Identification in Administrative Databases of Women Dying of Breast Cancer

2006 ◽  
Vol 24 (6) ◽  
pp. 856-862 ◽  
Author(s):  
Bruno Gagnon ◽  
Nancy E. Mayo ◽  
Carroll Laurin ◽  
James A. Hanley ◽  
Neil McDonald
Keyword(s):  
Breast Cancer ◽  
Health Services ◽  
Predictive Value ◽  
Chronic Care ◽  
Chart Review ◽  
Population Based ◽  
Place Of Death ◽  
Administrative Databases ◽  
Services Research

Purpose Palliative care is an essential component of cancer care, and population-based research is needed to monitor its impact. Administrative databases are the cornerstone of health services research. Their limitation is that cause of death is not sufficient to readily classify decedents as terminally ill for the study of the health services they received at the end of life. The study purpose is to develop and test the validity of an algorithm allowing the classification of the decedents as dying of breast cancer (BC), using administrative data. Methods Validation was carried out through a chart review of 119 BC decedents extracted from hospital-based databases. This algorithm was applied to 3,384 deceased women with BC representative of the whole population. The effect of the classification by the algorithm was illustrated by the shift in the distributions of age and place of death. Results The validation showed a sensitivity of 95%, a specificity of 89%, a positive predictive value of 98%, and negative predictive value of 77% for the classification of women dying of BC. Of the 3,384 decedents, 2,293 were classified as dying of, and 1,091 as not dying of BC. Women dying of BC were younger, died less often at home (6.9% v 17.9%), and in chronic care institutions (4.1% v 14.8%), and more often in acute-care beds (69.9% v 57.1%). Conclusion This novel way to classify decedents is conceptually based and empirically validated through chart review and impact on distribution of age and place of death.

scholarly journals Characteristics and Outcomes of Women Developing Heart Failure After Early Stage Breast Cancer Chemotherapy: A Population-Based Matched Cohort Study

2021 ◽  
Author(s):  
Husam Abdel-Qadir ◽  
Felicia Tai ◽  
Ruth Croxford ◽  
Peter C. Austin ◽  
Eitan Amir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Early Stage ◽  
Sequential Therapy ◽  
Cardiovascular Death ◽  
Population Based ◽  
Emergency Department Visits ◽  
Early Stage Breast Cancer ◽  
Administrative Databases ◽  
Breast Cancer Chemotherapy

Background: The prognosis of heart failure (HF) after early stage breast cancer (EBC) treatment with anthracyclines or trastuzumab is not well-characterized. Methods: Using administrative databases, women diagnosed with HF after receiving anthracyclines or trastuzumab for EBC in Ontario during 2007 to 2017 (the EBC-HF cohort) were categorized by cardiotoxic exposure (anthracycline alone, trastuzumab alone, sequential therapy with both agents) and matched on age with ≤3 cancer-free HF controls to compare baseline characteristics. To study prognosis after HF onset, we conducted a second match on age plus important HF prognostic factors. The cumulative incidence function was used to describe risk of hospitalization or emergency department visits (hospital presentations) for HF and cardiovascular death. Results: A total of 804 women with EBC developed HF after anthracyclines (n=312), trastuzumab (n=112), or sequential therapy (n=380); they had significantly fewer comorbidities than 2411 age-matched HF controls. After the second match, the anthracycline-HF cohort had a similar 5-year incidence of HF hospital presentations (16.5% [95% CI, 12.0%–21.7%]) as controls (17.1% [95% CI, 14.4%–20.1%]); the 5-year incidence was lower than matched controls for the trastuzumab-HF (9.7% [95% CI, 4.7%–16.9%]; controls 16.4% [95% CI, 12.1%–21.3%]; P =0.03) and sequential-HF cohorts (2.7% [95% CI, 1.4%–4.8%]; controls 10.8% [95% CI, 8.9%–13.0%]; P <0.001). At 5 years, the incidence of cardiovascular death was 2.9% (95% CI, 1.2%–5.9%) in the anthracycline-HF cohort vs. 9.5% (95% CI, 6.9%–12.6%) in controls, and 1.7% (0.6%–3.7%) for women developing HF after trastuzumab vs. 4.3% (95% CI, 3.1–5.8%) for controls. Conclusions: Women developing HF after cardiotoxic EBC chemotherapy have fewer comorbidities than cancer-free women with HF; trastuzumab-treated women who develop HF have better prognosis than matched HF controls.

Measuring The Quality Of Cancer Care In The Barwon South Western Region, Victoria, Australia

2020 ◽  
Author(s):  
Leigh M Matheson ◽  
Graham Pitson ◽  
Cheng Hon Yap ◽  
Madhu Singh ◽  
Ian Collins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Services ◽  
Quality Indicators ◽  
Cancer Care ◽  
Population Based ◽  
Western Region ◽  
Clinical Indicators ◽  
Clinical Quality ◽  
Quality Registry

ABSTRACT Objective The implementation of clinical quality indicators for monitoring cancer care in regional, rural and remote areas. Design Retrospective data from a population-based Clinical Quality Registry for lung, colorectal, and breast cancer. Setting All major Health Services in the Barwon South Western Region, Victoria, Australia. Participants All patients diagnosed with cancer presenting to a Health Service Intervention(s) Main Outcome Measures(s) Clinical Quality Indicators for Lung, Colorectal and Breast Cancer Results Clinical indicators included the following: discussion at multidisciplinary meetings, timeliness of care provided, type of care for different stages of the disease and survival outcomes. Many of the derived clinical indicator targets were reached. However, variation led to improvement in tumour stage being recorded in the medical record; improved awareness of the need for adjuvant chemotherapy for colorectal cancer; a reduction in time to treatment for lung cancer; reduced time to surgery for breast cancer; and highlighted the 30 day mortality post treatment for all of the tumour streams. Conclusions Clinical quality indicators allow for valuable insights into patterns of care, driving improvement in the quality of cancer care. These indicators are easily reproduced and may be of use to other cancer centres and health services.

Dementia in Ontario: Prevalence and Health Services Utilization

2003 ◽  
Vol 22 (4) ◽  
pp. 369-379 ◽  
Author(s):  
J.E. Tranmer ◽  
R. Croxford ◽  
P.C. Coyte
Keyword(s):  
Health Services ◽  
Health Services Utilization ◽  
Elderly Women ◽  
Home Care Services ◽  
Dementia Care ◽  
Administrative Databases ◽  
Services Research ◽  
Services Utilization ◽  
Study Results ◽  
The Impact

ABSTRACTTo understand the impact of ongoing reform of mental health and dementia care in Ontario, an examination of prevalence and health services utilization rates is needed. However, there exists a gap in current prevalence and health services research specific to dementia care in Ontario. The objective of this study was to address these concerns using linked administrative databases to determine the incremental use of health services by elderly Ontarians with dementia. Overall, study results demonstrated that individuals with dementia used services in a pattern similar to non-demented persons, albeit at a higher level. Exceptions were women's use of hospital and home care services, where the most elderly women received significantly fewer services. Thus, the study provided important insight regarding the relative levels of health services used by demented Ontarians. Research in this area will become increasingly important as the population ages and the settings integral to dementia care and management shift and evolve.

scholarly journals Utility of ICD Codes for Stress Cardiomyopathy in Hospital Administrative Databases: What Do They Signify?

2019 ◽  
pp. 160-163
Author(s):  
Anusha G Bhat ◽  
Kevin White ◽  
Kyle Gobeil ◽  
Tara Lagu ◽  
Peter K Lindenauer ◽  
...  
Keyword(s):  
Chart Review ◽  
Clinical Manifestations ◽  
International Classification Of Diseases ◽  
Stress Cardiomyopathy ◽  
Administrative Databases ◽  
Classification Of Diseases ◽  
Icd Codes ◽  
Hospital Administrative ◽  
New Diagnosis

Prior studies of stress cardiomyopathy (SCM) have used International Classification of Diseases (ICD) codes to identify patients in administrative databases without evaluating the validity of these codes. Between 2010 and 2016, we identified 592 patients discharged with a first known principal or secondary ICD code for SCM in our medical system. On chart review, 580 charts had a diagnosis of SCM (positive predictive value 98%; 95% CI: 96.4-98.8), although 38 (6.4%) did not have active clinical manifestations of SCM during the hospitalization. Moreover, only 66.8% underwent cardiac catheterization and 91.5% underwent echocardiography. These findings suggest that, although all but a few hospitalized patients with an ICD code for SCM had a diagnosis of SCM, some of these were chronic cases, and numerous patients with a new diagnosis of SCM did not undergo a complete diagnostic workup. Researchers should be mindful of these limitations in future studies involving administrative databases.

scholarly journals Validation of Diagnosis and Procedure Codes for Revascularization for Peripheral Artery Disease in Ontario Administrative Databases

2021 ◽  
Vol 44 (2) ◽  
pp. E36-43
Author(s):  
Jean Jacob-Brassard ◽  
Mohammed Al-Omran ◽  
Thérèse A. Stukel ◽  
Muhammad Mamdani ◽  
Douglas S. Lee ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Peripheral Artery Disease ◽  
Predictive Value ◽  
Population Based ◽  
Administrative Databases ◽  
Peripheral Artery ◽  
Predictive Values ◽  
Diagnosis Codes ◽  
Artery Disease ◽  
Procedure Codes

Purpose: To estimate the positive predictive value of diagnosis and procedure codes for open and endovascular revascularization for peripheral artery disease (PAD) in Ontario administrative databases. Methods: We conducted a retrospective validation study using population-based Ontario administrative databases (2005-2019) to identify a random sample of 600 patients who underwent revascularization for PAD at two academic centres, based on ICD-10 diagnosis codes and Canada Classification of Health Intervention procedure codes. Administrative data coding was compared to the gold standard diagnosis (PAD vs. non-PAD) and revascularization approach (open vs. endovascular) extracted through blinded hospital chart re-abstraction. Positive predictive values and 95% confidence intervals were calculated. Combinations of procedure codes with or without supplemental physician claims codes were evaluated to optimize the positive predictive value. Results: The overall positive predictive value of PAD diagnosis codes was 87.5% (84.6%-90.0%). The overall positive predictive value of revascularization procedure codes was 94.3% (92.2%-96.0%), which improved through supplementation with physician fee claim codes to 98.1% (96.6%-99.0%). Algorithms to identify individuals revascularized for PAD had combined positive predictive values ranging from 82.8% (79.6%-85.8%) to 95.7% (93.5%-97.3%). Conclusion: Diagnosis and procedure codes with or without physician claims codes allow for accurate identifi-cation of individuals revascularized for PAD in Ontario administrative databases.

scholarly journals Use of real-world data to study health services utilisation and comorbidities in long-term breast cancer survivors (the SURBCAN study): study protocol for a longitudinal population-based cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040253
Author(s):  
Anna Jansana ◽  
Isabel Del Cura ◽  
Alexandra Prados-Torres ◽  
Teresa Sanz Cuesta ◽  
Beatriz Poblador-Plou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Health Services ◽  
Cancer Survivors ◽  
Real World ◽  
Breast Cancer Survivors ◽  
Population Based ◽  
Real World Data ◽  
World Data

IntroductionBreast cancer has become a chronic disease due to survival improvement and the need to monitor the side effects of treatment and the disease itself. The aim of the SURBCAN study is to describe comorbidity, healthcare services use and adherence to preventive recommendations in long-term breast cancer survivors and to compare them with those in women without this diagnosis in order to improve and adapt the care response to this group of survivors.Methods and analysisPopulation-based retrospective cohort study using real-world data from cancer registries and linked electronic medical records in five Spanish regions. Long-term breast cancer survivors diagnosed between 2000 and 2006 will be identified and matched by age and administrative health area with women without this diagnosis. Sociodemographic and clinical variables including comorbidities and variables on the use of health services between 2012 and 2016 will be obtained from databases in primary and hospital care. Health services use will be assessed through the annual number of visits to primary care professionals and to specialists and through annual imaging and laboratory tests. Factors associated with healthcare utilisation and comorbidities will be analysed using multilevel logistic regression models. Recruitment started in December 2018.Ethics and disseminationThis study was approved by the Ethics Committee of Parc de Salut Mar. The results of the study will be published in a peer-reviewed journal and will be presented at national and international scientific conferences and at patient associations.Trial registration numberThis protocol is registered in Clinical Trials.gov (identifier: NCT03846999).

scholarly journals Opportunities for diversifying and enriching our article mix

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Bruce Rosen ◽  
Stephen C. Schoenbaum ◽  
Avi Israeli
Keyword(s):  
Health Policy ◽  
Health Services Research ◽  
Health Services ◽  
Large Scale ◽  
Policy Research ◽  
National Policy ◽  
Administrative Databases ◽  
Services Research ◽  
Health Policy Analysis ◽  
Access To Data

AbstractAs 2020 comes to a close, the Israel Journal of Health Policy Research (IJHPR) will soon be starting its tenth year of publication. This editorial compares data from 2012 (the journal’s first year of publication) and 2019 (the journal’s most recent full year of publication), regarding the journal’s mix of article types, topics, data sources and methods, with further drill-downs regarding 2019.The analysis revealed several encouraging findings, including a broad and changing mix of topics covered. However, the analysis also revealed several findings that are less encouraging, including the limited number of articles which assessed national policy changes, examined changes over time, and/or made secondary use of large-scale survey data. These findings apparently reflect, to some extent, the mix of studies being carried out by Israeli health services researchers.As the senior editors of the IJHPR we are interested in working with funders, academic institutions, the owners and principal users of relevant administrative databases, and individual scholars to further understand the factors influencing the mix of research being carried out, and subsequently published, by Israel’s health services research community. This deeper understanding could then be used to develop a joint plan to diversify and enrich health services research and health policy analysis in Israel. The plan should include a policy of ensuring improved access to data, to properly support information-based research.

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