Document Detail

Muddy water? Variation in reporting receipt of breast cancer radiation therapy by population-based tumor registries.
MedLine Citation:
PMID:  23773392     Owner:  NLM     Status:  MEDLINE    
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 χ(2) 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.
Gary V Walker; Sharon H Giordano; Melanie Williams; Jing Jiang; Jiangong Niu; Jill MacKinnon; Patricia Anderson; Brad Wohler; Amber H Sinclair; Francis P Boscoe; Maria J Schymura; Thomas A Buchholz; Benjamin D Smith
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  86     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-18     Completed Date:  2013-08-22     Revised Date:  2014-07-20    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  686-93     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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MeSH Terms
Aged, 80 and over
Breast Neoplasms / pathology,  radiotherapy*
Chi-Square Distribution
Clinical Coding / standards*
Medicare / standards,  statistics & numerical data
New York
Registries / standards*,  statistics & numerical data
SEER Program / standards,  statistics & numerical data
Sensitivity and Specificity
United States
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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