Validation of electronic data on chemotherapy and hormone therapy use in HMOs

Med Care. 2013 Oct;51(10):e67-73. doi: 10.1097/MLR.0b013e31824def85.

Abstract

Background: Most data regarding medical care for cancer patients in the United States comes from Surveillance, Epidemiology and End Results-linked Medicare analyses of individuals aged 65 years or older and typically excludes Medicare Advantage enrollees.

Objectives: To assess the accuracy of chemotherapy and hormone therapy treatment data available through the Cancer Research Network's Virtual Data Warehouse (VDW).

Research design: Retrospective, longitudinal cohort study. Medical record-abstracted, tumor registry-indicated treatments (gold standard) were compared with VDW-indicated treatments derived from health maintenance organization pharmacy, electronic medical record, and claim-based data systems.

Subjects: Enrollees aged 18 years and older diagnosed with incident breast, colorectal, lung, or prostate cancer from 2000 through 2007.

Measures: Sensitivity, specificity, and positive predictive value were computed at 6 and 12 months after cancer diagnosis.

Results: Approximately 45% of all cancer cases (total N=23,800) were aged 64 years or younger. Overall chemotherapy sensitivity/specificities across the 3 health plans for incident breast, colorectal, lung, and prostate cancer cases were 95%/90%, 95%/93%, 93%/93%, and 85%/77%, respectively. With the exception of prostate cancer cases, overall positive predictive value ranged from 86% to 89%. Small variations in chemotherapy data accuracy existed due to cancer site and data source, whereas greater variation existed in hormone therapy capture across sites.

Conclusions: Strong concordance exists between gold standard tumor registry measures of chemotherapy receipt and Cancer Research Network VDW data. Health maintenance organization VDW data can be used for a variety of studies addressing patterns of cancer care and comparative effectiveness research that previously could only be conducted among elderly Surveillance, Epidemiology and End Results-Medicare populations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / drug therapy
  • Cohort Studies
  • Colorectal Neoplasms / drug therapy
  • Databases, Factual
  • Drug Therapy / statistics & numerical data*
  • Electronic Health Records / standards*
  • Female
  • Health Maintenance Organizations / statistics & numerical data*
  • Hormones / therapeutic use*
  • Humans
  • Longitudinal Studies
  • Lung Neoplasms / drug therapy
  • Male
  • Medical Record Linkage
  • Medicare / statistics & numerical data
  • Middle Aged
  • Neoplasms / drug therapy*
  • Prostatic Neoplasms / drug therapy
  • Registries / standards
  • Registries / statistics & numerical data
  • Reproducibility of Results
  • Retrospective Studies
  • SEER Program / statistics & numerical data
  • Treatment Outcome
  • United States
  • Young Adult

Substances

  • Antineoplastic Agents
  • Hormones