Comparison of SEER Treatment Data With Medicare Claims.
Comparison of SEER Treatment Data With Medicare Claims.
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SEER 治疗数据与医疗保险索赔的比较。
DOI：
10.1097/mlr.0000000000000073
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发表时间：
2016-09
期刊：
影响因子：
3
通讯作者：
Warren JL
中科院分区：
文献类型：
--
作者：
Noone AM;Lund JL;Mariotto A;Cronin K;McNeel T;Deapen D;Warren JL
补充数字内容可在文本中找到。基于人群的监测、流行病学和最终结果（SEER）登记研究收集了关于第一疗程治疗的信息，包括手术、化疗、放疗和激素治疗。然而，由于数据完整性方面的不确定性，SEER计划不发布化疗或激素治疗的数据。正在开展活动，以研究用其他数据源补充SEER治疗数据的机会。使用SEER-医疗保险相关数据，我们检查了SEER数据的有效性，以确定2000年至2006年诊断为膀胱癌、女性乳腺癌、结直肠癌、肺癌、卵巢癌、胰腺癌或前列腺癌的65岁及以上患者接受化疗和放疗的情况，以及65岁及以上诊断为前列腺癌的男性接受激素治疗的情况。SEER收集的治疗与医疗保险索赔确定的治疗进行了比较，使用医疗保险索赔作为金标准。计算接受每种治疗方式的κ、灵敏度、特异性、阳性预测值和阴性预测值。SEER数据识别化疗、放疗和激素治疗的总体敏感性为中等（分别为68%、80%和69%），并因癌症部位、分期和患者特征而异。除前列腺癌化疗外，所有治疗类型和癌症部位的总体阳性预测值均较高（>85%）。SEER数据一般不应用于比较接受治疗和未接受治疗的个体或估计接受治疗的个体在人群中的比例。使用其他数据源增强SEER数据将提供最准确的治疗信息。
Supplemental Digital Content is available in the text. The population-based Surveillance, Epidemiology, and End Results (SEER) registries collect information on first-course treatment, including surgery, chemotherapy, radiation therapy, and hormone therapy. However, the SEER program does not release data on chemotherapy or hormone therapy due to uncertainties regarding data completeness. Activities are ongoing to investigate the opportunity to supplement SEER treatment data with other data sources. Using the linked SEER-Medicare data, we examined the validity of the SEER data to identify receipt of chemotherapy and radiation therapy among those aged 65 and older diagnosed from 2000 to 2006 with bladder, female breast, colorectal, lung, ovarian, pancreas, or prostate cancer and hormone therapy among men diagnosed with prostate cancer at age 65 or older. Treatment collected by SEER was compared with treatment as determined by Medicare claims, using Medicare claims as the gold standard. The κ, sensitivity, specificity, positive predictive values, and negative predictive values were calculated for the receipt of each treatment modality. The overall sensitivity of SEER data to identify chemotherapy, radiation, and hormone therapy receipt was moderate (68%, 80%, and 69%, respectively) and varied by cancer site, stage, and patient characteristics. The overall positive predictive value was high (>85%) for all treatment types and cancer sites except chemotherapy for prostate cancer. SEER data should not generally be used for comparisons of treated and untreated individuals or to estimate the proportion of treated individuals in the population. Augmenting SEER data with other data sources will provide the most accurate treatment information.