The sensitivity of Medicare data for identifying incident cases of invasive melanoma (United States).
BACKGROUND
The completeness of Medicare claims for identifying patients with melanoma for purposes of conducting population-based studies of melanoma is unknown.


METHODS
Using a linked Surveillance, Epidemiology, and End Result (SEER) tumor registry-Medicare database, the sensitivity of Medicare claims for identifying 5372 patients age > or =65 years diagnosed with invasive melanoma between 1992 and 1996 was determined. Sensitivity was calculated as the proportion of incident cases of melanoma reported by SEER that was also captured by Medicare claim diagnostic codes.


RESULTS
The overall sensitivity of combined Part A and Part B Medicare for incident cases of melanoma was 90.1%. Part B Medicare and Part A Medicare alone had 89.5% and 16.5% sensitivity respectively. Sensitivity was lower for patients with unrecorded Breslow depth and for patients with unstaged or distant stage melanoma.


CONCLUSIONS
Medicare Part B claims have a high sensitivity for detecting melanoma incidence; Medicare Part A has low sensitivity. This sharply contrasts with published studies of other cancers, for whom Part A rather than Part B Medicare captures the predominant portion of incident cases. Medicare Part B or combined Part A and Part B administrative data is a potentially valuable resource for population-based melanoma research in the elderly. Further research characterizing the specificity and predictive value of Medicare data is needed to assess the potential implications of false positive melanoma diagnostic codes.
Barzilai
David A
DA
Skin Diseases Research Center, University Hospitals of Cleveland, Case Western Reserve University, Cleveland OH 44106, USA. dxb69@po.cwru.edu
Koroukian
Siran M
SM
Neuhauser
Duncan
D
Cooper
Kevin D
KD
Rimm
Alfred A
AA
Cooper
Gregory S
GS
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data*; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D008545:Melanoma / Q000453:epidemiology* / Q000473:pathology; D009361:Neoplasm Invasiveness; D011159:Population Surveillance / Q000379:methods; D018426:SEER Program; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology