Defining care provided for breast cancer based on medical record review or Medicare claims: Information from the Centers for Disease Control and Prevention Patterns of Care Study

Steven T. Fleming, Gretchen G. Kimmick, Susan A. Sabatino, Rosemary D Cress, Xiao Cheng Wu, Amy Trentham-Dietz, Bin Huang, Wenke Hwang, Jonathan M. Liff

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Description of care patterns is important as evidence-based guidelines increasingly dictate care. We explore the level of agreement between claims and record abstraction for guideline concordant multidisciplinary breast cancer care. Methods: From the U.S. Centers for Disease Control and Prevention's National Program of Cancer Registries Patterns of Care study, in which medical record abstraction of breast cancer and treatment was accomplished, cases include breast cancer where Medicare claims were available. Components of care were breast-conserving surgery (BCS), mastectomy, node assessment, radiation (RT), and chemotherapy (CTX), including specific chemotherapeutic agents, and combinations. We compared Medicare claims with record abstraction, and measured concordance using the kappa statistic and sensitivity. Results: The study sample consisted of 1762 women with stage 0 to 4 breast cancer. Level of agreement was excellent for surgery type (kappa = 0.84) and CTX (kappa = 0.89); agreement for RT therapy was slightly lower (kappa = 0.79). For standard multicomponent strategies, sensitivities and specificities were high; for example, 88.8%/93.5% for mastectomy plus nodes and 86.6%/95.4% for BCS plus nodes and RT. For selected, standard, multi-agent, adjuvant CTX regimens, sensitivities ranged from 66.3% to 68.8% (kappa 0.63-0.73). Conclusions: Medicare claims, compared with chart abstraction, is a reliable method for determining patterns of multicomponent care for breast cancer.

Original languageEnglish (US)
Pages (from-to)807-813
Number of pages7
JournalAnnals of Epidemiology
Volume22
Issue number11
DOIs
StatePublished - Nov 2012

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Information Centers
Centers for Disease Control and Prevention (U.S.)
Medicare
Medical Records
Breast Neoplasms
Segmental Mastectomy
Mastectomy
Guidelines
Radiation
Registries
Radiotherapy
Drug Therapy
Sensitivity and Specificity
Neoplasms

Keywords

  • Breast neoplasm
  • Claims analysis
  • Clinical practice
  • Medical records
  • Medicare
  • Patterns

ASJC Scopus subject areas

  • Epidemiology

Cite this

Defining care provided for breast cancer based on medical record review or Medicare claims : Information from the Centers for Disease Control and Prevention Patterns of Care Study. / Fleming, Steven T.; Kimmick, Gretchen G.; Sabatino, Susan A.; Cress, Rosemary D; Wu, Xiao Cheng; Trentham-Dietz, Amy; Huang, Bin; Hwang, Wenke; Liff, Jonathan M.

In: Annals of Epidemiology, Vol. 22, No. 11, 11.2012, p. 807-813.

Research output: Contribution to journalArticle

Fleming, Steven T. ; Kimmick, Gretchen G. ; Sabatino, Susan A. ; Cress, Rosemary D ; Wu, Xiao Cheng ; Trentham-Dietz, Amy ; Huang, Bin ; Hwang, Wenke ; Liff, Jonathan M. / Defining care provided for breast cancer based on medical record review or Medicare claims : Information from the Centers for Disease Control and Prevention Patterns of Care Study. In: Annals of Epidemiology. 2012 ; Vol. 22, No. 11. pp. 807-813.
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