External Validation of Medicare Claims for Breast Cancer Chemotherapy Compared With Medical Chart Reviews

Du, Xianglin L.; Key, Charles R.; Dickie, Lois; Darling, Ronald; Geraci, Jane M.; Zhang, Dong

doi:10.1097/01.mlr.0000196978.34283.a6

Cited by 73 publications

(77 citation statements)

References 40 publications

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“…SEER provided reliable information that was validated by SEER staff, and Medicare data have been both externally and internally validated by many researchers. 33,43,44 However, we cannot exclude the possibility of misclassification of the factors that may have resulted from modeling categorized variables that were originally continuous and measured with nondifferential error. 45 In summary, this study has shown that ADT was not associated with significantly increased survival benefit in older men with locoregional CaP living in the community.…”

Section: Androgen Deprivation Therapy and Prostate Cancer Survival L mentioning

confidence: 99%

Effectiveness of androgen deprivation therapy in prolonging survival of older men treated for locoregional prostate cancer

Holmes

Chan

Jiang

et al. 2007

Prostate Cancer Prostatic Dis

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Epidemiologic and experimental evidence suggests the effectiveness of androgen deprivation therapy (ADT) in prostate cancer (CaP) management. Although ADT has been increasingly used as mono-therapy in CaP, the survival benefit of ADT remains unclear. We examined the effectiveness of ADT in prolonging survival in a community-based cohort of 64 475 older men diagnosed with locoregional CaP, in 1992-1999 with last follow-up through December 2002, in 11 Surveillance Epidemiology and End Results (SEER) registries. The effect of ADT on survival was assessed using Kaplan-Meier's method, log-rank test and Cox proportional hazards. After adjustment for propensity to receive ADT, the ADT and non-ADT groups were significantly different in the distribution of covariates except for comorbidity score and SEER registries. The crude overall mortality was significantly higher in cases with ADT compared with cases that received no ADT, hazard ratio (HR ¼ 1.54; 95% CI ¼ 1.50-1.58). However, mortality was substantially reduced (1.04, 1.00-1.08) after adjusting for standard care, socio-demographics, tumor characteristics, prognostic factors and chemotherapy. Therefore, ADT was not associated with significantly increased survival benefit for older men with locoregional CaP. Further studies may be needed to explore whether ADT is associated with other health benefits and the cost-effectiveness of these benefits.

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Section: Androgen Deprivation Therapy and Prostate Cancer Survival L mentioning

confidence: 99%

Effectiveness of androgen deprivation therapy in prolonging survival of older men treated for locoregional prostate cancer

Holmes

Chan

Jiang

et al. 2007

Prostate Cancer Prostatic Dis

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“…[31][32][33][34][35][36] In brief, patients with breast cancer were defined as having received chemotherapy if any of the following Medicare procedure codes was present in the physician or outpatient Medicare claims data 37-40 : the International Classification of Diseases (9th revision, clinical modification) procedure code 9925 and V codes of V58.1, V66.2, or V67.2 37 ; the common procedure codes of 96400 to 96549, J8530 to J8999, J9000 to J9999, or Q0083 to Q0085 38,39 ; and revenue center codes of 0331, 0332, or 0335. 40 The dosage and intensity of chemotherapy were not reliably identified through Medicare claims data.…”

Section: Study Variablesmentioning

confidence: 99%

Temporal and Geographic Variation in the Use of Hematopoietic Growth Factors in Older Women Receiving Breast Cancer Chemotherapy: Findings From a Large Population-Based Cohort

Lairson

Begley

et al. 2005

JCO

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Purpose-Hematopoietic growth factors have played a major role in preventing infection and shortening the duration of neutropenia in patients receiving cancer chemotherapy. Little information is available on how these growth factors are used in patients with cancer outside the clinical trial setting. We performed descriptive and exploratory analyses on the patterns and correlates of the use of hematopoietic growth factors in community-dwelling elderly patients.Patients and Methods-We identified 5,843 women from the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked data cohorts who were diagnosed with breast cancer at age 65 or older in 1992 to 1999 from the 11 SEER areas and received chemotherapy.Results-Overall, 17.3% of the elderly women with breast cancer chemotherapy received filgrastim and 6.8% received epoetin. The use of the growth factors increased significantly over time from 1992 to 1999 (P < .001 for trend). Compared with patients diagnosed in 1992 to 1994, patients diagnosed in 1998 to 1999 were more than five times and 65 times more likely to receive filgrastim and epoetin, respectively, after controlling for other factors such as age and comorbidity. There also was substantial geographic variation in the use of hematopoietic growth factors, ranging from 10.6% in Seattle to 22.9% in Atlanta. Significant predictors of growth factors included patient age, race, tumor stage, and comorbidity.Conclusion-There were substantial temporal and geographic variations in the use of hematopoietic growth factors among patients receiving chemotherapy for breast cancer. The nationwide and population-based Medicare claims provide potential for examining the effectiveness, medical costs, and cost effectiveness of hematopoietic growth factors in the community.

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“…A solution to this problem is to supplement clinical trial results with observational results. Prior research has shown Centers for Medicare and Medicaid Services (CMS) data accurately measure chemotherapy use [5][6][7][8] and the important end point of disease-free survival, 9 but the extent to which CMS data accurately measure the toxicity outcomes traditionally reported in clinical trials is not yet known.…”

Section: Introductionmentioning

confidence: 99%

Measuring Clinically Significant Chemotherapy-Related Toxicities Using Medicare Claims From Cancer and Leukemia Group B (CALGB) Trial Participants

Lamont¹,

Herndon²,

Weeks³

et al. 2008

Medical Care

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External Validation of Medicare Claims for Breast Cancer Chemotherapy Compared With Medical Chart Reviews

Abstract: Of cases identified as receiving chemotherapy by Medicare claims, 97% had strong evidence and only 3% had weak evidence for receiving this therapy.

Cited by 73 publications

References 40 publications

Effectiveness of androgen deprivation therapy in prolonging survival of older men treated for locoregional prostate cancer

Effectiveness of androgen deprivation therapy in prolonging survival of older men treated for locoregional prostate cancer

Temporal and Geographic Variation in the Use of Hematopoietic Growth Factors in Older Women Receiving Breast Cancer Chemotherapy: Findings From a Large Population-Based Cohort

Measuring Clinically Significant Chemotherapy-Related Toxicities Using Medicare Claims From Cancer and Leukemia Group B (CALGB) Trial Participants

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