Quantifying under-reporting of pathology tests in Medical Benefits Schedule claims data

2013 ◽  
Vol 37 (5) ◽  
pp. 649 ◽  
Author(s):  
Judy A. Trevena ◽  
Kris D. Rogers ◽  
Louisa R. Jorm ◽  
Tim Churches ◽  
Bruce Armstrong
Keyword(s):  
Prostate Specific Antigen ◽  
Test Item ◽  
Screening Test ◽  
Claims Data ◽  
Specific Antigen ◽  
Psa Test ◽  
Australian Health ◽  
Psa Screening ◽  
Episode Of Care ◽  
Medical Benefits

Objective We investigated the completeness of recording of pathology tests in Australian Medical Benefits Schedule (MBS) claims data, using the example of the prostate-specific antigen (PSA) test. With some exceptions, MBS claims data records only the three most expensive pathology items in an episode of care, and this practice (‘episode coning’) means that pathology tests can be under-recorded. Methods The analysis used MBS data for male participants in the 45 and Up Study. The number and cost of items in each episode of care were used to determine whether an episode contained a PSA screening test (Item 66655), or could have lacked a record of this item because of episode coning. Results MBS data for 1 070 392 episodes involving a request for a pathology test for 118 074 men were analysed. Of these episodes, 11% contained a request for a PSA test; a further 7.5% may have been missing a PSA request that was not recorded because of episode coning. Conclusions It is important to consider under-reporting of pathology tests as a result of episode coning when interpreting MBS claims data. Episode coning creates uncertainty about whether a person has received any given pathology test. The extent of this uncertainty can be estimated by determining the proportion of episodes in which the test may have been performed but was not recorded due to episode coning. What is known about the topic? Medical Benefits Schedule (MBS) claims data are a key resource for Australian health researchers. What does this paper add? We investigated a feature of MBS claims data known as episode coning, which may cause some pathology tests to be under-reported. Using the example of requests for PSA tests, we estimated the uncertainty in the amount of use of PSA tests introduced by episode coning. What are the implications for practitioners? Researchers using MBS data to identify use of specific pathology tests need to be aware of under-reporting caused by episode coning, and to estimate and report the uncertainty that this introduces into their findings.

scholarly journals Patient Provider Continuity and Prostate Specific Antigen Testing: Impact of Continuity on Receipt of a Non-recommended Test

2021 ◽  
Vol 8 ◽  
Author(s):  
Arch G. Mainous ◽  
Benjamin J. Rooks ◽  
Elvira S. Mercado ◽  
Peter J. Carek
Keyword(s):  
Prostate Specific Antigen ◽  
Continuity Of Care ◽  
Specific Antigen ◽  
Behavioral Risk ◽  
Psa Test ◽  
Advantages And Disadvantages ◽  
Psa Screening ◽  
Personal Doctor ◽  
Nationally Representative ◽  
To Receive

Background: Continuity of care with a regular physician has been associated with treatment adherence but it is unclear if continuity of care may lead to inappropriate treatments. We assessed the relationship between the receipt of prostate-specific antigen (PSA) screening, a non-recommended test, and having continuity with a single personal doctor.Methods: We analyzed the 2016 and 2018 Behavioral Risk Factor Surveillance System (BRFSS). Responses from men aged 40 and older with no symptoms or family history of prostate cancer were analyzed (unweighted n = 232,548, representing 36,919,766 individuals). Continuity with one doctor was analyzed in relation to discussions of advantages and disadvantages of PSA tests, provider recommendation to receive a test and receipt of a PSA test.Results: 39.5% of men received PSA screening during the time that the test was not recommended. Having a single personal doctor was associated with discussion of both advantages (53.3 vs. 29.7%, p < 0.001) and disadvantages (24.2 vs. 13.5%, p < 0.001) of PSA tests but also a recommendation to receive a PSA test (45.3 vs. 29.3%, p < 0.001). The adjusted odds of receiving a PSA test was higher among those with a single personal doctor compared to those without (OR 2.31; 95% CI, 2.17–2.46).Conclusion: In a nationally representative sample during the time when PSA screening was not recommended by the US Preventive Services Taskforce, having a single personal doctor was associated with both recommendations for the test and receipt of the test. These findings emphasize the importance of the patient physician relationship and the need for evidence-based care.

scholarly journals Are Men Making Informed Decisions According to the Prostate-Specific Antigen Test Guidelines? Analysis of the 2015 Behavioral Risk Factor Surveillance System

2019 ◽  
Vol 13 (2) ◽  
pp. 155798831983484 ◽  
Author(s):  
Dexter L. Cooper ◽  
Latrice Rollins ◽  
Tanesha Slocumb ◽  
Brian M. Rivers
Keyword(s):  
Prostate Specific Antigen ◽  
Surveillance System ◽  
Specific Antigen ◽  
Future Research ◽  
Behavioral Risk ◽  
Adult Males ◽  
Psa Test ◽  
Advantages And Disadvantages ◽  
Psa Screening ◽  
Chi Square Analysis

The prostate-specific antigen (PSA) screening recommendation endorses the opportunity for men to make an informed decision about whether or not to screen. This entails speaking with a provider to discuss the potential advantages, disadvantages, and uncertainties about the PSA screening test. The purpose of this study was to examine (a) the reported level of being informed about the PSA test by race and (b) the association between the receipt of the PSA test and participants reporting that they were informed about the test. U.S. adult males (ages 40–74 years) were identified from the 2015 Behavioral Risk Factors Surveillance System (BRFSS; n = 3,877). Chi-square analysis assessed bivariate differences among men who received different levels of PSA screening information. Binomial logistic regression models assessed the relationship of race/ethnicity and the receipt of the PSA test on being informed about the PSA test. Over half (54.3%) of the sample had a PSA test and most (72.0%) reported that they did not receive information about both the advantages and disadvantages (being informed) of the PSA test. Black men (40.3%) were significantly most likely to report being informed ( p < .001), and 61.3% reported receipt of a recommendation from their provider ( p < .001). White men (63.1%) were significantly more likely to report receiving the PSA test. Findings indicate that more men reported receiving the PSA test than men who reported being informed about it. Future research and interventions should strive for men of all racial and ethnic backgrounds to be informed about the PSA test before making a decision.

scholarly journals PSA testing in general practice

2012 ◽  
Vol 4 (3) ◽  
pp. 199 ◽  
Author(s):  
Fraser Hodgson ◽  
Zuzana Obertová ◽  
Charis Brown ◽  
Ross Lawrenson
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Age Groups ◽  
Psa Test ◽  
Psa Screening ◽  
Psa Testing ◽  
Asymptomatic Patients ◽  
Keywords Prostate ◽  
General Practices

INTRODUCTION: In New Zealand, prostate-specific antigen (PSA) testing has increased significantly (275 000 tests/year). Controversy exists around PSA testing as part of an unorganised screening programme. AIM: To look at the use of PSA testing in a sample of general practices and investigate the reasons GPs undertake PSA testing. METHODS: Five Waikato general practices investigated looking at PSA laboratory tests of men =40 years in 2010 compared against GP notes. Testing rates, reasons for testing, histology and referral/s were examined for different age groups. A questionnaire was sent to the GPs to determine their views on PSA testing. RESULTS: One in four men aged 40+ years had a PSA test in 2010. Of these men, 71% were asymptomatic. More than half of men tested aged 70+ years were asymptomatic. Ten percent of all PSA tests were elevated. Twenty-one of 23 prostate cancers were diagnosed following an elevated PSA test: more than 80% of these men had histories of prostate pathology or lower urinary tract symptoms. The questionnaire confirmed that GPs believe in the benefits of PSA screening and it also showed they had difficulty in providing patients with information about pros and cons of PSA testing. DISCUSSION: All GPs in this study tested asymptomatic men. GPs in this study value PSA screening and believe that it reduces mortality rates. However, although PSA tests were most frequently done on asymptomatic patients, the majority of patients subsequently diagnosed with prostate cancer had been tested because of symptoms or had previous prostate problems. KEYWORDS: Prostate specific antigen (PSA); PSA testing; screening; prostate cancer; general practitioners

scholarly journals Relevance of nationwide prostate specific antigen screening test for prostate cancer

2020 ◽  
Vol 63 (11) ◽  
pp. 652-658
Author(s):  
Young Hwii Ko ◽  
Young Goo Lee
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Screening Test ◽  
Specific Antigen ◽  
Disease Stage ◽  
High Survival ◽  
Male Population ◽  
Western Countries ◽  
Psa Screening ◽  
Systemic Spread

The serum prostate specific antigen (PSA) screening test plays a pivotal role in the diagnosis of prostate cancer (PCa), especially for early detection, before symptoms of systemic spread. Even though clinical trials for the PSA screening test have demonstrated limited benefits with regard to patient survival, recent trends have shown a continuous decrease in the PCa mortality rate in Western countries. In many Asian countries where PSA screening has not yet been widely adopted, the screening strategy reduces the metastatic spread. While PCa became the 10th most common malignant disease in the Korean male population in 2000, recent national reports indicate that its increase in the last two decades have now made it the third most popular malignant condition. Due to the different epidemiologic background and limited social awareness of PCa compared to Western countries, the PSA screening test was not routinely performed in Korea, in contrast with other prevalent malignant diseases such as stomach, colon, and lung cancers. Therefore, only about a quarter of the patients newly diagnosed with PCa in Korea were found to have undergone repeated PSA screening. However, the screened population showed a higher probability of local rather than systemic treatment, which reflects an earlier disease stage at the time of diagnosis in comparison with their non-screened counterparts. Given the relatively high survival rate of PCa and the increasing lifespan of Korean males, the increase of PCa will accelerate, suggesting the clinical relevance of PSA screening as part of regular checkups for Korean males.

Prostate-specific antigen testing in the disabled population: A cross-sectional analysis of the Health Information National Trends Survey (HINTS).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17000-e17000
Author(s):  
Joon Yau Leong ◽  
Ruben Pinkhasov ◽  
Thenappan Chandrasekar ◽  
Oleg Shapiro ◽  
Michael Daneshvar ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Information ◽  
Prostate Specific Antigen ◽  
Healthcare Provider ◽  
Specific Antigen ◽  
Cross Sectional ◽  
Psa Screening ◽  
Psa Testing ◽  
The Usa ◽  
National Trends

e17000 Background: Disabled patients are a unique minority population that may have lower literacy levels and difficulty communicating with physicians. Furthermore, their knowledge for cancer prevention recommendations is unknown. Herein, we aim to compare prostate-specific antigen (PSA) testing rates and associated predictors among disabled men and non-disabled men in the USA. Methods: We performed a cross-sectional study utilizing the Health Information National Trends Survey (HINTS) to analyze factors predicting PSA testing rates in men with disabilities (disabled, deaf, blind). Multivariable logistic regression models were used to determine clinically significant predictors of PSA testing in men with disabilities compared to that of the healthy cohort. Results: A total of 782 (14.6%) disabled men were compared to 4,569 (85.4%) non-disabled men. Disabled men were older with a mean age of 65.0 ± 14.2 vs. 55.0 ± 15.9 years (p < 0.001). On multivariable analysis, after adjusting for all available confounders including race, age, geographical region, survey year, marital status, health insurance, healthcare provider, amongst others, men with any disability were less likely to undergo PSA screening (OR 0.772, 95% CI 0.623-0.956, p = 0.018). Variables associated with increased PSA screening rates included age, having a healthcare provider or health insurance, and living with a partner. Although prostate cancer detection rates were shown to be higher among disabled men, this did not reach statistical significance. Conclusions: Our data suggests that significant inequalities in PSA screening exist among men with disabilities in the USA, with disabled men, especially the deaf and the blind, being less likely to be offered PSA screening. There is a clear need to implement strategies to reduce existing gaps in the care of disabled men and strive to reach equality in PSA screening in this unique population.

THE ACCURACY AND EFFECTIVENESS OF ROUTINE POPULATION SCREENING WITH MAMMOGRAPHY, PROSTATE-SPECIFIC ANTIGEN, AND PRENATAL ULTRASOUND

2001 ◽  
Vol 17 (3) ◽  
pp. 275-304 ◽  
Author(s):  
Steven H. Woolf
Keyword(s):  
Breast Cancer ◽  
Prostate Specific Antigen ◽  
False Positive ◽  
Congenital Anomalies ◽  
Specific Antigen ◽  
Prenatal Ultrasound ◽  
Screening Tests ◽  
Published Data ◽  
Psa Screening ◽  
Abnormal Results

Objective: To review published data regarding the accuracy and effectiveness of three screening tests: mammography, prostate-specific antigen (PSA), and prenatal ultrasound.Methods: Published evidence regarding the accuracy and effectiveness of the three tests was collected by computerized literature search and supplemented by manual review of relevant bibliographies.Results: Screening mammograms lower breast cancer mortality by about 20%. Most data come from women aged 50–64 years; women aged 40–49 years may also benefit, but the absolute risk reduction is lower. Up to 1,500 to 2,500 women must undergo screening to prevent one death from breast cancer. Mammograms miss approximately 12% to 37% of cancers, generate false-positive results, and cause anxiety while abnormal results are evaluated. PSA screening can detect 80% to 85% of prostate cancers but has a high false-positive rate. There is little direct evidence that early detection reduces morbidity or mortality. Indirect evidence includes a trend toward earlier stage tumors and steadily declining mortality rates in geographic areas where PSA screening has become common. Potential harms include the morbidity associated with evaluating abnormal results, and complications from treatment (e.g., impotence, incontinence). The overall balance of benefits and harms remains uncertain in the absence of better evidence. Prenatal ultrasound may reduce perinatal mortality, primarily through elective abortions for congenital anomalies, but does not appear to lower live birth rates. Although ultrasound has no proven effect on neonatal morbidity, it provides more accurate estimates of gestational age that prevent unnecessary inductions for post-term pregnancy. Screening detects multiple gestations, congenital anomalies, and intrauterine growth retardation, but direct health benefits from having this knowledge are unproved. Ultrasound has both positive and negative psychological effects on parents. The scans do not appear to harm childhood development.Conclusions: Even for the most established screening tests, the appropriateness of routine testing depends on subjective value judgments about the quality of supporting evidence and about the trade-offs between benefits and harms. Individuals, clinicians, policy makers, and governments must weigh the evidence in light of these values and the constraints imposed by available resources.

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