Evaluation of Chemotherapy Claims for Breast Cancer

描述(申请人提供)：在过去的几十年里，无数 临床试验一直证明化疗是有效的。 在患有乳腺癌的绝经前和绝经后妇女中。然而， 对化疗的使用及其在卵巢癌中的有效性知之甚少 由于缺乏大量的以人口为基础的数据，这一数据在社区中占主导地位。而当 监测、流行病学和最终结果(SEER)肿瘤登记提供数据 关于乳腺癌的放射治疗和外科治疗，他们没有 提供有关化疗的信息。他们不需要收集这个。 信息和肿瘤学家办公室的医疗记录，在那里 化疗可能会被实施，可能不会定期审查 关于癌症导向治疗的主要疗程的数据。 医疗保险声明是关于化疗用途的国家数据的潜在来源 65岁及以上的乳腺癌病例。然而，还没有研究检查过 此信息的有效性。如果医疗保险索赔提供了准确和完整的 关于化疗的数据，它们对乳腺癌研究的效用将是 相当大的增强，允许对当前 化疗的使用以及社区的有效性研究。 因此，我们建议研究有关化疗的信息的实用性。 来自已确诊的65岁及以上女性的联邦医疗保险索赔数据 患有乳腺癌。 我们的方法是识别65岁或以上的女性 新墨西哥州肿瘤登记处(SEER)诊断为乳腺癌 注册表)，它可以通过唯一标识符链接到联邦医疗保险索赔数据。 我们将与注册处签订合同，将医疗记录 在所有设施中为符合条件的患者进行化疗，包括 肿瘤内科医生的办公室，病人可能在那里接受了化疗。我们 然后会比较医疗病历中有关化疗使用的信息 使用从联邦医疗保险索赔数据中获得的信息进行审核。我们的目标是1) 确定联邦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)确定医疗保险数据是否可以区分 在具体的化疗方案中；以及3)确定是否 索赔的数量可以用来估计化疗周期的数量。 根据这些信息，我们将描述错误的性质和程度 在老年人群中利用医疗保险索赔进行化疗效果研究 被诊断出患有乳腺癌的女性。然后我们将使用Medicare-SEER链接 所有SEER地区的数据，以检查化疗的模式和结果 患有乳腺癌的老年女性。从病历生成的信息 审查还将使我们能够检查独立于化疗护理的模式 联邦医疗保险索赔数据或独立于我们的那些索赔部分 查找生成无效预估。

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.