使用病历回顾验证基于行政索赔的卵巢癌妇女治疗路线算法。

IF 3.4 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Daniel Simmons, John White, Valery Walker, Stephanie V Blank, Jiefen Munley, Kimmie McLaurin
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引用次数: 0

摘要

导言:治疗晚期卵巢癌的新维持疗法增加了现实世界证据(RWE)研究中确定治疗线(lot)的复杂性。本研究评估了一种基于索赔的算法的性能,该算法使用病历回顾验证在卵巢癌患者中识别lot。方法:该算法以前是利用Optum研究数据库(ORD)开发的,该数据库是一个包含行政索赔数据的美国数据库。为了验证算法,在患者水平上通过计算活跃和维持批次总数、治疗类型(新辅助与辅助分类)和方案类型(单个药物)之间的一致性百分比来比较使用索赔数据和图表数据生成的LOT结果。2014年12月1日至2017年9月15日期间开始化疗的卵巢癌诊断患者被纳入研究。我们报告了描述性统计,医疗记录和索赔数据之间的对应百分比,以及kappa统计来衡量一致性的程度。结果:共纳入294例患者;164例患者仅接受化疗,未接受维持治疗,77例接受贝伐单抗治疗,53例接受聚(adp -核糖)聚合酶抑制剂(PARPi)治疗。平均年龄为64.9岁,其中47.3%为III期癌症。该算法表明,在主动和维持治疗的总线数方面,索赔与医疗记录之间存在实质性的一致性(加权kappa分别为0.65和0.62 p)。结论:我们验证了一种基于行政索赔的算法,该算法在识别卵巢癌患者的LOT方面与医疗记录具有很强的一致性。该算法可以应用于未来的研究,以分析治疗模式和结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Validation of an Administrative Claims-based Line of Therapy Algorithm for Women with Ovarian Cancer Using Medical Chart Review.

Introduction: New maintenance therapies to treat advanced ovarian cancer have added complexity to identifying lines of therapy (LOTs) for real-world evidence (RWE) studies. This study evaluated the performance of a claims-based algorithm that identifies LOTs among patients with ovarian cancer using medical chart review validation.

Methods: The algorithm was developed previously utilizing the Optum Research Database (ORD), a US database that contains administrative claims data. To validate the algorithm, LOT results generated using claims data vs chart data were compared at the patient level by calculating the percent agreement between total number of active and maintenance LOTs, type of therapy (neoadjuvant vs adjuvant classification), and type of regimen (individual drugs). Patients with a diagnosis of ovarian cancer who initiated chemotherapy between December 1, 2014, and September 15, 2017, were included in the study. We report descriptive statistics, the percentage correspondence between medical records and claims data, and kappa statistics to measure the magnitude of agreement.

Results: A total of 294 patients were included in the analysis; 164 received only chemotherapy and no maintenance, 77 received bevacizumab, and 53 patients received poly (ADP-ribose) polymerase inhibitors (PARPi). Mean age was 64.9 years, and 47.3% had stage III cancer. The algorithm demonstrated substantial agreement between claims and medical records for total number of lines of active and maintenance therapy (weighted kappa 0.65 and 0.62 p < 0.0001). There was moderate-to-substantial agreement for neoadjuvant and adjuvant therapy (kappa 0.56 and 0.62 p < 0.0001). The algorithm performed best at identifying early treatment with a regimen match of 82% and 88% agreement for first-line active and first-line maintenance, respectively.

Conclusion: We validated an administrative claims-based algorithm that demonstrates strong concordance with medical records for identifying LOT among patients with ovarian cancer. The algorithm can be applied in future studies to analyze treatment patterns and outcomes.

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来源期刊
Advances in Therapy
Advances in Therapy 医学-药学
CiteScore
7.20
自引率
2.60%
发文量
353
审稿时长
6-12 weeks
期刊介绍: Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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