WW2: USING LINKABLE CLINICAL AND ADMINISTRATIVE CLAIMS DATA TO IMPROVE OUTCOMES RESEARCH: SELECTED CASE STUDIES FROM ONCOLOGY AND DIABETES MELLITUS

Abstract

OBJECTIVES: The objectives of this workshop are to describe various types of linkable clinical and administrative claims data, review selected case studies, and highlight the strengths and limitations of these databases. PARTICIPANTS WHO WOULD BENEFIT: Those involved in planning, designing, implementing, and using data from retrospective database studies would benefit from this workshop. Administrative claims are increasingly used for outcomes research studies, despite known limitations associated with data reliability and validity, and a lack of clinical content. In recent years, efforts have been made to link claims to other sources, such as disease registries and clinical laboratory files, to create richer databases for research purposes. These linked data sources offer the potential for improved accuracy in case identification and outcomes ascertainment. For example, study patients can be selected based on their presence in a disease registry instead of relying on diagnoses reported on medical claim forms, and clinical laboratory files can be used to evaluate the success or failure of therapy. In this workshop, we will review, via case studies from oncology and diabetes, the content of linkable clinical and claims databases, the specific ways in which such data have been used in published outcomes studies, and the remaining limitations of this record linkage approach. Participants will learn how clinical data can be applied to strengthen studies of treatment costs and the burden of illness, and they will gain an appreciation of the improvements that linked data sources can make to the pharmacoeconomics and outcomes research fields. One case study will review applications of the SEER-Medicare database, which includes a linkage between cancer registry data and Medicare administrative claims for approximately 14% of U.S. cancer cases across 17 diverse regions. The other illustration will describe published studies of the economic benefits of improving glycemic control among diabetes patients, in which claims data from several managed-care organizations were linked to glycosylated hemoglobin test results.