Utility of the SEER-Medicare Data to Identify Chemotherapy Use

Warren, Joan L.; Harlan, Linda C.; Fahey, Angela; Virnig, Beth A; Freeman, Jean L.; Klabunde, Carrie N.; Cooper, Gregory S.; Knopf, Kevin

doi:10.1097/00005650-200208001-00008

Cited by 323 publications

(324 citation statements)

References 10 publications

Supporting

Mentioning

313

Contrasting

Order By: Relevance

“…We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database [19][20][21][22][23] . All incident cancer patients reported to the SEER registries are cross-matched with Medicare enrollment and claims files 24 .…”

Section: Methodsmentioning

confidence: 99%

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

et al. 2011

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

et al. 2011

View full text Add to dashboard Cite

“…Inpatient and outpatient Medicare claims from the year before diagnosis were used to assess pre-existing comorbidity using the Deyo adaptation of the Charlson comorbidity index (22). The administration of chemotherapy was ascertained by identifying chemotherapy administration codes and specific drug codes from within a patient's Medicare files (23). Care at a teaching hospital was defined as any indirect medical education payment during a hospitalization after the patient's diagnosis of cancer.…”

Section: Study Covariatesmentioning

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

“…Radiotherapy planning and simulation were classified into simple, intermediate, and complex using Medicare physician claims (14). Adjuvant chemotherapy (platinum or nonplatinum) use is not reported in SEER and, therefore, was ascertained using a validated algorithm from Medicare inpatient, outpatient, physician, and durable medical equipment files (15).…”

Section: Study Populationmentioning

confidence: 99%

Adjuvant Treatment for Elderly Patients with Early-Stage Lung Cancer Treated with Limited Resection

Mhango

Bonomi²,

Neugut

et al. 2013

Annals ATS

View full text Add to dashboard Cite

Objectives: Limited resection is commonly used for treating older patients with early-stage non-small cell lung cancer (NSCLC) who cannot tolerate lobectomy. However, parenchymal-sparing procedures leave patients at increased risk of recurrence. The role of postoperative radiotherapy (PORT) and chemotherapy after limited resection is not established. Methods:We identified 1,929 patients with stage I-II (<5 cm in size) NSCLC who underwent limited resection (wedge or segmentectomy) from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Using propensity score methods, we compared toxicity and survival of patients treated with limited resection alone, PORT, adjuvant chemotherapy, or PORT and chemotherapy. We conducted secondary analysis stratifying the sample by size (.2-5 cm), stage (IA vs. IB/IIA), and type of limited resection (wedge resection vs. segmentectomy).Measurements and Main Results: Overall, 1,656 (85.8%), 159 (8.3%), 74 (3.8%), and 40 (2.1%) patients were treated with limited resection alone, PORT, adjuvant chemotherapy, or PORT and chemotherapy, respectively. Adjusted analysis using inverse probability weighting showed that PORT (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.45-1.69), adjuvant chemotherapy (HR, 1.48; 95% CI, 1.36-1.61), and PORT and chemotherapy (HR, 1.73; 95% CI, 1.61-1.86) were associated with worse survival compared with limited resection alone. Similar results were obtained in secondary analyses. Compared with limited resection alone, the adjusted odds ratios for toxicity were 1.97 (95% CI, 1.6-2.4), 3.15 (95% CI, 2.58-3.85), 2.59 (95% CI, 2.0-3.4) for PORT, chemotherapy, and PORT and chemotherapy, respectively.Conclusions: PORT and adjuvant chemotherapy are not beneficial and appear to be associated with increased toxicity and worse survival after limited resection in elderly patients with early-stage NSCLC. Alternative strategies should be explored to improve local control.

show abstract

Utility of the SEER-Medicare Data to Identify Chemotherapy Use

Cited by 323 publications

References 10 publications

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

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

Adjuvant Treatment for Elderly Patients with Early-Stage Lung Cancer Treated with Limited Resection

Contact Info

Product

Resources

About