从新型癌症护理质量计划中获取的临床数据的验证与行政索赔数据直接集成。

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL Pragmatic and Observational Research Pub Date : 2017-08-26 eCollection Date: 2017-01-01 DOI:10.2147/POR.S140579
David M Kern, John J Barron, Bingcao Wu, Alex Ganetsky, Vincent J Willey, Ralph A Quimbo, Michael J Fisch, Joseph Singer, Ann Nguyen, Ronac Mamtani
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引用次数: 8

摘要

背景:来自癌症护理质量计划的数据直接与行政索赔数据相结合,以提供基于索赔的研究中无法获得的临床细节水平,并被称为HealthCore综合研究环境(HIRE)-肿瘤学数据。本研究评估了HIRE-Oncology数据与乳腺癌、肺癌和结直肠癌患者医疗记录的有效性。方法:数据元素包括癌症类型、分期、组织学(仅肺)和生物标志物。在HIRE-Oncology数据中选取了300例乳腺癌、200例肺癌和200例结直肠癌患者作为样本进行医疗记录审查。有效性的统计度量(一致性、阳性预测值[PPV]、阴性预测值[NPV]、敏感性、特异性)用于比较数据源之间的临床信息,病历数据被认为是金标准。结果:300例乳腺癌病例全部确诊为乳腺癌,肺癌病例197例,结直肠癌病例197例(PPV均为0.99)。乳腺癌的疾病分期一致性为85%,肺癌为90%,结直肠癌为94%。肺癌组织学(小细胞与非小细胞)的一致性为97%。孕激素受体、雌激素受体和人表皮生长因子受体2状态生物标志物在乳腺癌中的一致性分别为92%、97%和92%;肺表皮生长因子受体与间变性淋巴瘤激酶的一致性分别为97%和92%;KRAS状态在结直肠癌中的一致性为95%。PPV、NPV、敏感性和特异性的测量同样显示出强有力的有效性证据。结论:HIRE-Oncology数据与医疗记录之间的良好一致性支持了这些数据在研究中的有效性。
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A validation of clinical data captured from a novel Cancer Care Quality Program directly integrated with administrative claims data.

Background: Data from a Cancer Care Quality Program are directly integrated with administrative claims data to provide a level of clinical detail not available in claims-based studies, and referred to as the HealthCore Integrated Research Environment (HIRE)-Oncology data. This study evaluated the validity of the HIRE-Oncology data compared with medical records of breast, lung, and colorectal cancer patients.

Methods: Data elements included cancer type, stage, histology (lung only), and biomarkers. A sample of 300 breast, 200 lung, and 200 colorectal cancer patients within the HIRE-Oncology data were identified for medical record review. Statistical measures of validity (agreement, positive predictive value [PPV], negative predictive value [NPV], sensitivity, specificity) were used to compare clinical information between data sources, with medical record data considered the gold standard.

Results: All 300 breast cancer records reviewed were confirmed breast cancer, while 197 lung and 197 colorectal records were confirmed (PPV =0.99 for each). The agreement of disease stage was 85% for breast, 90% for lung, and 94% for colorectal cancer. The agreement of lung cancer histology (small cell vs non-small cell) was 97%. Agreement of progesterone receptor, estrogen receptor, and human epidermal growth factor receptor 2 status biomarkers in breast cancer was 92%, 97%, and 92%, respectively; epidermal growth factor receptor and anaplastic lymphoma kinase agreement in lung was 97% and 92%, respectively; and agreement of KRAS status in colorectal cancer was 95%. Measures of PPV, NPV, sensitivity, and specificity showed similarly strong evidence of validity.

Conclusion: Good agreement between the HIRE-Oncology data and medical records supports the validity of these data for research.

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Pragmatic and Observational Research
Pragmatic and Observational Research MEDICINE, GENERAL & INTERNAL-
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期刊介绍: Pragmatic and Observational Research is an international, peer-reviewed, open-access journal that publishes data from studies designed to closely reflect medical interventions in real-world clinical practice, providing insights beyond classical randomized controlled trials (RCTs). While RCTs maximize internal validity for cause-and-effect relationships, they often represent only specific patient groups. This journal aims to complement such studies by providing data that better mirrors real-world patients and the usage of medicines, thus informing guidelines and enhancing the applicability of research findings across diverse patient populations encountered in everyday clinical practice.
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