Abstract
BackgroundTo assess concordance between Medicare claims and Surveillance, Epidemiology, and End Results (SEER) reports of incident BM among prostate cancer (PCa) patients. The prevalence and consequences of bone metastases (BM) have been examined across tumor sites using healthcare claims data however the reliability of these claims-based BM measures has not been investigated.MethodsThis retrospective cohort study utilized linked registry and claims (SEER-Medicare) data on men diagnosed with incident stage IV M1 PCa between 2005 and 2007. The SEER-based measure of incident BM was cross-tabulated with three separate Medicare claims approaches to assess concordance. Sensitivity, specificity and positive predictive value (PPV) were calculated to assess the concordance between registry- and claims-based measures.ResultsBased on 2,708 PCa patients in SEER-Medicare, there is low to moderate concordance between the SEER- and claims-based measures of incident BM. Across the three approaches, sensitivity ranged from 0.48 (0.456 – 0.504) to 0.598 (0.574 - 0.621), specificity ranged from 0.538 (0.507 - 0.569) to 0.620 (0.590 - 0.650) and PPV ranged from 0.679 (0.651 - 0.705) to 0.690 (0.665 - 0.715). A comparison of utilization patterns between SEER-based and claims-based measures suggested avenues for improving sensitivity.ConclusionClaims-based measures using BM ICD 9 coding may be insufficient to identify patients with incident BM diagnosis and should be validated against chart data to maximize their potential for population-based analyses.
Highlights
To assess concordance between Medicare claims and Surveillance, Epidemiology, and End Results (SEER) reports of incident bone metastasis (BM) among prostate cancer (PCa) patients
Using the Surveillance, Epidemiology and End Results (SEER) registry and linked Medicare claims available from the National Cancer Institute, we undertook the present study in an effort to better understand the concordance between registry-based data on BM and claims-based measures of BM, using men diagnosed with incident metastatic PCa as a model
We found that there is low to moderate concordance between the SEER-based and claims-based measures of Claims Approach 3
Summary
To assess concordance between Medicare claims and Surveillance, Epidemiology, and End Results (SEER) reports of incident BM among prostate cancer (PCa) patients. Using the Surveillance, Epidemiology and End Results (SEER) registry and linked Medicare claims available from the National Cancer Institute, we undertook the present study in an effort to better understand the concordance between registry-based data on BM and claims-based measures of BM, using men diagnosed with incident metastatic PCa as a model. To our knowledge, this is the first study to investigate the agreement between claims-based and registry-based sources of BM. Other studies have defined BM patients as persons with at least one inpatient claim with the 198.5 code, at least one outpatient claim with the 198.5 code paired with a code for procedures used to diagnose or treat BM, or at least one outpatient physician evaluation and management claim with the 198.5 code [6,7]
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