Do Medicare Claims Measure Chemotherapy Use and Outcomes

医疗保险索赔是否衡量化疗的使用和结果

• 批准号: 6422828
• 负责人: ELIZABETH B LAMONT
• 金额: $ 13.11万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-02-01 至 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6422828
• 关键词: Medicare /Medicaid; aging; cancer registry /resource; clinical research; drug adverse effect; geriatrics; health care service evaluation; health care service utilization; human old age (65+); human subject; neoplasm /cancer; neoplasm /cancer chemotherapy; oncology; outcomes research

DESCRIPTION (provided by applicant): Although they present more than half of all Americans with cancer, the elderly are under-represented on the clinical trials that seek to determine efficacy and toxicity of chemotherapy. For this reason, results of clinical trials may not be applicable to the general population of elderly cancer patients. Nonetheless, physicians need clinical information regarding tile risks and benefits of chemotherapy in this substantial group of patients. I am a medical oncologist who seeks to develop a career at the crossroads oncology and health services research that is focused on determining the risks and benefits of chemotherapy in the general population of elderly cancer patients. In five years, I want to be able to execute a series of epidemiologic studies examining the possible contribution of medical comorbidity to the chemotherapy utilization and outcomes of elderly Americans with cancer. This long-term research agenda requires additional training on my part and three preliminary studies to determine the ability of a candidate data source, Heath Care Financing Administration's Medicare claims files, to provide inexpensive but reliable clinical information for these studies. Through the three related projects, I seek to determine the reliability of Medicare chemotherapy claims at capturing three critical elements of anti-cancer therapy 1) chemotherapy administration, 2) chemotherapy-related toxicities, and 3) disease-free survival. To meet these three aims, I will create a new and unique data set by linking Medicare claims to a gold-standard of clinical information regarding chemotherapy administration and outcomes, Cancer and Leukemia Group B (CALGB) clinical trial data. Defining the CALGB data as the gold standard against which to compare the Medicare claims, I will then calculate the sensitivity and specificity of the Medicare claims at capturing 1) chemotherapy administration, and 2) specific chemotherapy-related toxicities, and 3) disease-free survival. In the next phase of my career, I will use Medicare claims, to the extent of their validity, to execute a series of epidemiologic studies examining the chemotherapy utilization and outcomes of elderly Americans with cancer and medical comorbidity.

描述（由申请人提供）：虽然他们提出了一半以上 所有美国人都患有癌症，但老年人在临床上的代表性不足 旨在确定化疗疗效和毒性的试验。 为了这 因此，临床试验结果可能不适用于一般情况 老年癌症患者群体。 尽管如此，医生仍需要临床 有关化疗风险和益处的信息 大量的患者群体。 我是一名肿瘤内科医生，致力于发展 处于肿瘤学和卫生服务研究十字路口的职业 重点是确定化疗的总体风险和益处 老年癌症患者群体。 五年后，我希望能够 进行一系列流行病学研究来检验可能的贡献 医学合并症对老年人化疗利用和结果的影响 患有癌症的美国人。 这项长期研究议程需要额外的 我的培训和三项初步研究以确定的能力 候选数据源，医疗保健融资管理局的医疗保险索赔 文件，为这些提供廉价但可靠的临床信息 研究。 通过这三个相关的项目，我试图确定 医疗保险化疗索赔的可靠性在捕获三个关键 抗癌治疗的要素 1) 化疗给药，2) 化疗相关的毒性，以及 3) 无病生存。 为了满足这些 三个目标，我将通过链接医疗保险索赔创建一个新的、独特的数据集 化疗临床信息的黄金标准 给药和结果，癌症和白血病 B 组 (CALGB) 临床 试验数据。 将 CALGB 数据定义为黄金标准 比较医疗保险索赔，然后我将计算敏感性和 医疗保险索赔在捕获 1) 化疗时的特异性 给药，以及 2) 特定的化疗相关毒性，以及 3) 无病生存。 在我职业生涯的下一阶段，我将使用医疗保险 声称在其有效性范围内执行一系列流行病学调查 研究检查老年人化疗的利用和结果 患有癌症和合并症的美国人。