@article{6c161a5d0b6a497db160f216f503544f,
title = "Development and validation of algorithms to differentiate ductal carcinoma in situ from invasive breast cancer within administrative claims data",
abstract = "BACKGROUND: Overtreatment is a common concern for patients with ductal carcinoma in situ (DCIS), but this entity is difficult to distinguish from invasive breast cancers in administrative claims data sets because DCIS often is coded as invasive breast cancer. Therefore, the authors developed and validated algorithms to select DCIS cases from administrative claims data to enable outcomes research in this type of data. METHODS: This retrospective cohort using invasive breast cancer and DCIS cases included women aged 66 to 70 years in the 2004 through 2011 Texas Cancer Registry (TCR) data linked to Medicare administrative claims data. TCR records were used as “gold” standards to evaluate the sensitivity, specificity, and positive predictive value (PPV) of 2 algorithms. Women with a biopsy enrolled in Medicare parts A and B at 12 months before and 6 months after their first biopsy without a second incident diagnosis of DCIS or invasive breast cancer within 12 months in the TCR were included. Women in 2010 Medicare data were selected to test the algorithms in a general sample. RESULTS: In the TCR data set, a total of 6907 cases met inclusion criteria, with 1244 DCIS cases. The first algorithm had a sensitivity of 79%, a specificity of 89%, and a PPV of 62%. The second algorithm had a sensitivity of 50%, a specificity of 97%. and a PPV of 77%. Among women in the general sample, the specificity was high and the sensitivity was similar for both algorithms. However, the PPV was approximately 6% to 7% lower. CONCLUSIONS: DCIS frequently is miscoded as invasive breast cancer, and thus the proposed algorithms are useful to examine DCIS outcomes using data sets not linked to cancer registries. Cancer 2018;124:2815-2823.",
keywords = "administrative claims data, algorithm performance, breast cancer, ductal carcinoma in situ (DCIS), validation",
author = "Jacqueline Hirth and Hatch, {Sandra S.} and Lin, {Yu Li} and Giordano, {Sharon H.} and Silva, {H. Colleen} and Kuo, {Yong Fang}",
note = "Funding Information: This study was conducted with the support of the Institute for Translational Sciences at the University of Texas Medical Branch, supported in part by a Clinical and Translational Science Award (UL1 TR001439) from the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH). This study also was supported by the Cancer Prevention Research Institute of Texas Comparative Effectiveness Research on Cancer in Texas award (RP160674; Principal Investigator: James Goodwin). Jacqueline M. Hirth was a scholar supported by a research career development award (K12HD052023; Building Interdisciplinary Research Careers in Women's Health Program [Principal Investigator: Berenson]) from the Office of Research on Women's Health, the Office of the Director, the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the NIH during data analyses for this study. The sponsors had no role in the design or conduct of this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Funding Information: This study was conducted with the support of the Institute for Translational Sciences at the University of Texas Medical Branch, supported in part by a Clinical and Translational Science Award (UL1 TR001439) from the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH). This study also was supported by the Cancer Prevention Research Institute of Texas Comparative Effectiveness Research on Cancer in Texas award (RP160674; Principal Investigator: James Goodwin). Jacqueline M. Hirth was a scholar supported by a research career development award (K12HD052023; Building Interdisciplinary Research Careers in Women{\textquoteright}s Health Program [Principal Investigator: Berenson]) from the Office of Research on Women{\textquoteright}s Health, the Office of the Director, the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the NIH during data analyses for this study. The sponsors had no role in the design or conduct of this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Funding Information: Jacqueline M. Hirth received grants from Bayer HealthCare Pharmaceuticals Inc and the Cancer Prevention Research Institute of Texas, and a K12 training grant from the NIH for work performed outside of the current study. Yu-Li Lin received grants from the NIH and the Cancer Prevention Research Institute of Texas for work performed as part of the current study and grants from the NIH, Agency for Healthcare Research and Quality, and Bayer HealthCare Pharmaceuticals Inc for work performed outside of the current study and is employed by The University of Texas Medical Branch. Yong-Fang Kuo has received grants from the Cancer Prevention Research Institute of Texas for work performed as part of the current study and grants from the Agency for Healthcare Research and Quality and National Institute on Drug Abuse for work performed outside of the current study. Publisher Copyright: {\textcopyright} 2018 American Cancer Society",
year = "2018",
month = jul,
day = "1",
doi = "10.1002/cncr.31393",
language = "English (US)",
volume = "124",
pages = "2815--2823",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "13",
}