Evaluation of Chemotherapy Claims for Breast Cancer

乳腺癌化疗声明的评估

• 批准号: 6577352
• 负责人: XIANGLIN DU
• 金额: $ 14.29万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-03-01 至 2004-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6577352
• 关键词: Medicare /Medicaid; aging; body water dehydration; breast neoplasms; cancer registry /resource; clinical research; emesis; female; hospital utilization; human old age (65+); human subject; human therapy evaluation; hyperthermia; nausea; neoplasm /cancer chemotherapy; neoplasm /cancer epidemiology; outcomes research; women's health

DESCRIPTION (provided by applicant): Over the past several decades, numerous clinical trials have consistently demonstrated that chemotherapy is efficacious in both premenopausal and postmenopausal women with breast cancer. However, little is known about the use of chemotherapy and its effectiveness in the community because of a lack of large population-based data. While the Surveillance, Epidemiology and End Results (SEER) tumor registries provide data on radiation therapy and surgical treatment for breast cancer, they do not provide information on chemotherapy. They are not required to collect this information, and the medical records in oncologists' offices, where chemotherapy is likely to be administered, may not be routinely reviewed for data on the primary course of cancer-directed therapy. Medicare claims are a potential source of national data on chemotherapy use for breast cancer cases aged 65 and older. However, no study has examined the validity of this information. If Medicare claims provide accurate and complete data on chemotherapy, their utility for breast cancer research would be considerably enhanced, allowing for population-based analyses of the current uses of chemotherapy as well as effectiveness studies in the community. Therefore, we propose to examine the utility of information on chemotherapy from Medicare claims data for women aged 65 and older who have been diagnosed with breast cancer. Our approach is to identify women aged 65 years or older who have been diagnosed with breast cancer in the New Mexico Tumor Registry (a SEER registry), that can be linked with Medicare claims data by unique identifiers. We will contract with the registry to abstract the medical records on chemotherapy administration for eligible patients in all facilities including medical oncologists' offices where patients may have received chemotherapy. We will then compare information on the use of chemotherapy from medical chart review with information obtained from Medicare claims data. Our aims are 1) to determine whether Medicare data can identify women who received chemotherapy for breast cancer; 2) to determine whether Medicare data can differentiate among the specific regimens of chemotherapy; and 3) to determine whether the number of claims can be used to estimate the number of cycles of chemotherapy. Based on this information, we will characterize the nature and extent of error in using Medicare claims for chemotherapy effectiveness research among older women diagnosed with breast cancer. We will then use the Medicare-SEER linked data for all SEER areas to examine patterns and outcomes of chemotherapy among older women with breast cancer. Information generated from the medical chart reviews will also allow us to examine patterns of chemotherapy care independent of the Medicare claims data or independent of those parts of the claims that we find generate invalid estimates.

描述（由申请人提供）：在过去的几十年里，无数 临床试验一致证明化疗是有效的 患有乳腺癌的绝经前和绝经后妇女。然而， 关于化疗的使用及其在治疗中的有效性知之甚少 社区，因为缺乏大量基于人口的数据。虽然 监测、流行病学和最终结果 (SEER) 肿瘤登记处提供数据 对于乳腺癌的放射治疗和手术治疗，他们没有 提供有关化疗的信息。他们不需要收集这个 信息以及肿瘤科医生办公室的医疗记录，其中 可能会进行化疗，但可能不会进行常规检查 有关癌症定向治疗的初级疗程的数据。 医疗保险索赔是国家化疗使用数据的潜在来源 65 岁及以上的乳腺癌病例。然而，没有研究检验过 该信息的有效性。如果 Medicare 索赔提供准确且完整 化疗数据，它们对乳腺癌研究的效用是 大大增强，允许对当前的人口进行分析 化疗的使用以及社区中的有效性研究。 因此，我们建议检查化疗信息的效用 来自 65 岁及以上已确诊女性的医疗保险索赔数据 患有乳腺癌。 我们的方法是找出 65 岁或以上的女性 在新墨西哥州肿瘤登记处（SEER 登记处），可以通过唯一标识符与医疗保险索赔数据链接。 我们将与登记处签订合同，提取以下医疗记录： 在所有设施中为符合条件的患者进行化疗，包括 患者可能接受化疗的肿瘤内科医生办公室。我们 然后将比较医疗图表中有关化疗使用的信息 使用从医疗保险索赔数据中获得的信息进行审查。我们的目标是 1) 确定医疗保险数据是否可以识别接受化疗的女性 用于乳腺癌； 2）确定Medicare数据是否可以区分 具体化疗方案之中； 3) 确定是否 索赔数量可用于估计化疗周期数。 根据这些信息，我们将描述错误的性质和程度 使用医疗保险索赔对老年人进行化疗有效性研究 被诊断患有乳腺癌的女性。然后我们将使用 Medicare-SEER 链接 所有 SEER 领域的数据，用于检查化疗的模式和结果 患有乳腺癌的老年女性。从医疗图表生成的信息 审查还将使我们能够检查独立化疗护理的模式 医疗保险索赔数据或独立于我们的索赔部分 find 生成无效的估计。