY HRG TREATMENT COURSE.
The remainder of the description is unchanged.
Change Type:
Delete attribute
TELETHERAPY HRG FRACTIONS
Change Type:
Change attribute name and description
TELETHERAPY HRG MULTIPLE PLANNING
An indication of whether a TELETHERAPY HRG TREATMENT COURSE requires a full
repeat of planning and preparation to be undertaken, this excludes simple boosts and
resimulation.
The remainder of the description is unchanged.
Change Type:
Change attribute name and description
TELETHERAPY HRG PHOTON ENERGY
The prescribed photon energy of a TELETHERAPY HRG TREATMENT COURSE.
The remainder of the description is unchanged.
Change Type:
New attribute
TELETHERAPY PRESCRIBED FRACTIONS
The prescribed number of fractions or hyperfractionation of a TELETHERAPY TREATMENT
COURSE.
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References:
National Cancer Data Set Version1.1_ISB October 2001
Reference Costs for Radiotherapy Services based on Healthcare Resource Groups
Change Type:
New attribute
TREATMENT COURSE STATUS
The status of the RADIOTHERAPY TREATMENT COURSE and the reason why it may not
have been given or completed.
National Codes:
0 Treatment completed as prescribed
1 Course not completed - Patient died
2 Course not completed - Progressive disease during Radiotherapy
3 Course not completed - Acute Radiotherapy toxicity
4 Course not completed - Technical or organisational problems
5 Treatment stopped or interrupted - Patient choice
References:
National Cancer Data Set Version1.1_ISB October 2001
Change Type:
Change attribute name and description
UNSEALED SOURCE HRG ISOTOPE TYPE
The prescribed type of isotope of an UNSEALED SOURCE HRG TREATMENT COURSE.
The remainder of the description is unchanged.
Change Type:
Change attribute name and description
UNSEALED SOURCE HRG PATIENT TYPE
The classification of patient type for an UNSEALED SOURCE HRG TREATMENT COURSE.
Change Type:
Change model view diagram contents
Hospital  HP190  Diagram
1. Delete RADIOTHERAPY HRG TREATMENT COURSE.
2. Insert subtypes BRACHYTHERAPY TREATMENT COURSE and TELETHERAPY
TREATMENT COURSE to be subtypes of RADIOTHERAPY TREATMENT
COURSE.
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3. Insert subtype UNSEALED SOURCE TREATMENT COURSE to be subtype of
BRACHYTHERAPY TREATMENT COURSE.
4. Delete relationship between FRACTION and PATIENT
5. Delete relationship between EXPOSURE and RADIOTHERAPY TREATMENT
COURSE
6. Delete relationship between FRACTION and RADIOTHERAPY DEPARTMENT
7. Insert relationship between FRACTION and RADIOTHERAPY TREATMENT
COURSE
8. Insert relationship between RADIOTHERAPY TREATMENT COURSE and
RADIOTHERAPY DEPARTMENT including the ‘the responsibility of’ label
9. Change relationship between RADIOTHERAPY TREATMENT COURSE and
SERVICE PROVIDED to mandatory
Change Type:
Change model view diagram overview text
Hospital  HP190  Overview Text
HP190 - RADIOTHERAPY DEPARTMENTS
1. This diagram shows the entity types relevant to RADIOTHERAPY DEPARTMENTS.
2. A RADIOTHERAPY DEPARTMENT contains RADIOTHERAPY MACHINES for
treatment, simulation or planning.
3. Each PATIENT may undergo one or more RADIOTHERAPY TREATMENT
COURSES each comprising one or more FRACTIONS EXPOSURES. A FRACTION is
a set of EXPOSURES delivered to a PATIENT in the course of one visit to a
RADIOTHERAPY DEPARTMENT as part of a RADIOTHERAPY TREATMENT
COURSE. An EXPOSURE may be the single occasion on which a PATIENT is exposed
to ionising radiation. For total body irradiation procedures the EXPOSURE may last for
several hours.
4. The MACHINE OPERATIONAL PLAN is a prospective statement about the time each
radiation and simulation machine is to be available for use or intended to be set aside for
planned maintenance.
5. The use of each radiotherapy and simulation machine is measured retrospectively in
terms of the time the machine was actually available and time spent on planned and
unplanned maintenance. This is recorded on RADIOTHERAPY MACHINE
AVAILABILITY.
6. The Reference Costs for radiotherapy services based upon Healthcare Resource Groups
are derived from RADIOTHERAPY HRG TREATMENT COURSE.
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PERSON ROLE IN
ORGANISATION
RADIOTHERAPY
DEPARTMENT
PATIENT
SERVICE
PROVIDED
RADIOTHERAPY
TREATMENT COURSE
TELETHERAPY
TREATMENT
COURSE
BRACHYTHERAPY
TREATMENT
COURSE
UNSEALED
SOURCE
TREATMENT
COURSE
FRACTION
EXPOSURE
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RADIOTHERAPY
MACHINE
Please address enquiries about this DSCN to:Data Standards Team
NHS Information Authority
Aqueous II
Aston Cross
Rocky Lane
Birmingham
B6 5RQ
Tel: 0121 333 0333
DSCN 10/2002
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