title: Treatment patterns for prostate cancer: comparison of Medicare claims data to medical record review.
abstract: BACKGROUND
  As evidence-based guidelines increasingly define standards of care, the accurate reporting of patterns of treatment becomes critical to determine if appropriate care has been provided. We explore the level of agreement between claims and record abstraction for treatment regimens for prostate cancer.
  
  
  METHODS
  Medicare claims data were linked to medical records abstraction using data from the Centers for Disease Control and Prevention's National Program of Cancer Registry-funded Breast and Prostate Patterns of Care study. The first course of therapy included surgery, radiation therapy (RT), and hormonal therapy with luteinizing hormone-releasing hormone agonists.
  
  
  RESULTS
  The linked sample included 2765 men most (84.7%) of whom had stage II prostate cancer. Agreement was excellent for surgery (κ=0.92) and RT (κ=0.92) and lower for hormonal therapy (κ=0.71); however, most of the discrepancies were due to greater number of patients reported who received hormonal therapy in the claims database than in the medical records database. For some standard multicomponent management strategies sensitivities were high, for example, hormonal therapy with either combination RT (86.9%) or cryosurgery (96.6%).
  
  
  CONCLUSIONS
  Medicare claims are sensitive for determining patterns of multicomponent care for prostate cancer and for detecting use of hormonal therapy when not reported in the medical records abstracts.
authors.affiliation: *Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY †Keck School of Medicine of University of Southern California, Los Angeles, CA ‡Centers for Disease Control and Prevention, Atlanta, GA §Duke University Medical Center, Durham, NC ∥Louisiana State University Health Sciences Center, New Orleans, LA ¶American College of Radiology Clinical Research Center, Philadelphia, PA #University of Kentucky Markey Cancer Center, Lexington, KY **Pennsylvania State University College of Medicine, Hershey, PA.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Fleming
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.forename: Susan A
authors.initials: SA
authors.lastname: Sabatino
authors.forename: Gretchen G
authors.initials: GG
authors.lastname: Kimmick
authors.forename: Xiao-Cheng
authors.initials: XC
authors.lastname: Wu
authors.forename: Jean B
authors.initials: JB
authors.lastname: Owen
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.forename: Wenke
authors.initials: W
authors.lastname: Hwang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D015897:Comorbidity; D003625:Data Collection / Q000379:methods*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000628:therapy*; D012042:Registries; D018426:SEER Program; D014481:United States