Validation of Medicare Claims Data for Mammography

乳房 X 光检查的医疗保险索赔数据验证

基本信息

批准号：
8244989
负责人：
Joshua J Fenton
金额：
$ 17.16万
依托单位：
UNIVERSITY OF CALIFORNIA AT DAVIS
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-01 至 2014-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8244989
关键词：
Algorithms Breast Breast Cancer Surveillance Consortium Cancer Detection Catchment Area Classification Clinical Code Congresses Data Data Element Data Sources Diagnostic Diffusion Digital Computers Digital Mammography Economics Enrollment Evaluation Event Evolution Fees Film Gold Health Information Systems Link Malignant Neoplasms Mammography Measures Medicare Medicare claim NIH Program Announcements Patient Noncompliance Patients Performance Policies Population Procedures Recording of previous events Reference Standards Reporting Research Sampling Screening procedure Technology Testing Ultrasonography Uncertainty Update Validation Woman aged base comparative effectiveness computer aided detection digital economic impact effectiveness research follow-up improved malignant breast neoplasm public health priorities public health relevance radiologist research clinical testing response

项目摘要

DESCRIPTION (provided by applicant): Over one-half of incident breast cancers occur among Medicare-enrolled women, and Medicare enrollees receive approximately one-third of all screening mammograms nationwide (~13 million annual mammograms). Thus, improving the quality of screening mammography received by Medicare enrollees remains a public health priority. In 2001, Congress extended Medicare coverage to digital mammography and the application of computer-aided detection (CAD) during screening mammography. Rigorous evaluation of the clinical and economic impact of dissemination these technologies within the Medicare population have substantial policy significance. Although Medicare claims could be fruitful data source for such evaluations, uncertainty remains about the validity of key data elements. The Program Announcement, "Cancer Surveillance Using Health Claims-based Data System," calls for research to expand the scientific utility of Medicare claims files. In response, this study will use the newly linked Breast Cancer Surveillance Consortium (BCSC)-Medicare data to validate critical data elements of Medicare mammography claims and to evaluate the performance of claims-based algorithms for distinguishing screening from diagnostic mammograms and normal from abnormal radiologist interpretations. Specific aims are: 1) To refine and validate a promising claims-based algorithm to distinguish screening from diagnostic mammograms. 2) To externally validate claims procedure codes for digital mammography and computer-aided detection (CAD). 3) To develop and validate a claims-based algorithm to distinguish whether screening mammograms were interpreted as normal vs. abnormal. Analyses will demonstrate the potential utility of the claims algorithms for comparative effectiveness research or radiologist-level quality assessment in the context of mammography technology diffusion. PUBLIC HEALTH RELEVANCE: This study may provide essential methodological support for subsequent claims-based comparative effectiveness, economic, quality improvement research related to mammography. By elucidating the strengths and weaknesses of the claims data, study findings may also direct programmatic efforts to improve the quality of Medicare claims data.

描述（由申请人提供）：在医疗保险注册的妇女中发生了超过一半的事件乳腺癌，而Medicare Pronolles在全国范围内大约有三分之一的乳房X光检查（约1300万次年度乳房X光检查）。因此，提高医疗保险参与者收到的乳房X线摄影的质量仍然是公共卫生的重中之重。 2001年，国会将Medicare覆盖范围扩展到数字乳房X线摄影以及筛查乳房X线摄影过程中计算机辅助检测（CAD）的应用。对传播的临床和经济影响进行严格评估，这些技术在医疗保险人群中具有实质性的政策意义。尽管Medicare主张可能是此类评估的富有成效的数据来源，但有关关键数据元素的有效性仍然存在不确定性。计划公告“使用基于健康索赔的数据系统的癌症监视”呼吁进行研究以扩大Medicare索赔文件的科学实用性。作为回应，这项研究将使用新连接的乳腺癌监视联盟（BCSC） - 梅医学数据来验证Medicare乳腺检查主张的关键数据元素，并评估基于索赔的算法的性能，以区分筛查，以将筛查与诊断乳腺检查和正常的诊断性乳腺检查和正常的放射性放射学家解释。具体目的是：1）完善和验证有希望的基于索赔的算法，以区分筛查与诊断乳房X线照片。 2）外部验证索赔程序代码数字乳房X线摄影和计算机辅助检测（CAD）。 3）开发和验证基于索赔的算法，以区分筛查乳房X线照片是否被解释为正常和异常。分析将证明在乳房X线摄影技术扩散的背景下，主张算法对比较有效性研究或放射科医师级质量评估的潜在效用。公共卫生相关性：这项研究可能会为随后的基于索赔的比较有效性，与乳房X线摄影相关的经济，质量改善研究提供基本的方法学支持。通过阐明索赔数据的优势和劣势，研究结果还可以指导计划努力以提高Medicare索赔数据的质量。