title: Agreement of reported vascular access on the medical evidence report and on medicare claims at hemodialysis initiation.
abstract: BACKGROUND
  The choice of vascular access type is an important aspect of care for incident hemodialysis patients. However, data from the Centers for Medicare & Medicaid Services (CMS) Medical Evidence Report (form CMS-2728) identifying the first access for incident patients have not previously been validated. Medicare began requiring that vascular access type be reported on claims in July 2010. We aimed to determine the agreement between the reported vascular access at initiation from form CMS-2728 and from Medicare claims.
  
  
  METHODS
  This retrospective study used a cohort of 9777 patients who initiated dialysis in the latter half of 2010 and were eligible for Medicare at the start of renal replacement therapy to compare the vascular access type reported on form CMS-2728 with the type reported on Medicare outpatient dialysis claims for the same patients. For each patient, the reported access from each data source was compiled; the percent agreement represented the percent of patients for whom the access was the same. Multivariate logistic analysis was performed to identify characteristics associated with the agreement of reported access.
  
  
  RESULTS
  The two data sources agreed for 94% of patients, with a Kappa statistic of 0.83, indicating an excellent level of agreement. Further, we found no evidence to suggest that agreement was associated with the patient characteristics of age, sex, race, or primary cause of renal failure.
  
  
  CONCLUSIONS
  These results suggest that vascular access data as reported on form CMS-2728 are valid and reliable for use in research studies.
authors: United States Renal Data System, Minneapolis Medical Research Foundation, 914 South 8th Street, Suite S4,100, Minneapolis, Minnesota 55404, USA. csolid@usrds.org.
authors: Craig A
authors: CA
authors: Solid
authors: Allan J
authors: AJ
authors: Collins
authors: James P
authors: JP
authors: Ebben
authors: Shu-Cheng
authors: SC
authors: Chen
authors: Arman
authors: A
authors: Faravardeh
authors: Robert N
authors: RN
authors: Foley
authors: Areef
authors: A
authors: Ishani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000706:statistics & numerical data*; D002405:Catheterization, Central Venous / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D019221:Mandatory Reporting; D019300:Medical Errors / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000145:classification* / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014481:United States