Concordance between administrative claims and registry data for identifying metastasis to the bone: an exploratory analysis in prostate cancer

BMC Medical Research Methodology

C Daniel Mullins²  Brian Seal³  Arif Hussain¹  Candice Yong²  Eberechukwu Onukwugha² 

[1] Baltimore Veterans Affairs Medical Center, 655 West Baltimore Street, Baltimore, MD 21201, USA;Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, 220 Arch Street, Baltimore, MD 21201, USA;Bayer Healthcare Pharmaceuticals, 6 West Belt, Wayne, NJ 07470-6806, USA

关键词: Concordance;    Claims;    SEER;    Bone;    Metastasis;   

Others  :  866527
DOI  :  10.1186/1471-2288-14-1

 received in 2013-05-17, accepted in 2013-12-20,  发布年份 2014

【 摘 要 】

Background

To assess concordance between Medicare claims and Surveillance, Epidemiology, and End Results (SEER) reports of incident BM among prostate cancer (PCa) patients. The prevalence and consequences of bone metastases (BM) have been examined across tumor sites using healthcare claims data however the reliability of these claims-based BM measures has not been investigated.

Methods

This retrospective cohort study utilized linked registry and claims (SEER-Medicare) data on men diagnosed with incident stage IV M1 PCa between 2005 and 2007. The SEER-based measure of incident BM was cross-tabulated with three separate Medicare claims approaches to assess concordance. Sensitivity, specificity and positive predictive value (PPV) were calculated to assess the concordance between registry- and claims-based measures.

Results

Based on 2,708 PCa patients in SEER-Medicare, there is low to moderate concordance between the SEER- and claims-based measures of incident BM. Across the three approaches, sensitivity ranged from 0.48 (0.456 – 0.504) to 0.598 (0.574 - 0.621), specificity ranged from 0.538 (0.507 - 0.569) to 0.620 (0.590 - 0.650) and PPV ranged from 0.679 (0.651 - 0.705) to 0.690 (0.665 - 0.715). A comparison of utilization patterns between SEER-based and claims-based measures suggested avenues for improving sensitivity.

Conclusion

Claims-based measures using BM ICD 9 coding may be insufficient to identify patients with incident BM diagnosis and should be validated against chart data to maximize their potential for population-based analyses.

【 授权许可】

   
2014 Onukwugha et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Barlev A, Song X, Ivanov B, Setty V, Chung K: Payer costs for inpatient treatment of pathologic fracture, surgery to bone, and spinal cord compression among patients with multiple myeloma or bone metastasis secondary to prostate or breast cancer. J Manag Care Pharm 2010, 16(9):693-702.
• [2]Bruera ED, Sweeney C: Bone pain. In Cancer Pain: Assessment and Management. Edited by Bruera ED, Portenoy RK. New York: Cambridge University Press; 2003:413-428.
• [3]Groot MT, Boeken Kruger CG, Pelger RC, Uyl-de Groot CA: Costs of prostate cancer, metastatic to the bone, in the Netherlands. Eur Urol 2003, 43(3):226-232.
• [4]Lage MJ, Barber BL, Harrison DJ, Jun S: The cost of treating skeletal-related events in patients with prostate cancer. Am J Manag Care 2008, 14(5):317-322.
• [5]Saad F, Lipton A, Cook R, Chen YM, Smith M, Coleman R: Pathologic fractures correlate with reduced survival in patients with malignant bone disease. Cancer 2007, 110(8):1860-1867.
• [6]Sathiakumar N, Delzell E, Morrisey M, Falkson C, Yong M, Chia V, Blackburn J, Arora T, Kilgore M: Mortality following bone metastasis and skeletal-related events among men with prostate cancer: a population-based analysis of US Medicare beneficiaries,1999-2006. Prostate Cancer Prostatic Dis 2011, 14:177-183.
• [7]Sathiakumar N, Delzell E, Morrisey MA, Falkson C, Yong M, Chia V, Blackburn J, Arora T, Brill I, Kilgore ML: Mortality following bone metastasis and skeletal-related events among women with breast cancer: a population-based analysis of U.S. Medicare beneficiaries, 1999–2006. Breast Cancer Res Treat 2011, 131(1):231-238.
• [8]Schulman KL, Kohles J: Economic burden of metastatic bone disease in the U.S. Cancer 2007, 109(11):2334-2342.
• [9]Delea T, McKiernan J, Brandman J, Edelsberg J, Sung J, Raut M, Oster G: Retrospective study of the effect of skeletal complications on total medical care costs in patients with bone metastases of breast cancer seen in typical clinical practice. J Support Oncol 2006, 4(7):341-347.
• [10]Delea TE, McKiernan J, Brandman J, Edelsberg J, Sung J, Raut M, Oster G: Impact of skeletal complications on total medical care costs among patients with bone metastases of lung cancer. J Thorac Oncol 2006, 1(6):571-576.
• [11]Hassett MJ, Ritzwoller DP, Taback N, Carroll N, Cronin AM, Ting GV, Schrag D, Warren JL, Hornbrook MC, Weeks JC: Validating billing/encounter codes as indicators of lung, colorectal, breast, and prostate cancer recurrence using 2 large contemporary cohorts. Med Care 2012. [Epub ahead of print]
• [12]Nordstrom BL, Whyte JL, Stolar M, Mercaldi C, Kallich JD: Identification of metastatic cancer in claims data. Pharmacoepidemiol Drug Saf 2012, 21(Suppl 2):21-28.
• [13]Thomas SK, Brooks SE, Mullins CD, Baquet CR, Merchant S: Use of ICD-9 coding as a proxy for stage of disease in lung cancer. Pharmacoepidemiol Drug Saf 2002, 11(8):709-713.
• [14]AJCC: Manual for Staging of Cancer. 6th edition. 175 Fifth Avenue, New York, NY, 10010, USA: Springer-Verlag New York, Inc; 2002.
• [15]SEER-Medicare: defining the date of diagnosis & treatment. [http://healthservices.cancer.gov/seermedicare/considerations/date.html webcite]
• [16]Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987, 40(5):373-383.
• [17]Klabunde CN, Legler JM, Warren JL, Baldwin LM, Schrag D: A refined comorbidity measurement algorithm for claims-based studies of breast, prostate, colorectal, and lung cancer patients. Ann Epidemiol 2007, 17(8):584-590.
• [18]VassarStats: statistical computation web site. [http://www.vassarstats.net/ webcite]
• [19]DePuy V, Anstrom KJ, Castel LD, Schulman KA, Weinfurt KP, Saad F: Effects of skeletal morbidities on longitudinal patient-reported outcomes and survival in patients with metastatic prostate cancer. Support Care Cancer 2007, 15(7):869-876.
• [20]Norgaard M, Jensen AO, Jacobsen JB, Cetin K, Fryzek JP, Sorensen HT: Skeletal related events, bone metastasis and survival of prostate cancer: a population based cohort study in Denmark (1999 to 2007). J Urol 2010, 184(1):162-167.