The most rigorous and accurate approach to evaluating clinical events in cancer screening
studies is to use data obtained through medical record abstraction (MRA). Although MRA is complex,
the particulars of the procedure—such as the specific training and quality assurance processes, challenges
of implementation, and other factors that influence the quality of abstraction—are usually not
described in reports of studies that employed the technique. In this paper, we present the details of
MRA activities used in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which used MRA to
determine primary and secondary outcomes and collect data on other clinical events. We describe triggers of the MRA cycle
and the specific tasks that were part of the abstraction process. We also discuss training and certification of abstracting
staff, and technical methods and communication procedures used for data quality assurance. We include discussion of
challenges faced and lessons learned.
Keywords: Abstraction, medical record abstraction, medical record requests, quality assurance, screening.
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