Treatment patterns for prostate cancer: comparison of Medicare claims data to medical record review.

Published

Journal Article

As evidence-based guidelines increasingly define standards of care, the accurate reporting of patterns of treatment becomes critical to determine if appropriate care has been provided. We explore the level of agreement between claims and record abstraction for treatment regimens for prostate cancer.Medicare claims data were linked to medical records abstraction using data from the Centers for Disease Control and Prevention's National Program of Cancer Registry-funded Breast and Prostate Patterns of Care study. The first course of therapy included surgery, radiation therapy (RT), and hormonal therapy with luteinizing hormone-releasing hormone agonists.The linked sample included 2765 men most (84.7%) of whom had stage II prostate cancer. Agreement was excellent for surgery (κ=0.92) and RT (κ=0.92) and lower for hormonal therapy (κ=0.71); however, most of the discrepancies were due to greater number of patients reported who received hormonal therapy in the claims database than in the medical records database. For some standard multicomponent management strategies sensitivities were high, for example, hormonal therapy with either combination RT (86.9%) or cryosurgery (96.6%).Medicare claims are sensitive for determining patterns of multicomponent care for prostate cancer and for detecting use of hormonal therapy when not reported in the medical records abstracts.

Full Text

Duke Authors

Cited Authors

  • Fleming, ST; Hamilton, AS; Sabatino, SA; Kimmick, GG; Wu, X-C; Owen, JB; Huang, B; Hwang, W; Patterns of Care Study Group,

Published Date

  • September 2014

Published In

Volume / Issue

  • 52 / 9

Start / End Page

  • e58 - e64

PubMed ID

  • 23222532

Pubmed Central ID

  • 23222532

Electronic International Standard Serial Number (EISSN)

  • 1537-1948

International Standard Serial Number (ISSN)

  • 0025-7079

Digital Object Identifier (DOI)

  • 10.1097/MLR.0b013e318277eba5

Language

  • eng