Emilie D Duchesneau, Til Stürmer, Katherine Reeder-Hayes, Dae Hyun Kim, Jessie K Edwards, Keturah R Faurot, Jennifer L Lund
{"title":"Impact of Lookback Duration on the Performance of a Claims-Based Frailty Proxy in Women With Stage I-III Breast Cancer.","authors":"Emilie D Duchesneau, Til Stürmer, Katherine Reeder-Hayes, Dae Hyun Kim, Jessie K Edwards, Keturah R Faurot, Jennifer L Lund","doi":"10.1002/pds.70103","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Frailty is an important prognostic indicator in older women with breast cancer. The Faurot frailty index, a validated claims-based frailty proxy measure, uses healthcare billing codes during a user-specified ascertainment window to predict frailty. We assessed how the duration of frailty ascertainment affected the ability of the Faurot frailty index to predict one-year mortality in women with stage I-II breast cancer.</p><p><strong>Methods: </strong>We included 128 857 women (66+ years) with stage I-III breast cancer in the SEER-Medicare database (2003-2019). The Faurot frailty index was calculated using 3-, 6-, 8-, and 12-month ascertainment windows prior to diagnosis or using all-available lookback. Associations between the Faurot frailty index using each window and one-year all-cause mortality were estimated using Kaplan-Meier curves. Discrimination of one-year mortality risk was assessed using C-statistics.</p><p><strong>Results: </strong>Five percent of women died during the year following diagnosis. Higher Faurot scores were associated with increased mortality risk for all frailty ascertainment windows. Differences in one-year mortality risk for women with high vs. low Faurot frailty scores were reduced when using all-available lookback (16% vs. 2%, difference = 15%, 95% CI 0.14-0.15) compared to shorter windows (e.g., 8 months: 25% vs. 2%, difference = 23%, 95% CI 0.22-0.24). C-statistics ranged from 0.758 (all-available lookback) to 0.770 (12 months) and were robust in subgroups defined by age, race, ethnicity, region, stage, and cancer subtype.</p><p><strong>Conclusions: </strong>The Faurot frailty index performed well across 3- to 12-month frailty ascertainment windows in women with breast cancer. Researchers should employ this index to address confounding by frailty in studies of cancer populations.</p>","PeriodicalId":19782,"journal":{"name":"Pharmacoepidemiology and Drug Safety","volume":"34 2","pages":"e70103"},"PeriodicalIF":2.4000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pharmacoepidemiology and Drug Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pds.70103","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Frailty is an important prognostic indicator in older women with breast cancer. The Faurot frailty index, a validated claims-based frailty proxy measure, uses healthcare billing codes during a user-specified ascertainment window to predict frailty. We assessed how the duration of frailty ascertainment affected the ability of the Faurot frailty index to predict one-year mortality in women with stage I-II breast cancer.
Methods: We included 128 857 women (66+ years) with stage I-III breast cancer in the SEER-Medicare database (2003-2019). The Faurot frailty index was calculated using 3-, 6-, 8-, and 12-month ascertainment windows prior to diagnosis or using all-available lookback. Associations between the Faurot frailty index using each window and one-year all-cause mortality were estimated using Kaplan-Meier curves. Discrimination of one-year mortality risk was assessed using C-statistics.
Results: Five percent of women died during the year following diagnosis. Higher Faurot scores were associated with increased mortality risk for all frailty ascertainment windows. Differences in one-year mortality risk for women with high vs. low Faurot frailty scores were reduced when using all-available lookback (16% vs. 2%, difference = 15%, 95% CI 0.14-0.15) compared to shorter windows (e.g., 8 months: 25% vs. 2%, difference = 23%, 95% CI 0.22-0.24). C-statistics ranged from 0.758 (all-available lookback) to 0.770 (12 months) and were robust in subgroups defined by age, race, ethnicity, region, stage, and cancer subtype.
Conclusions: The Faurot frailty index performed well across 3- to 12-month frailty ascertainment windows in women with breast cancer. Researchers should employ this index to address confounding by frailty in studies of cancer populations.
背景：虚弱是老年乳腺癌患者预后的重要指标。Faurot虚弱指数是一种有效的基于索赔的虚弱代理度量，在用户指定的确定窗口期间使用医疗保健计费代码来预测虚弱。我们评估了衰弱确定的持续时间如何影响Faurot衰弱指数预测I-II期乳腺癌妇女一年死亡率的能力。方法：我们在SEER-Medicare数据库（2003-2019）中纳入12857名66岁以上的I-III期乳腺癌女性。采用诊断前3个月、6个月、8个月和12个月的确定窗口或使用所有可用的回顾来计算Faurot衰弱指数。使用Kaplan-Meier曲线估计每个窗口的Faurot衰弱指数与一年全因死亡率之间的关联。采用c统计方法评估1年死亡风险的区别性。结果：5%的女性在确诊后的一年内死亡。高Faurot评分与所有虚弱确定窗口的死亡风险增加相关。与较短的窗口期（例如，8个月：25%对2%，差异= 23%,95% CI 0.22-0.24）相比，采用全可回溯法（16%对2%，差异= 15%,95% CI 0.14-0.15）降低了福罗衰弱评分高与低的女性一年死亡风险的差异。c -统计量范围从0.758（全可用回顾）到0.770（12个月），并且在年龄、种族、民族、地区、分期和癌症亚型定义的亚组中是稳健的。结论：福罗衰弱指数在乳腺癌妇女3- 12个月的衰弱确定窗口期表现良好。研究人员应该利用这一指数来解决癌症人群研究中脆弱造成的混淆。
期刊介绍：
The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report.
Particular areas of interest include:
design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology;
comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world;
methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology;
assessments of harm versus benefit in drug therapy;
patterns of drug utilization;
relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines;
evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
