ReCAPSE: Recurrence from Claims And PROs for SEER Enhancement

项目摘要 国家癌症研究所的监测、流行病学和最终结果（SEER）计划 作为癌症监测的国家仪表板，是癌症的权威资源 发病率和死亡率。然而，登记处缺乏关于癌症复发的信息， 这是一项重大成果，将影响世界各国和地区有关疾病管理的决策和政策。 个人和群体水平。拟议研究的目标是开发一种可扩展的方法 以人群为基础确定癌症复发，特别关注乳腺癌。的 研究的第一阶段（UG 3）将开发一种创新算法，用于检测首次复发， 将医疗索赔与患者报告的结果（PRO）相结合。这一阶段将在 与西雅图-普吉特海湾SEER登记处合作，并将利用正在进行的研究 与普吉特海湾的付款人达成协议。将开发不同的算法，以允许灵活性， 最大化灵敏度或特异性。这些算法将根据金本位递归进行验证 信息基于两个主要本地供应商的电子医疗记录。研究参与者 将2013-2016年确诊的I-III期乳腺癌患者一致定为“金标准” 有关于复发的资料。将采用回顾性病例对照设计， 将在每个验证中心征集相同数量的复发病例和非复发对照 关于他们的复发史。所有确认活动将明确调整缺失 数据来自参与者对PRO请求的不响应。第二阶段（UH 3）将是 与肯塔基州癌症登记处合作进行。UG 3中开发的算法 2015-2017年，将在所有肯塔基州I-III期乳腺癌诊断中部署第一阶段， 索赔数据可用。这一阶段将包括根据患者的医疗记录进行验证 在同一时期在肯塔基州大学马基癌症中心确诊。在这 在第一阶段，研究小组将开发一个可视化界面，用于总结总体复发风险， 在特定的预后亚组中。该界面将允许用户检查 用于估计复发风险的患者队列，还将提供调整后的估计值 参与者无反应。拟议的工作将代表一种开创性的努力， 医疗索赔数据与患者自我报告相结合是否构成了一个有希望的途径， 确定是否可以将癌症复发的关键终点添加到基于人群的 癌症登记处。

PROJECT SUMMARY The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute serves as a national dashboard for cancer surveillance and is an authoritative resource for cancer incidence and mortality rates. However, the registry lacks information on cancer recurrence, which is a major outcome impacting decisions and policies around management of disease at both the individual and the population levels. The goal of the proposed study is to develop a scalable approach for population-based ascertainment of cancer recurrence with a specific focus on breast cancer. The first (UG3) phase of the study will develop an innovative algorithm for detecting a first recurrence by combining medical claims with patient reported outcomes (PROs). This phase will be conducted in collaboration with the Seattle-Puget Sound SEER registry and will leverage ongoing research agreements with Puget Sound payers. Different algorithms will be developed to allow for flexibility in maximizing sensitivity or specificity. The algorithms will be validated against gold-standard recurrence information based on electronic medical records from two major local providers. Study participants will consistent of stage I-III breast cancer patients diagnosed in 2013–2016 on whom “gold standard” information on recurrence is available. A retrospective case-control design will be employed in which an equal number of recurrent cases and non-recurrent controls at each validation site will be solicited for PROs regarding their recurrence histories. All validation activities will explicitly adjust for missing data resulting from participant non-response to the PRO solicitation. The second (UH3) phase will be conducted in collaboration with the Kentucky Cancer Registry. The algorithms developed in the UG3 phase will be deployed on all Kentucky stage I-III breast cancer diagnoses in 2015–2017 on whom claims data are available. This phase will include a validation against medical records from patients diagnosed at the University of Kentucky Markey Cancer Center over a concurrent period. In this phase, the study team will develop a visual interface for summarizing recurrence risks overall and within specified prognostic subgroups. The interface will allow users to examine representativeness of the patient cohort used to estimate recurrence risks and will also provide estimates that are adjusted for participant non-response. The proposed work will represent a pioneering effort that establish whether medical claims data combined with patient self-report constitute a promising avenue towards determining whether the critical endpoint of cancer recurrence can be added to population-based cancer registries.