Tradeoffs of using administrative claims and medical records to identify the use of personalized medicine for patients with breast cancer

Medical Care

Volumn 49, Issue 6, 2011, Pages

  Liang, Su Ying ^a   Phillips, Kathryn A ^a   Wang, Grace ^a   Keohane, Carol ^b   Armstrong, Joanne ^c   Morris, William M ^c   Haas, Jennifer S ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b BRIGHAM AND WOMEN S HOSPITAL   (United States)

^c AETNA   (United States)

Author keywords

breast neoplasm; claims data; medical record; personalized medicine

Indexed keywords

CAPECITABINE; CARBOPLATIN; CYCLOPHOSPHAMIDE; DOCETAXEL; DOXORUBICIN; EPIDERMAL GROWTH FACTOR RECEPTOR 2; EPIRUBICIN; FLUOROURACIL; METHOTREXATE; NAVELBINE; PACLITAXEL; TRASTUZUMAB;

ADULT; AGED; ARTICLE; BILLING AND CLAIMS; BREAST CANCER; CANCER ADJUVANT THERAPY; CANCER COMBINATION CHEMOTHERAPY; CONTROLLED STUDY; FEMALE; GENE EXPRESSION PROFILING; HEALTH CARE COST; HUMAN; MAJOR CLINICAL STUDY; MEDICAL RECORD; PATIENT CODING; PERSONALIZED MEDICINE; PRIORITY JOURNAL; RETROSPECTIVE STUDY; SENSITIVITY AND SPECIFICITY;

ADULT; AGED; BREAST NEOPLASMS; CLINICAL CODING; FEMALE; HEALTH CARE COSTS; HUMANS; INDIVIDUALIZED MEDICINE; INSURANCE CLAIM REPORTING; MEDICAL RECORD LINKAGE; MIDDLE AGED;

EID: 79957438830     PISSN: 00257079     EISSN: 15371948     Source Type: Journal    
DOI: 10.1097/MLR.0b013e318207e87e     Document Type: Article

References (27)

1. Du XL, Key CR, Dickie L, et al. External validation of Medicare claims for breast cancer chemotherapy compared with medical chart reviews. Med Care. 2006;44:124-131. (Pubitemid 43755463)
2. Gold HT, Do HT. Evaluation of three algorithms to identify incident breast cancer in Medicare claims data. Health Serv Res. 2007;42:2056-2069. (Pubitemid 47397185)
3. Miller DC, Saigal CS, Warren JL, et al. External validation of a claims-based algorithm for classifying kidney-cancer surgeries. BMC Health Serv Res. 2009;9:92.
4. Nattinger AB, Laud PW, Bajorunaite R, et al. An algorithm for the use of Medicare claims data to identify women with incident breast cancer. Health Serv Res. 2004;39(6 pt 1):1733-1749. (Pubitemid 39601249)
5. Ramsey SD, Scoggins JF, Blough DK, et al. Sensitivity of administrative claims to identify incident cases of lung cancer: a comparison of 3 health plans. J Manag Care Pharm. 2009;15:659-668.
6. Setoguchi S, Solomon DH, Glynn RJ, et al. Agreement of diagnosis and its date for hematologic malignancies and solid tumors between Medicare claims and cancer registry data. Cancer Causes Control. 2007;18:561-569. (Pubitemid 46684827)
7. Warren JL, Harlan LC, Fahey A, et al. Utility of the SEER-Medicare data to identify chemotherapy use. Med Care. 2002;40(suppl 8):IV-55-IV-61.
8. Virnig BA, Warren JL, Cooper GS, et al. Studying radiation therapy using SEER-Medicare-linked data. Med Care. 2002;40(suppl 8):IV-49-IV-54.
9. Tisnado DM, Adams JL, Liu H, et al. What is the concordance between the medical record and patient self-report as data sources for ambulatory care? Med Care. 2006;44:132-140. (Pubitemid 43755464)
10. Schenck AP, Klabunde CN, Warren JL, et al. Data sources for measuring colorectal endoscopy use among Medicare enrollees. Cancer Epidemiol Biomarkers Prev. 2007;16:2118-2127. (Pubitemid 47621189)
11. Schenck AP, Klabunde CN, Warren JL, et al. Evaluation of claims, medical records, and self-report for measuring fecal occult blood testing among Medicare enrollees in fee for service. Cancer Epidemiol Biomarkers Prev. 2008;17:799-804. (Pubitemid 351536408)
12. Wolff AC, Hammond ME, Schwartz JN, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol. 2007;25:118-145. (Pubitemid 350003059)
13. Carlson RW, Moench SJ, Hammond ME, et al. HER2 testing in breast cancer: NCCN Task Force report and recommendations. J Natl Compr Cancer Netw. 2006;4(suppl 3):S1-S22; quiz S23-S24.
14. De Laurentiis M, Cancello G, Zinno L, et al. Targeting HER2 as a therapeutic strategy for breast cancer: a paradigmatic shift of drug development in oncology. Ann Oncol. 2005;16(suppl 4): iv7-iv13. (Pubitemid 43084939)
15. Genomic Health Incorporated Press Release. Genomic Health Announces Fourth Quarter and Year-End 2008 Financial Results and Business Progress, Provides 2009 Financial Guidance. Redwood City, CA: Genomic Health Incorporated Press Release 2009.
16. Ferrusi IL, Marshall DA, Kulin NA, et al. Looking back at 10 years of trastuzumab therapy: what is the role of HER2 testing? A systematic review of health economic analyses. Per Med. 2009;6:193-215.
17. Hassett MJ, O'Malley AJ, Pakes JR, et al. Frequency and cost of chemotherapy-related serious adverse effects in a population sample of women with breast cancer. J Natl Cancer Inst. 2006;98: 1108-1117. (Pubitemid 44288785)
18. Aetna. Clinical Policy Bulletin: Tumor Markers. Hartford, CT: Aetna 2009. Bulletin No. 352.
19. Chen G, Faris P, Hemmelgarn B, et al. Measuring agreement of administrative data with chart data using prevalence unadjusted and adjusted kappa. BMC Med Res Methodol. 2009;9:5.
20. Feinstein AR, Cicchetti DV. High agreement but low kappa: part I. The problems of two paradoxes. J Clin Epidemiol. 1990;43:543-549. (Pubitemid 20178543)
21. Cicchetti DV, Feinstein AR. High agreement but low kappa: part II. Resolving the paradoxes. J Clin Epidemiol. 1990;43:551-558. (Pubitemid 20178544)
22. Kundel HL, Polansky M. Measurement of observer agreement. Radiology. 2003;228:303-308. (Pubitemid 36910064)
23. Weiner MG, Garvin JH, Ten Have TR. Assessing the accuracy of diagnostic codes in administrative databases: the impact of the sampling frame on sensitivity and specificity. AMIA Annu Symp Proc. 2006:1140.
24. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-174. (Pubitemid 8054849)
25. Chen-Hardee S, Chrischilles EA, Voelker MD, et al. Population-based assessment of hospitalizations for neutropenia from chemotherapy in older adults with non-Hodgkin's lymphoma (United States). Cancer Causes Control. 2006;17:647-654. (Pubitemid 43668322)
26. Cooper GS, Virnig B, Klabunde CN, et al. Use of SEER-Medicare data for measuring cancer surgery. Med Care. 2002;40(suppl 8):IV-43-IV-48.
27. Phillips KA, Liang SY, Van Bebber S. Challenges to the translation of genomic information into clinical practice and health policy: utilization, preferences and economic value. Curr Opin Mol Ther. 2008;10:260-266. (Pubitemid 351799277)