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Titolo:
The utility of Medicare claims data for measuring cancer stage
Autore:
Cooper, GS; Yuan, Z; Stange, KC; Amini, SB; Dennis, LK; Rimm, AA;
Indirizzi:
Case Western Reserve Univ, Dept Med, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA Case Western Reserve Univ, Dept Epidemiol & Biostat, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA Case Western Reserve Univ, Dept Family Med, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA Case Western Reserve Univ, Canc Res Ctr, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA
Titolo Testata:
MEDICAL CARE
fascicolo: 7, volume: 37, anno: 1999,
pagine: 706 - 711
SICI:
0025-7079(199907)37:7<706:TUOMCD>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
BREAST-CANCER; COLORECTAL-CANCER; ELDERLY AMERICANS; LUNG-CANCER; MORTALITY; RESECTION; RATES;
Keywords:
breast neoplasms; colorectal neoplasms; endometrial neoplasms; lung neoplasms; pancreatic neoplasms; prostatic neoplasms; Medicare; stage;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Cooper, GS Univ Hosp Cleveland, Div Gastroenterol, 11100 Euclid Ave, Cleveland, OH 44106 USA Univ Hosp Cleveland 11100 Euclid Ave Cleveland OH USA 44106 USA
Citazione:
G.S. Cooper et al., "The utility of Medicare claims data for measuring cancer stage", MED CARE, 37(7), 1999, pp. 706-711

Abstract

BACKGROUND, The validity of using claims data for measuring tumor stage, one of he most important determinants of choice of therapy and longterm survival, is unknown. OBJECTIVES. TO determine the relative accuracy of both inpatient and hospital Outpatient Medicare claims for measuring the stage of disease of six commonly diagnosed cancers. RESEARCH DESIGN. Analysis of a database linking Surveillance, Epidemiology, and End Results (SEER) registry data and Medicare claims in patients aged65 years with cancer,SUBJECTS. Three hundred twenty thousand, six hundred and thirty seven cases of invasive breast, colorectal, endometrial, lung, pancreatic, and prostate cancers diagnosed between 1984 and 1993. MEASURES. Using SEER files as the "gold standard," concordance with Medicare claims, as well as sensitivity and positive predictive value of coding for each stage was measured. RESULTS. Although Medicare data correctly categorized local, regional, anddistant stage tumors in 97%, 33%, and 65%, respectively, the data substantially overestimated the proportion of localized tumors and underestimated the rate of regional stage disease. The highest concordance was observed forbreast and colorectal cancer, However, the sensitivity and positive predictive values were never simultaneously 80% within one stage of a specific cancer. The accuracy of coding for stage in Outpatient files was inferior to inpatient data. CONCLUSIONS. With few exceptions, Medicare claims have limited utility as a measure of cancer stage. If: tumor registry data are not available, investigators should consider the trade offs in sensitivity and predictive valuewhen considering a study that will use claims data.

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Documento generato il 22/09/20 alle ore 13:18:36