Incidence of the myelodysplastic syndromes using a novel claims-based algorithm: high number of uncaptured cases by cancer registries
Incidence of the myelodysplastic syndromes using a novel claims-based algorithm: high number of uncaptured cases by cancer registries
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DOI：
10.1182/blood-2011-02-337964
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发表时间：
2011-06-30
期刊：
影响因子：
20.3
通讯作者：
List, Alan F.
中科院分区：
文献类型：
--
作者：
Cogle, Christopher R.;Craig, Benjamin M.;List, Alan F.
骨髓增生异常综合征（mds）是血液学上多样化的造血干细胞恶性肿瘤，主要影响老年人。在美国，MDS的发病率估计为每10万人3.3例；然而，有证据表明，在集中的癌症登记处少报MDS。与临床建议相反，2001-2010年的注册指南只要求在髓系系中捕获一种恶性肿瘤，而不需要血细胞计数（BC）或骨髓活检（BM）来确认MDS。为了解决这些潜在的局限性，我们构建了4种基于索赔的算法来评估MDS发病率，将这些算法应用于2000 - 2008年监测流行病学和最终结果(SEER)-Medicare数据库，并使用SEER登记的MDS病例评估算法的有效性。每种算法都需要一个或多个MDS索赔，并在第一个索赔之前的一年内考虑推荐的诊断服务：1+，2+，2+ BC和2+ BCBM（按灵敏度排序）。两种算法的灵敏度均为中等（78.05% ~ 92.90%），特异性为高（98.49% ~ 99.84%），其中2 + BCBM算法的特异性最高。基于2 + BCBM算法，65岁及以上人群的年MDS发病率为75 / 10万，远高于使用相同样本的SEER报告的20 / 10万。(血。2011;117 (26):7121 - 7125)
The myelodysplastic syndromes (MDSs) are hematologically diverse hematopoietic stem cell malignancies primarily affecting older individuals. The incidence of MDS in the United States is estimated at 3.3 per 100 000; however, evidence suggests underreporting of MDS to centralized cancer registries. Contrary to clinical recommendations, registry guidelines from 2001-2010 required the capture of only one malignancy in the myeloid lineage and did not require blood count (BC) or bone marrow (BM) biopsy for MDS confirmation. To address these potential limitations, we constructed 4 claims-based algorithms to assess MDS incidence, applied the algorithms to the 20002008 Surveillance Epidemiology and End Results (SEER)-Medicare database, and assessed algorithm validity using SEER-registered MDS cases. Each algorithm required one or more MDS claims and accounted for recommended diagnostic services during the year before the first claim: 1+, 2+, 2 + BC, and 2 + BCBM (ordered by sensitivity). Each had moderate sensitivities (78.05%-92.90%) and high specificities (98.49%-99.84%), with the 2 + BCBM algorithm demonstrating the highest specificity. Based on the 2 + BCBM algorithm, the annual incidence of MDS is 75 per 100 000 persons 65 years or older-much higher than the 20 per 100 000 reported by SEER using the same sample. (Blood. 2011;117(26):7121-7125)