Development and validation of coding algorithms to identify patients with incident lung cancer in United States healthcare claims data.
Pharmacoepidemiol Drug Saf
; 29(11): 1465-1479, 2020 11.
Article
in En
| MEDLINE
| ID: mdl-33012044
ABSTRACT
PURPOSE:
Our aim was to develop and validate a practical US healthcare claims algorithm for identifying incident lung cancer that improves on positive predictive value (PPV) and sensitivity observed in past studies.METHODS:
Patients newly diagnosed with lung cancer in Surveillance, Epidemiology, and End Results (SEER) (gold standard) were linked with Medicare claims. A 5% Medicare "other cancer" sample and noncancer sample served as controls. A split-sample validation approach was used. Rules-based, regression, and machine learning models for developing algorithms were explored. Algorithms were developed in the model building subset. Rules-based algorithms and those with the highest F scores were evaluated in the validation subset. F scores were compared for 1000 bootstrap samples. Misclassification was evaluated by calculating the odds of selection by the algorithm among true positives and true negatives.RESULTS:
A practical single-score algorithm derived from a logistic regression model had sensitivity = 78.22% and PPV = 78.50% (F score 78.36). The algorithm was most likely to misclassify older patients (ages ≥80 years) or with missing data in the SEER registry, shorter follow-up time in Medicare (<3 months), insurance through Veterans Affairs, >1 cancer in SEER, or certain Charlson comorbidities (dementia, chronic pulmonary disease, liver disease, or myocardial infarction).CONCLUSION:
In this dataset, a practical point-based algorithm for identifying incident lung cancer demonstrated significant and substantial improvement (7.9% and 23.9% absolute improvement in sensitivity and PPV, respectively) compared with a current standard.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Medicare
/
Lung Neoplasms
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Aged
/
Aged80
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
Pharmacoepidemiol Drug Saf
Journal subject:
EPIDEMIOLOGIA
/
TERAPIA POR MEDICAMENTOS
Year:
2020
Document type:
Article
Affiliation country: