Utility of the SEER-Medicare data to identify chemotherapy use.

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

Research output: Contribution to journalArticle

317 Citations (Scopus)

Abstract

BACKGROUND: Medicare claims include codes for chemotherapy administration and specific drugs given, and researchers are increasingly using these data to measure the use of chemotherapy. However, the validity and completeness of these data as a source of information has not been established. OBJECTIVES: This analysis is intended to assess the utility of the Medicare claims to capture chemotherapy use. METHODS: Persons with breast, colorectal, and ovarian cancer were identified from the linked SEER-Medicare data. Their Medicare claims were reviewed to determine if there were any bills for chemotherapy, and if so, if there were claims for specific agents. This information was compared with data on the first course of treatment obtained from hospitals and treating physicians by the SEER registries through an NCI-supported Patterns of Care Studies (POC). Agreement was measured using kappa statistics. The sensitivity of the Medicare claims to capture chemotherapy, as reported from the POC data, was also measured. An additional comparison assessed the agreement between the two data sources concerning which specific drugs had been given. RESULTS: For all of the cancers, there was a high level of agreement between the Medicare claims and the POC data regarding whether or not the patient had received chemotherapy (kappa >or=0.73). The sensitivity of the Medicare data to determine if a person had received chemotherapy was high (>or=88%). In cases where the Medicare claim included a code for a specific drug, there high agreement between Medicare and POC about the specific drug given in breast and colorectal cancers, although the agreement was lower for ovarian cancers. The sensitivity of the Medicare claims to identify specific agents varies by cancer type. CONCLUSIONS: The Medicare claims can be used to identify which persons are receiving chemotherapy. The utility of Medicare data to measure treatment with specific agents varies by cancer type and specific agent. For some cancers, it is possible to use these claims to assess use of specific drugs, while for other drugs the data are limited.

Original languageEnglish (US)
JournalMedical Care
Volume40
Issue number8 Suppl
StatePublished - Aug 2002
Externally publishedYes

Fingerprint

Medicare
Drug Therapy
cancer
drug
Pharmaceutical Preparations
human being
Ovarian Neoplasms
Colorectal Neoplasms
Neoplasms
Breast Neoplasms
bill
source of information
Information Storage and Retrieval
statistics
physician
Registries
Research Personnel
Physicians

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Warren, J. L., Harlan, L. C., Fahey, A., Virnig, B. A., Freeman, J. L., Klabunde, C. N., ... Knopf, K. B. (2002). Utility of the SEER-Medicare data to identify chemotherapy use. Medical Care, 40(8 Suppl).

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 B.

In: Medical Care, Vol. 40, No. 8 Suppl, 08.2002.

Research output: Contribution to journalArticle

Warren, JL, Harlan, LC, Fahey, A, Virnig, BA, Freeman, JL, Klabunde, CN, Cooper, GS & Knopf, KB 2002, 'Utility of the SEER-Medicare data to identify chemotherapy use.', Medical Care, vol. 40, no. 8 Suppl.
Warren JL, Harlan LC, Fahey A, Virnig BA, Freeman JL, Klabunde CN et al. Utility of the SEER-Medicare data to identify chemotherapy use. Medical Care. 2002 Aug;40(8 Suppl).
Warren, Joan L. ; Harlan, Linda C. ; Fahey, Angela ; Virnig, Beth A. ; Freeman, Jean L. ; Klabunde, Carrie N. ; Cooper, Gregory S. ; Knopf, Kevin B. / Utility of the SEER-Medicare data to identify chemotherapy use. In: Medical Care. 2002 ; Vol. 40, No. 8 Suppl.
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abstract = "BACKGROUND: Medicare claims include codes for chemotherapy administration and specific drugs given, and researchers are increasingly using these data to measure the use of chemotherapy. However, the validity and completeness of these data as a source of information has not been established. OBJECTIVES: This analysis is intended to assess the utility of the Medicare claims to capture chemotherapy use. METHODS: Persons with breast, colorectal, and ovarian cancer were identified from the linked SEER-Medicare data. Their Medicare claims were reviewed to determine if there were any bills for chemotherapy, and if so, if there were claims for specific agents. This information was compared with data on the first course of treatment obtained from hospitals and treating physicians by the SEER registries through an NCI-supported Patterns of Care Studies (POC). Agreement was measured using kappa statistics. The sensitivity of the Medicare claims to capture chemotherapy, as reported from the POC data, was also measured. An additional comparison assessed the agreement between the two data sources concerning which specific drugs had been given. RESULTS: For all of the cancers, there was a high level of agreement between the Medicare claims and the POC data regarding whether or not the patient had received chemotherapy (kappa >or=0.73). The sensitivity of the Medicare data to determine if a person had received chemotherapy was high (>or=88{\%}). In cases where the Medicare claim included a code for a specific drug, there high agreement between Medicare and POC about the specific drug given in breast and colorectal cancers, although the agreement was lower for ovarian cancers. The sensitivity of the Medicare claims to identify specific agents varies by cancer type. CONCLUSIONS: The Medicare claims can be used to identify which persons are receiving chemotherapy. The utility of Medicare data to measure treatment with specific agents varies by cancer type and specific agent. For some cancers, it is possible to use these claims to assess use of specific drugs, while for other drugs the data are limited.",
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AU - Warren, Joan L.

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AU - Fahey, Angela

AU - Virnig, Beth A.

AU - Freeman, Jean L.

AU - Klabunde, Carrie N.

AU - Cooper, Gregory S.

AU - Knopf, Kevin B.

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N2 - BACKGROUND: Medicare claims include codes for chemotherapy administration and specific drugs given, and researchers are increasingly using these data to measure the use of chemotherapy. However, the validity and completeness of these data as a source of information has not been established. OBJECTIVES: This analysis is intended to assess the utility of the Medicare claims to capture chemotherapy use. METHODS: Persons with breast, colorectal, and ovarian cancer were identified from the linked SEER-Medicare data. Their Medicare claims were reviewed to determine if there were any bills for chemotherapy, and if so, if there were claims for specific agents. This information was compared with data on the first course of treatment obtained from hospitals and treating physicians by the SEER registries through an NCI-supported Patterns of Care Studies (POC). Agreement was measured using kappa statistics. The sensitivity of the Medicare claims to capture chemotherapy, as reported from the POC data, was also measured. An additional comparison assessed the agreement between the two data sources concerning which specific drugs had been given. RESULTS: For all of the cancers, there was a high level of agreement between the Medicare claims and the POC data regarding whether or not the patient had received chemotherapy (kappa >or=0.73). The sensitivity of the Medicare data to determine if a person had received chemotherapy was high (>or=88%). In cases where the Medicare claim included a code for a specific drug, there high agreement between Medicare and POC about the specific drug given in breast and colorectal cancers, although the agreement was lower for ovarian cancers. The sensitivity of the Medicare claims to identify specific agents varies by cancer type. CONCLUSIONS: The Medicare claims can be used to identify which persons are receiving chemotherapy. The utility of Medicare data to measure treatment with specific agents varies by cancer type and specific agent. For some cancers, it is possible to use these claims to assess use of specific drugs, while for other drugs the data are limited.

AB - BACKGROUND: Medicare claims include codes for chemotherapy administration and specific drugs given, and researchers are increasingly using these data to measure the use of chemotherapy. However, the validity and completeness of these data as a source of information has not been established. OBJECTIVES: This analysis is intended to assess the utility of the Medicare claims to capture chemotherapy use. METHODS: Persons with breast, colorectal, and ovarian cancer were identified from the linked SEER-Medicare data. Their Medicare claims were reviewed to determine if there were any bills for chemotherapy, and if so, if there were claims for specific agents. This information was compared with data on the first course of treatment obtained from hospitals and treating physicians by the SEER registries through an NCI-supported Patterns of Care Studies (POC). Agreement was measured using kappa statistics. The sensitivity of the Medicare claims to capture chemotherapy, as reported from the POC data, was also measured. An additional comparison assessed the agreement between the two data sources concerning which specific drugs had been given. RESULTS: For all of the cancers, there was a high level of agreement between the Medicare claims and the POC data regarding whether or not the patient had received chemotherapy (kappa >or=0.73). The sensitivity of the Medicare data to determine if a person had received chemotherapy was high (>or=88%). In cases where the Medicare claim included a code for a specific drug, there high agreement between Medicare and POC about the specific drug given in breast and colorectal cancers, although the agreement was lower for ovarian cancers. The sensitivity of the Medicare claims to identify specific agents varies by cancer type. CONCLUSIONS: The Medicare claims can be used to identify which persons are receiving chemotherapy. The utility of Medicare data to measure treatment with specific agents varies by cancer type and specific agent. For some cancers, it is possible to use these claims to assess use of specific drugs, while for other drugs the data are limited.

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