TY - JOUR
T1 - Muddy water? Variation in reporting receipt of breast cancer radiation therapy by population-based tumor registries
AU - Walker, Gary V.
AU - Giordano, Sharon H.
AU - Williams, Melanie
AU - Jiang, Jing
AU - Niu, Jiangong
AU - Mackinnon, Jill
AU - Anderson, Patricia
AU - Wohler, Brad
AU - Sinclair, Amber H.
AU - Boscoe, Francis P.
AU - Schymura, Maria J.
AU - Buchholz, Thomas A.
AU - Smith, Benjamin D.
N1 - Funding Information:
B.D.S. and S.H.G. are supported by Grant RP101207 from the Cancer Prevention and Research Institute of Texas . This study was also supported in part by the US Department of Health and Human Services National Cancer Institute (Grants CA16672 and T32CA77050 ). A portion of this work was also supported by a philanthropic contribution from Ann and Clarence Cazalot . M.J.S. is supported by Cooperative Agreement S3888 from the Association of Schools of Public Health/Centers for Disease Control supporting the New York–Medicare linkage.
PY - 2013/7/15
Y1 - 2013/7/15
N2 - Purpose: To evaluate, in the setting of breast cancer, the accuracy of registry radiation therapy (RT) coding compared with the gold standard of Medicare claims. Methods and Materials: Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified 73,077 patients aged ≥66 years diagnosed with breast cancer in the period 2001-2007. Underascertainment (1 - sensitivity), sensitivity, specificity, κ, and χ2 were calculated for RT receipt determined by registry data versus claims. Multivariate logistic regression characterized patient, treatment, and geographic factors associated with underascertainment of RT. Findings in the SEER-Medicare registries were compared with three non-SEER registries (Florida, New York, and Texas). Results: In the SEER-Medicare registries, 41.6% (n=30,386) of patients received RT according to registry coding, versus 49.3% (n=36,047) according to Medicare claims (P<.001). Underascertainment of RT was more likely if patients resided in a newer SEER registry (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.60-1.80; P<.001), rural county (OR 1.34, 95% CI 1.21-1.48; P<.001), or if RT was delayed (OR 1.006/day, 95% CI 1.006-1.007; P<.001). Underascertainment of RT receipt in SEER registries was 18.7% (95% CI 18.6-18.8%), compared with 44.3% (95% CI 44.0-44.5%) in non-SEER registries. Conclusions: Population-based tumor registries are highly variable in ascertainment of RT receipt and should be augmented with other data sources when evaluating quality of breast cancer care. Future work should identify opportunities for the radiation oncology community to partner with registries to improve accuracy of treatment data.
AB - Purpose: To evaluate, in the setting of breast cancer, the accuracy of registry radiation therapy (RT) coding compared with the gold standard of Medicare claims. Methods and Materials: Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified 73,077 patients aged ≥66 years diagnosed with breast cancer in the period 2001-2007. Underascertainment (1 - sensitivity), sensitivity, specificity, κ, and χ2 were calculated for RT receipt determined by registry data versus claims. Multivariate logistic regression characterized patient, treatment, and geographic factors associated with underascertainment of RT. Findings in the SEER-Medicare registries were compared with three non-SEER registries (Florida, New York, and Texas). Results: In the SEER-Medicare registries, 41.6% (n=30,386) of patients received RT according to registry coding, versus 49.3% (n=36,047) according to Medicare claims (P<.001). Underascertainment of RT was more likely if patients resided in a newer SEER registry (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.60-1.80; P<.001), rural county (OR 1.34, 95% CI 1.21-1.48; P<.001), or if RT was delayed (OR 1.006/day, 95% CI 1.006-1.007; P<.001). Underascertainment of RT receipt in SEER registries was 18.7% (95% CI 18.6-18.8%), compared with 44.3% (95% CI 44.0-44.5%) in non-SEER registries. Conclusions: Population-based tumor registries are highly variable in ascertainment of RT receipt and should be augmented with other data sources when evaluating quality of breast cancer care. Future work should identify opportunities for the radiation oncology community to partner with registries to improve accuracy of treatment data.
UR - https://www.scopus.com/pages/publications/84879232430
UR - https://www.scopus.com/pages/publications/84879232430#tab=citedBy
U2 - 10.1016/j.ijrobp.2013.03.016
DO - 10.1016/j.ijrobp.2013.03.016
M3 - Article
C2 - 23773392
AN - SCOPUS:84879232430
SN - 0360-3016
VL - 86
SP - 686
EP - 693
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 4
ER -