Studying Radiation Therapy Using SEER-Medicare-Linked Data

Virnig, Beth A; Warren, Joan L.; Cooper, Gregory S.; Klabunde, Carrie N.; Schussler, Nicola; Freeman, Jean L.

doi:10.1097/00005650-200208001-00007

Cited by 251 publications

(195 citation statements)

References 7 publications

Supporting

Mentioning

190

Contrasting

Unclassified

Order By: Relevance

“…SEER adheres to strict quality assessment measures by ensuring the accuracy of sample cases by reabstracting data from the medical records annually. Based on a recent studies by Virnig et al (2002), these authors found a 98% completeness in each sample case with a 490% rate in the accuracy of reporting adjuvant therapy Maggard et al, 2003). In addition, the database also appears to be accurate for major surgical procedures .…”

Section: Discussionmentioning

confidence: 99%

Ovarian cancer in younger vs older women: a population-based analysis

et al. 2006

View full text Add to dashboard Cite

To compare the clinico-pathologic prognostic factors and survival of younger vs older women diagnosed with epithelial ovarian cancer. Demographic, clinico-pathologic, treatment, and surgery information were obtained from patients with ovarian cancer from the Surveillance, Epidemiology, and End Results Program from 1988 to 2001 and analysed using Kaplan -Meier estimates. Of 28 165 patients, 400 were o30 years (very young), 11 601 were 30 -60 (young), and 16 164 were 460 (older) years of age. Of the very young, young, and older patients, 261 (65.3%), 4664 (40.2%), and 3643 (22.5%) had stage I -II disease, respectively (Po0.001). Across all stages, very young women had a significant survival advantage over the young and older groups with 5-year disease-specific survival estimates at 78.8% vs 58.8 and 35.3%, respectively (Po0.001). This survival difference between the age groups persists even after adjusting for race, stage, grade, and surgical treatment. Reproductive age (16 -40 years) women with stage I -II epithelial ovarian cancer who received uterine-sparing procedures had similar survivals compared to those who underwent standard surgery (93.3% vs 91.5%, P ¼ 0.26). Younger women with epithelial ovarian cancer have a survival advantage compared to older patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Ovarian cancer in younger vs older women: a population-based analysis

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Radiation therapy was identified in the carrier claims and outpatient files using HCPCS codes (Table E1; available online at www.redjournal.org) (24). A course of radiation therapy was defined as a cluster of claims with breaks of 30 days or more between codes assumed to be indicative of a separate course of radiation therapy.…”

Section: Radiation Therapy and Providermentioning

confidence: 99%

The Impact of Radiation Oncologists on the Early Adoption of Hypofractionated Radiation Therapy for Early-Stage Breast Cancer

Boero

Gillespie

Hou

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

SummaryThis study evaluated the impact of radiation oncologists on the early adoption of hypofractionated radiation therapy for early-stage breast cancer. Using SEERMedicare data and multilevel, multivariable logistic models, we assessed the impact of radiation oncologist and geographic practice area on the likelihood of receiving hypofractionated radiation therapy. The key finding of our study was that the individual radiation oncologist heavily influenced the decision to pursue hypofractionation.Purpose: Despite multiple randomized trials showing the efficacy of hypofractionated radiation therapy in early-stage breast cancer, the United States has been slow to adopt this treatment. The goal of this study was to evaluate the impact of individual radiation oncologists on the early adoption of hypofractionated radiation therapy for early-stage breast cancer. Methods: We identified 22,233 Medicare beneficiaries with localized breast cancer that was diagnosed from 2004 to 2011 who underwent breast-conserving surgery with adjuvant radiation. Multilevel, multivariable logistic models clustered by radiation oncologist and geographic practice area were used to determine the impact of the provider and geographic region on the likelihood of receiving hypofractionated compared with standard fractionated radiation therapy while controlling for a patient's clinical and demographic covariates. Odds ratios (OR) describe the impact of demographic or clinical covariates, and the median OR (MOR) describes the relative impact of the individual radiation oncologist and geographic region on the likelihood of undergoing hypofractionated radiation therapy. Results: Among the entire cohort, 2333 women (10.4%) were treated with hypofractionated radiation therapy, with unadjusted rates ranging from 0.0% in the bottom quintile of radiation oncologists to 30.4% in the top quintile. Multivariable analysis found that the individual radiation oncologist (MOR 3.08) had a greater impact on the use of hypofractionation than did geographic region (MOR 2. Radiation OncologyInternational Journal of biology physics www.redjournal.org long-term randomized trial results in early 2010. Male physician and radiation oncologists treating the highest volume of breast cancer patients were less likely to perform hypofractionation (P<.05). Conclusions: The individual radiation oncologist strongly influenced the likelihood of a patient's receiving hypofractionated radiation therapy, and this trend increased despite the publication of long-term data showing equivalence to standard fractionation. Future research should focus on physician-related factors that influence this decision. Ó

show abstract

“…Using validated claim-based algorithms, we classified patients as treated with chemotherapy if they received treatment within 4 months of NSCLC diagnosis (27). Receipt of radiation therapy was ascertained using SEER and Medicare data (28).…”

Section: Cancer-related Factors and Treatmentmentioning

confidence: 99%

Survival of Patients with Stage IV Lung Cancer with Diabetes Treated with Metformin

Lin

Gallagher

Sigel

et al. 2015

Am J Respir Crit Care Med

121

106

View full text Add to dashboard Cite

Rationale: Prior studies have shown an anticancer effect of metformin in patients with breast and colorectal cancer. It is unclear, however, whether metformin has a mortality benefit in lung cancer.Objectives: To compare overall survival of patients with diabetes with stage IV non-small cell lung cancer (NSCLC) taking metformin versus those not on metformin.Methods: Using data from the Surveillance, Epidemiology, and End Results registry linked to Medicare claims, we identified 750 patients with diabetes 65-80 years of age diagnosed with stage IV NSCLC between 2007 and 2009. We used propensity score methods to assess the association of metformin use with overall survival while controlling for potential confounders.Measurements and Main Results: Overall, 61% of patients were on metformin at the time of lung cancer diagnosis. Median survival in the metformin group was 5 months, compared with 3 months in patients not treated with metformin (P , 0.001). Propensity score analyses showed that metformin use was associated with a statistically significant improvement in survival (hazard ratio, 0.80; 95% confidence interval, 0.71-0.89), after controlling for sociodemographics, diabetes severity, other diabetes medications, cancer characteristics, and treatment.Conclusions: Metformin is associated with improved survival among patients with diabetes with stage IV NSCLC, suggesting a potential anticancer effect. Further research should evaluate plausible biologic mechanisms and test the effect of metformin in prospective clinical trials.

show abstract

Studying Radiation Therapy Using SEER-Medicare-Linked Data

Cited by 251 publications

References 7 publications

Ovarian cancer in younger vs older women: a population-based analysis

Ovarian cancer in younger vs older women: a population-based analysis

The Impact of Radiation Oncologists on the Early Adoption of Hypofractionated Radiation Therapy for Early-Stage Breast Cancer

Survival of Patients with Stage IV Lung Cancer with Diabetes Treated with Metformin

Contact Info

Product

Resources

About