title: Validation of electronic data on chemotherapy and hormone therapy use in HMOs.
abstract: BACKGROUND
  Most data regarding medical care for cancer patients in the United States comes from Surveillance, Epidemiology and End Results-linked Medicare analyses of individuals aged 65 years or older and typically excludes Medicare Advantage enrollees.
  
  
  OBJECTIVE
  To assess the accuracy of chemotherapy and hormone therapy treatment data available through the Cancer Research Network's Virtual Data Warehouse (VDW).
  
  
  METHODS
  Retrospective, longitudinal cohort study. Medical record-abstracted, tumor registry-indicated treatments (gold standard) were compared with VDW-indicated treatments derived from health maintenance organization pharmacy, electronic medical record, and claim-based data systems.
  
  
  METHODS
  Enrollees aged 18 years and older diagnosed with incident breast, colorectal, lung, or prostate cancer from 2000 through 2007.
  
  
  METHODS
  Sensitivity, specificity, and positive predictive value were computed at 6 and 12 months after cancer diagnosis.
  
  
  RESULTS
  Approximately 45% of all cancer cases (total N=23,800) were aged 64 years or younger. Overall chemotherapy sensitivity/specificities across the 3 health plans for incident breast, colorectal, lung, and prostate cancer cases were 95%/90%, 95%/93%, 93%/93%, and 85%/77%, respectively. With the exception of prostate cancer cases, overall positive predictive value ranged from 86% to 89%. Small variations in chemotherapy data accuracy existed due to cancer site and data source, whereas greater variation existed in hormone therapy capture across sites.
  
  
  CONCLUSIONS
  Strong concordance exists between gold standard tumor registry measures of chemotherapy receipt and Cancer Research Network VDW data. Health maintenance organization VDW data can be used for a variety of studies addressing patterns of cancer care and comparative effectiveness research that previously could only be conducted among elderly Surveillance, Epidemiology and End Results-Medicare populations.
authors.affiliation: *The Institute for Health Research, Kaiser Permanente Colorado, Denver, CO †The Center for Health Research, Kaiser Permanente Northwest, Portland, OR ‡The Group Health Research Institute, Seattle, WA §Department of Social and Behavioral Health, School of Medicine, Virginia Commonwealth University, Richmond, VA ∥Henry Ford Health System, Detroit, MI.
authors.forename: Debra P
authors.initials: DP
authors.lastname: Ritzwoller
authors.forename: Nikki
authors.initials: N
authors.lastname: Carroll
authors.forename: Thomas
authors.initials: T
authors.lastname: Delate
authors.forename: Maureen
authors.initials: M
authors.lastname: O'Keeffe-Rossetti
authors.forename: Paul A
authors.initials: PA
authors.lastname: Fishman
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Loggers
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Aiello Bowles
authors.forename: Jennifer
authors.initials: J
authors.lastname: Elston-Lafata
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy; D016208:Databases, Factual; D004358:Drug Therapy / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000592:standards*; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008498:Medical Record Linkage; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D011471:Prostatic Neoplasms / Q000188:drug therapy; D012042:Registries / Q000592:standards / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018426:SEER Program / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D006728:Hormones