Sensitivity of Administrative Claims to Identify Incident Cases of Lung Cancer: A Comparison of 3 Health Plans

Ramsey, Scott D.; Scoggins, John F.; Blough, David K.; McDermott, Cara L.; Reyes, Carolina

doi:10.18553/jmcp.2009.15.8.659

Cited by 32 publications

(25 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Claims are surrogate measures for diagnoses and coding errors are possible. However, emerging validation data regarding lung cancer claims demonstrated a high degree of accuracy for detection of lung cancer diagnoses in cancer registry data and medical records (23, 24). We also employed the same claims-based algorithms that have been previously used to study cancer among kidney transplant recipients (25).…”

Section: Discussionmentioning

confidence: 99%

Cancer Diagnoses After Living Kidney Donation

et al. 2012

View full text Add to dashboard Cite

Background Mortality records identify cancer as the leading cause of death among living kidney donors, but information on the burden of cancer outside of death records is limited in this population. Methods We examined a database wherein OPTN identifiers for 4,650 living kidney donors in 1987–2007 were linked to administrative data of a U.S. private health insurer (2000–2007 claims) to identify post-donation cancer diagnoses. Skin and non-skin cancer diagnoses were ascertained from ICD-9-CM codes on billing claims. Donors were also matched one-to-one with general insurance beneficiaries by sex and age when benefits began. Diagnosis rates within observation windows were compared as rate ratios. Results The median time from donation to the end of plan insurance enrollment was 7.7 years, with a median observation period of 2.1 years. Skin cancer rates were similar among prior living donors in the observation period and non-donor controls (rate ratio 0.91, 95% CI 0.59–1.40). In contrast, the rate of total non-skin cancers was significantly less common among donors than controls (rate ratio 0.74, 95% CI 0.55–0.99), although reduced relative risk was limited to donors captured earlier in relation to donation. Several cases of cancer diagnosis (uterine, melanoma, other) were identified within the first year after donation. Prostate cancer was significantly more common among living donors compared with controls (rate ratio 3.80, 95% CI 1.42–10.2). Conclusions Continued study of cancer after kidney donation is warranted to ensure that evaluation, selection, and long-term follow-up support overall good health of the donor.

show abstract

Section: Discussionmentioning

confidence: 99%

Cancer Diagnoses After Living Kidney Donation

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Even physician report may be unreliable, as the treating rheumatologist may not have the primary information about an incident malignancy. Administrative databases based on claims data are also not ideal, as the methodology used to define malignancy can cause the positive predictive value to vary widely [21,22]. We attempted to validate physician report of incident malignancy based on physician questionnaires and adverse event forms using a gold standard of pertinent medical records review in a large cohort of patients with RA.…”

Section: Discussionmentioning

confidence: 99%

Malignancy validation in a United States registry of rheumatoid arthritis patients

Fisher

Furer

Hochberg

et al. 2012

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundPhysician reporting is commonly used to ascertain adverse events or outcomes measured in epidemiologic studies. However, little is known on the accuracy of physician reported malignancies compared to pertinent medical record review in large cohort studies.MethodsThe Consortium of Rheumatology Researchers of North America (CORRONA) registry gathers physician-completed questionnaires for rheumatoid arthritis (RA) patients, including request for information on incident malignancies, approximately every three months. For incident malignancies reported from October 1st, 2001, through December 31st, 2007, we retrospectively requested completion of a Targeted Adverse Event (TAE) form for additional information as well as primary source documents to adjudicate the malignancy reports. CORRONA has employed a prospective request for source documentation for these events since 2008. We classified each malignancy as definite, probable, possible, or not a malignancy.ResultsFrom 20,837 RA patients enrolled in CORRONA, 461 incident malignancies were initially reported on physician questionnaires. After review of returned source documents with adjudication, 234 were deemed definite, 69 probable, 101 possible, and 57 not an incident malignancy. The positive predictive value (PPV) of initial physician report of a malignancy versus “definite or probable” malignancy based on adjudication was 0.66 (95% CI 0.61 - 0.70). The PPV was 0.68 (95% CI 0.63 – 0.72) when the subsequent TAE form also confirmed the presence of malignancy. When possible malignancies were included, the PPV of physician-reported malignancies without a subsequent TAE form increased to 0.86 (0.83 – 0.89), and with a subsequent TAE form, 0.89 (0.85-0.91).ConclusionTwelve percent of initial physician reports of incident malignancy could not be confirmed with review of source documents. The most common reason for lack of confirmation was inability to obtain documents or insufficient data in source materials. These results suggest that timely collection of relevant medical records and an adjudication process are required to improve the accuracy of cancer reporting in epidemiologic studies.

show abstract

“…21,22 In the lung cancer population, the sensitivity of ICD-9 codes is 99.4% for patients with private insurance, 87.7% for Medicare patients, and 51.1% for Medicaid patients. 23 Undercoding for specific insurance groups may have systematically introduced bias into the data. Our results showed that complicated diverticulitis was present in 10.5% of Medicaid patients and 11.1% of private-insurance patients, but Medicaid patients had more emergency admissions (87.9%) than private-insurance patients did (75.6%).…”

Section: Discussionmentioning

confidence: 99%

Insurance But Not Race Is Associated With Diverticulitis Mortality in a Statewide Database

Nash²,

Feldman³

et al. 2011

Diseases of the Colon &Amp; Rectum

View full text Add to dashboard Cite

show abstract

Sensitivity of Administrative Claims to Identify Incident Cases of Lung Cancer: A Comparison of 3 Health Plans

Abstract: BACKGROUND: Administrative claims are readily available, but their usefulness for identifying persons with non-small cell lung cancer (NSCLC) is relatively unknown, particularly for younger persons and those enrolled in Medicaid.

Cited by 32 publications

References 32 publications

Cancer Diagnoses After Living Kidney Donation

Cancer Diagnoses After Living Kidney Donation

Malignancy validation in a United States registry of rheumatoid arthritis patients

Insurance But Not Race Is Associated With Diverticulitis Mortality in a Statewide Database

Contact Info

Product

Resources

About