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Association between cancer‐specific adverse event triggers and mortality: A validation study

BACKGROUND: As there are few validated measures of patient safety in clinical oncology, creating an efficient measurement instrument would create significant value. Accordingly, we sought to assess the validity of a novel patient safety measure by examining the association of oncology‐specific trigg...

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Autores principales: Weingart, Saul N., Nelson, Jason, Koethe, Benjamin, Yaghi, Omar, Dunning, Stephan, Feldman, Albert, Kent, David, Lipitz‐Snyderman, Allison
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300390/
https://www.ncbi.nlm.nih.gov/pubmed/32285614
http://dx.doi.org/10.1002/cam4.3033
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author Weingart, Saul N.
Nelson, Jason
Koethe, Benjamin
Yaghi, Omar
Dunning, Stephan
Feldman, Albert
Kent, David
Lipitz‐Snyderman, Allison
author_facet Weingart, Saul N.
Nelson, Jason
Koethe, Benjamin
Yaghi, Omar
Dunning, Stephan
Feldman, Albert
Kent, David
Lipitz‐Snyderman, Allison
author_sort Weingart, Saul N.
collection PubMed
description BACKGROUND: As there are few validated measures of patient safety in clinical oncology, creating an efficient measurement instrument would create significant value. Accordingly, we sought to assess the validity of a novel patient safety measure by examining the association of oncology‐specific triggers and mortality using administrative claims data. METHODS: We examined a retrospective cohort of 322 887 adult cancer patients enrolled in commercial or Medicare Advantage products for one year after an initial diagnosis of breast, colorectal, lung, or prostate cancer in 2008‐2014. We used diagnosis and procedure codes to calculate the prevalence of 16 cancer‐specific "triggers"–events that signify a potential adverse event. We compared one‐year mortality rates among patients with and without triggers by cancer type and metastatic status using logistic regression models. RESULTS: Trigger events affected 19% of patients and were most common among patients with metastatic colorectal (41%) and lung (50%) cancers. There was increased one‐year mortality among patients with triggers compared to patients without triggers across all cancer types in unadjusted and multivariate analyses. The increased mortality rate among patients with trigger events was particularly striking for nonmetastatic prostate cancer (1.3% vs 7.5%, adjusted odds ratio 1.96 [95% CI 1.49‐2.57]) and nonmetastatic colorectal cancer (4.1% vs 11.7%, 1.44 [1.19‐1.75]). CONCLUSIONS: The association between adverse event triggers and poor survival among a cohort of cancer patients supports the validity of a cancer‐specific, administrative claims‐based trigger tool.
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spelling pubmed-73003902020-06-18 Association between cancer‐specific adverse event triggers and mortality: A validation study Weingart, Saul N. Nelson, Jason Koethe, Benjamin Yaghi, Omar Dunning, Stephan Feldman, Albert Kent, David Lipitz‐Snyderman, Allison Cancer Med Cancer Prevention BACKGROUND: As there are few validated measures of patient safety in clinical oncology, creating an efficient measurement instrument would create significant value. Accordingly, we sought to assess the validity of a novel patient safety measure by examining the association of oncology‐specific triggers and mortality using administrative claims data. METHODS: We examined a retrospective cohort of 322 887 adult cancer patients enrolled in commercial or Medicare Advantage products for one year after an initial diagnosis of breast, colorectal, lung, or prostate cancer in 2008‐2014. We used diagnosis and procedure codes to calculate the prevalence of 16 cancer‐specific "triggers"–events that signify a potential adverse event. We compared one‐year mortality rates among patients with and without triggers by cancer type and metastatic status using logistic regression models. RESULTS: Trigger events affected 19% of patients and were most common among patients with metastatic colorectal (41%) and lung (50%) cancers. There was increased one‐year mortality among patients with triggers compared to patients without triggers across all cancer types in unadjusted and multivariate analyses. The increased mortality rate among patients with trigger events was particularly striking for nonmetastatic prostate cancer (1.3% vs 7.5%, adjusted odds ratio 1.96 [95% CI 1.49‐2.57]) and nonmetastatic colorectal cancer (4.1% vs 11.7%, 1.44 [1.19‐1.75]). CONCLUSIONS: The association between adverse event triggers and poor survival among a cohort of cancer patients supports the validity of a cancer‐specific, administrative claims‐based trigger tool. John Wiley and Sons Inc. 2020-04-13 /pmc/articles/PMC7300390/ /pubmed/32285614 http://dx.doi.org/10.1002/cam4.3033 Text en © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Prevention
Weingart, Saul N.
Nelson, Jason
Koethe, Benjamin
Yaghi, Omar
Dunning, Stephan
Feldman, Albert
Kent, David
Lipitz‐Snyderman, Allison
Association between cancer‐specific adverse event triggers and mortality: A validation study
title Association between cancer‐specific adverse event triggers and mortality: A validation study
title_full Association between cancer‐specific adverse event triggers and mortality: A validation study
title_fullStr Association between cancer‐specific adverse event triggers and mortality: A validation study
title_full_unstemmed Association between cancer‐specific adverse event triggers and mortality: A validation study
title_short Association between cancer‐specific adverse event triggers and mortality: A validation study
title_sort association between cancer‐specific adverse event triggers and mortality: a validation study
topic Cancer Prevention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300390/
https://www.ncbi.nlm.nih.gov/pubmed/32285614
http://dx.doi.org/10.1002/cam4.3033
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