Linkage between Utah All Payers Claims Database and Central Cancer Registry

Garvin, Jennifer H.; Herget, Kimberly; Hashibe, Mia; Kirchhoff, Anne C.; Hawley, Charles; Bolton, Dan; Sweeney, Carol

doi:10.1111/1475-6773.13114

Cited by 12 publications

(18 citation statements)

References 11 publications

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“…This information can be used for evaluating the effects of coverage disruptions and differences in state and insurer‐level policies, such as Medicaid generosity, changes in reimbursement policies, managed care, and the care of dually eligible patients (Medicare and Medicaid) 14 . However, as of 2021, only one state, Utah, reported an APCD‐registry linkage and only for 1 year of data 15 . Recent reports by The Commonwealth Fund found that states have implemented APCDs in diverse ways, from governmental initiatives to public–private partnerships and voluntary efforts.…”

Section: Introductionmentioning

confidence: 99%

“…14 However, as of 2021, only one state, Utah, reported an APCD-registry linkage and only for 1 year of data. 15 Recent reports by The Commonwealth Fund found that states have implemented APCDs in diverse ways, from governmental initiatives to publicprivate partnerships and voluntary efforts. Consequently, the governance of APCDs, their funding, and the authority of APCDs to require claims submissions also varies by state.…”

Section: Introductionmentioning

confidence: 99%

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The role of all‐payer claims databases to expand central cancer registries: Experience from Colorado

Perraillon

Liang

Sabik

et al. 2021

Health Services Research

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Objective To evaluate the quality of a multiyear linkage between the Colorado all‐payer claims database (APCD) and the Colorado Central Cancer Registry. Data sources Secondary 2012–2017 data from the APCD and the Colorado Cancer Registry. Study design Descriptive analysis of the proportion of cases captured by the linkage in relation to the cases reported by the registry. Data collection/extraction methods We used probabilistic linkage to combine records from both data sources for all patients diagnosed with cancer. Results We successfully linked 93% of the 146,884 patients in the registry. Approximately 63% of linked patients were perfect matches on five identifiers. Of partial matches, 81.6% were matched on four identifiers with missing or partial Social Security Numbers. The linkage rate was lower for uninsured patients at diagnosis (74.7%) or patients with private plans (89.4%) but close to 100% for Medicare and Medicaid enrollees. Most of the 29% of patients who did not have claims at the time of diagnosis were covered by private plans that may not submit claims. Conclusions APCD‐registry linkages are a promising source of data to conduct population‐based research from multiple payers. However, not all payers submit claims, and the quality of the data may vary by state.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of all‐payer claims databases to expand central cancer registries: Experience from Colorado

Perraillon

Liang

Sabik

et al. 2021

Health Services Research

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“…Out of state residents who sought care at a Sutter facility would not be captured. False positives are possible with probabilistic linkage, however it has been shown to be valid and, compared to deterministic linkages processes, it is better suited for large data (54)(55)(56). Our choice of cancers in the validation sample may impact the results of our internal validity checks.…”

Section: Limitationsmentioning

confidence: 99%

Population-Based Registry Linkages to Improve Validity of Electronic Health Record–Based Cancer Research

Thompson

Jin

Luft

et al. 2020

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: There is tremendous potential to leverage the value gained from integrating electronic health records (EHRs) and population-based cancer registry data for research. Registries provide detailed diagnosis tumor characteristics, and treatment summaries, while EHRs contain rich clinical detail. A carefully conducted cancer registry linkage may also be used to improve the internal and external validity of inferences made from EHR-based studies. Methods:We linked the EHRs of a large, multispecialty, mixed-payer healthcare system with the statewide cancer registry and assessed the validity of our linked population. For internal validity, we identify patients that might be "missed" in a linkage, threatening the internal validity of an EHR study population. For generalizability, we compared linked cases with all other cancer patients in the 22-county EHR catchment region.Results: From an EHR population of 4.5M, we identified 306,554 cancer patients, 26% of the catchment regions cancer patients. 22.7% of linked patients were diagnosed with cancer after they migrated away from our healthcare system highlighting an advantage of system-wide linkage. We observed demographic differences between EHR patients and non-EHR patients in the surrounding region and demonstrated use of selection probabilities with model-based standardization to improve generalizability. Conclusions:Our experiences set the foundation to encourage and inform researchers interested in working with EHRs for cancer research as well as provide context for leveraging linkages to assess and improve validity and generalizability.Impact: Researchers conducting linkages may benefit from considering one or more of these approaches to establish and evaluate the validity of their EHR-based populations.

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“…We created APCD treatment variables using codes from the Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and National Drug Code Directory to indicate if the treatment was found in the APCD. Codes corresponding to cancer therapies were compiled from lists used by prior investigations using claims to study cancer treatment information 7 and from a review of CPT manuals for new codes. The combined list, provided as a table in the Data Supplement, is a combination of multiple data sources, including SEER*RX, the Cancer Medications Inquiry Database, literature review, and manual review of HCPCs/CPT books for codes.…”

Section: Patientsmentioning

confidence: 99%

“…The UCR linked records for 82% of individual patients with cancer with the Utah APCD, with varying success by cancer diagnosis age, cancer site, and insurance type, as previously reported. 7 Our aim in this report is to investigate the improvement in registry variables representing the first course of cancerdirected therapy through linkage to APCD.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Capturing Cancer Treatment Data in the Utah All-Payer Claims Database

Hashibe

Herget

et al. 2019

JCO Clinical Cancer Informatics

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Purpose Incompleteness of treatment data is a recognized limitation of cancer registry data. An all-payer claims database (APCD) is a tool that states use to capture health care information across systems and payer. We linked the Utah Cancer Registry (UCR) records to Utah’s statewide APCD and evaluated how this linkage led to improvements in the capture of cancer treatment information. Methods We linked cancers diagnosed and reported to the UCR with Utah APCD claims for the calendar years 2013 and 2014 using LinkPlus Software. For patients with breast or colorectal cancers, manual abstraction was completed to provide a gold-standard comparison for the treatment data obtained from the claims. Results Among 10,759 reportable cancer occurrences linked to the APCD, the claims identified additional patients with cancer who received therapies that had been unknown to the registry, increasing the proportion treated with chemotherapy from 23.7% to 27.6%, hormone therapy from 14.1% to 18.8%, immunotherapy from 4.3% to 13.2%, and radiation therapy from 24.9% to 27.5%. The APCD increased the sensitivity of treatment variables compared with the abstraction gold standard. Notably, sensitivity of hormonal therapy for breast cancer increased from 78.6% to 95.2% when augmented with APCD claims data. However, the APCD alone did not achieve as high specificity for treatment data as did the data collected through traditional registry methods. Conclusions This is the first study, to our knowledge, showing that linking cancer registry data with a statewide claims database that covers multiple insurance companies improves cancer treatment data collection. Linking of cancer registry and APCD data can improve comprehensiveness of cancer registry treatment data.

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Linkage between Utah All Payers Claims Database and Central Cancer Registry

Cited by 12 publications

References 11 publications

The role of all‐payer claims databases to expand central cancer registries: Experience from Colorado

The role of all‐payer claims databases to expand central cancer registries: Experience from Colorado

Population-Based Registry Linkages to Improve Validity of Electronic Health Record–Based Cancer Research

Feasibility of Capturing Cancer Treatment Data in the Utah All-Payer Claims Database

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