基于人口的数据集经常被用来估计新疗法使用量或治疗效果的变化。包含或排除未分期的患者可能会对这些研究的解释产生影响。在加拿大安大略省的一个大型基于人口的非小细胞肺癌患者数据集中，研究了未分期患者与分期患者的特征和结果。使用多变量泊松回归评估了不同组之间患者水平特征的差异。采用Kaplan-Meier生存曲线法和对数秩检验统计法。在我们安大略省51,152名NSCLC患者队列中，11.2%（n=5,707）为未分期患者，有证据表明分期数据不是完全随机缺失的。未分配分期的人比分期患者更有可能年龄较大（RR[95%CI]），（70-79 vs. 20-59：1.51 [1.38-1.66]; 80+ vs. 20-59：2.87 [2.62-3.15]），并且具有更高的并发症指数（分数1-2 vs 0: 1.19 [1.12-1.27]; 3 vs 0: 1.49 [1.38-1.60]），并且具有较低的社会经济阶层（4 vs 1(最低): 0.91 [0.84-0.98]; 5 vs 1(最低): 0.89 [0.83-0.97]）。未分期患者的总体生存显示了早期和晚期混合，但大部分很可能是IV期患者，死亡速度比报告的IV期疾病患者更快。在这个案例研究中，对IV期疾病患者的分期特定的医疗利用和结果在人群水平上的评估可能存在偏差，因为一些明显的IV期患者很可能在未记载分期的管理数据中。版权所有 © 2023 Robinson、Nguyen、Goldie、Jalink和Hanna。

Population-based datasets are often used to estimate changes in utilization or outcomes of novel therapies. Inclusion or exclusion of unstaged patients may impact on interpretation of these studies.A large population-based dataset in Ontario, Canada of non-small cell lung cancer patients was examined to evaluate the characteristics and outcomes of unstaged patients compared to staged patients. Multivariable Poisson regression was used to evaluate differences in patient-level characteristics between groups. Kaplan-Meier estimates of survival and log-rank statistics were utilized.In our Ontario cohort of 51,152 patients with NSCLC, 11.2% (n=5,707) were unstaged, and there was evidence that stage data was not missing completely at random. Those without assigned stage were more likely than staged patients to be older (RR [95%CI]), (70-79 vs. 20-59: 1.51 [1.38-1.66]; 80+ vs. 20-59: 2.87 [2.62-3.15]), have a higher comorbidity index (Score 1-2 vs 0: 1.19 [1.12-1.27]; 3 vs. 0: 1.49 [1.38-1.60]), and have a lower socioeconomic class (4 vs. 1 (lowest): 0.91 [0.84-0.98]; 5 vs. 1 (lowest): 0.89 [0.83-0.97]). Overall survival of unstaged patients suggested a mixture of early and advanced stage, but with a large proportion that are probably stage IV patients with more rapid death than those with reported stage IV disease.In this case study, evaluation of stage-specific health care utilization and outcomes for staged patients with stage IV disease at the population level may have a bias as a distinct subset of stage IV patients with rapid death are likely among those without a documented stage in administrative data.Copyright © 2023 Robinson, Nguyen, Goldie, Jalink and Hanna.