Evaluation of Chemotherapy Claims for Breast Cancer

描述（由申请人提供）：在过去的几十年里，许多 临床试验一致表明化疗是有效的， 在绝经前和绝经后乳腺癌妇女中。然而，在这方面， 关于化疗的使用及其在癌症中的有效性知之甚少。 由于缺乏大量的基于人口的数据。而 监测、流行病学和最终结果（SEER）肿瘤登记处提供数据 在乳腺癌的放射治疗和手术治疗方面， 提供化疗的信息。他们不需要收集这些 信息和肿瘤学家办公室的医疗记录， 化疗很可能是管理，可能不会定期审查， 关于癌症导向治疗的主要过程的数据。 医疗保险索赔是关于化疗使用的国家数据的潜在来源， 65岁及以上的乳腺癌病例。然而，没有任何研究检查了 这些信息的有效性。如果医疗保险索赔提供了准确和完整的 化疗的数据，它们对乳腺癌研究的效用将是 大幅度提高，从而能够对目前的人口状况进行分析， 化疗的使用以及社区的有效性研究。 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岁或以上的妇女， 在新墨西哥州肿瘤登记处（SEER）被诊断为乳腺癌 登记处），可以通过唯一标识符与Medicare索赔数据链接。 我们将与登记处签订合同， 所有机构中合格患者的化疗给药，包括 肿瘤科医生的办公室，那里的病人可能已经接受了化疗。我们 然后将比较医疗图表中关于使用化疗的信息， 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妇女 乳腺癌; 2）确定医疗保险数据是否可以区分 在化疗的具体方案;和3）以确定是否 索赔次数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 在老年人中使用医疗保险索赔进行化疗有效性研究， 被诊断为乳腺癌然后，我们将使用Medicare-SEER链接 所有SEER领域的数据，以检查化疗的模式和结果， 患有乳腺癌的老年妇女。从病历中生成的信息 回顾也将使我们能够检查独立的化疗护理模式 医疗保险索赔数据或独立的索赔，我们 find生成无效估计。

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.