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Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases
BACKGROUND: Healthcare claims databases have been used in several studies to characterize the risk and burden of chemotherapy-induced febrile neutropenia (FN) and effectiveness of colony-stimulating factors against FN. The accuracy of methods previously used to identify FN in such databases has not...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576237/ https://www.ncbi.nlm.nih.gov/pubmed/23406481 http://dx.doi.org/10.1186/1472-6963-13-60 |
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author | Weycker, Derek Sofrygin, Oleg Seefeld, Kim Deeter, Robert G Legg, Jason Edelsberg, John |
author_facet | Weycker, Derek Sofrygin, Oleg Seefeld, Kim Deeter, Robert G Legg, Jason Edelsberg, John |
author_sort | Weycker, Derek |
collection | PubMed |
description | BACKGROUND: Healthcare claims databases have been used in several studies to characterize the risk and burden of chemotherapy-induced febrile neutropenia (FN) and effectiveness of colony-stimulating factors against FN. The accuracy of methods previously used to identify FN in such databases has not been formally evaluated. METHODS: Data comprised linked electronic medical records from Geisinger Health System and healthcare claims data from Geisinger Health Plan. Subjects were classified into subgroups based on whether or not they were hospitalized for FN per the presumptive “gold standard” (ANC <1.0×10(9)/L, and body temperature ≥38.3°C or receipt of antibiotics) and claims-based definition (diagnosis codes for neutropenia, fever, and/or infection). Accuracy was evaluated principally based on positive predictive value (PPV) and sensitivity. RESULTS: Among 357 study subjects, 82 (23%) met the gold standard for hospitalized FN. For the claims-based definition including diagnosis codes for neutropenia plus fever in any position (n=28), PPV was 100% and sensitivity was 34% (95% CI: 24–45). For the definition including neutropenia in the primary position (n=54), PPV was 87% (78–95) and sensitivity was 57% (46–68). For the definition including neutropenia in any position (n=71), PPV was 77% (68–87) and sensitivity was 67% (56–77). CONCLUSIONS: Patients hospitalized for chemotherapy-induced FN can be identified in healthcare claims databases--with an acceptable level of mis-classification--using diagnosis codes for neutropenia, or neutropenia plus fever. |
format | Online Article Text |
id | pubmed-3576237 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-35762372013-02-20 Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases Weycker, Derek Sofrygin, Oleg Seefeld, Kim Deeter, Robert G Legg, Jason Edelsberg, John BMC Health Serv Res Research Article BACKGROUND: Healthcare claims databases have been used in several studies to characterize the risk and burden of chemotherapy-induced febrile neutropenia (FN) and effectiveness of colony-stimulating factors against FN. The accuracy of methods previously used to identify FN in such databases has not been formally evaluated. METHODS: Data comprised linked electronic medical records from Geisinger Health System and healthcare claims data from Geisinger Health Plan. Subjects were classified into subgroups based on whether or not they were hospitalized for FN per the presumptive “gold standard” (ANC <1.0×10(9)/L, and body temperature ≥38.3°C or receipt of antibiotics) and claims-based definition (diagnosis codes for neutropenia, fever, and/or infection). Accuracy was evaluated principally based on positive predictive value (PPV) and sensitivity. RESULTS: Among 357 study subjects, 82 (23%) met the gold standard for hospitalized FN. For the claims-based definition including diagnosis codes for neutropenia plus fever in any position (n=28), PPV was 100% and sensitivity was 34% (95% CI: 24–45). For the definition including neutropenia in the primary position (n=54), PPV was 87% (78–95) and sensitivity was 57% (46–68). For the definition including neutropenia in any position (n=71), PPV was 77% (68–87) and sensitivity was 67% (56–77). CONCLUSIONS: Patients hospitalized for chemotherapy-induced FN can be identified in healthcare claims databases--with an acceptable level of mis-classification--using diagnosis codes for neutropenia, or neutropenia plus fever. BioMed Central 2013-02-13 /pmc/articles/PMC3576237/ /pubmed/23406481 http://dx.doi.org/10.1186/1472-6963-13-60 Text en Copyright ©2013 Weycker et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Weycker, Derek Sofrygin, Oleg Seefeld, Kim Deeter, Robert G Legg, Jason Edelsberg, John Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases |
title | Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases |
title_full | Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases |
title_fullStr | Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases |
title_full_unstemmed | Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases |
title_short | Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases |
title_sort | technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576237/ https://www.ncbi.nlm.nih.gov/pubmed/23406481 http://dx.doi.org/10.1186/1472-6963-13-60 |
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