title: Comparison of administrative/billing data to expected protocol-mandated chemotherapy exposure in children with acute myeloid leukemia: A report from the Children's Oncology Group.
abstract: BACKGROUND
  Recently investigators have used analysis of administrative/billing datasets to answer clinical and pharmacoepidemiology questions in pediatric oncology. However, the accuracy of pharmacy data from administrative/billing datasets have not yet been evaluated. The primary objective of this study was to determine the concordance of Pediatric Health Information System (PHIS) administrative/billing chemotherapy data with Children's Oncology Group (COG) protocol-mandated chemotherapy and to assess the implications of this level of concordance for further PHIS research.
  
  
  METHODS
  Data from 384 pediatric patients (1,060 courses of chemotherapy) with acute myeloid leukemia treated on COG clinical trial AAML0531 were previously merged with PHIS data. PHIS chemotherapy administrative/billing data were reviewed for the first three courses of chemotherapy. Accuracy was assessed using three metrics: recognizability of chemotherapy pattern by course, chemotherapy administration pattern by individual medication, and concordance with the number of days of protocol-defined chemotherapy.
  
  
  RESULTS
  The chemotherapy pattern was recognizable in 87.3% of courses when course-wide accuracy was assessed. Chemotherapy administration pattern varied by medication. Cytarabine had perfect concordance 70.9% of the time, daunorubicin had perfect concordance 77.4% of the time, and etoposide had perfect concordance 67.8% of the time.
  
  
  CONCLUSIONS
  The accuracy of chemotherapy administrative/billing data supports the continued use of PHIS data for epidemiology studies as long as investigators perform data quality control checks and evaluate each specific medication prior to undertaking definitive analyses.
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Tamara P
authors.initials: TP
authors.lastname: Miller
authors.affiliation: Department of Biostatistics and Epidemiology The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Troxel
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Yimei
authors.initials: Y
authors.lastname: Li
authors.affiliation: Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Yuan-Shung
authors.initials: YS
authors.lastname: Huang
authors.affiliation: Department of Preventative Medicine, University of Southern California, Arcadia, California.|Children's Oncology Group, Arcadia, California.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Alonzo
authors.affiliation: Children's Oncology Group, Arcadia, California.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Gerbing
authors.affiliation: Children's Hospital Association, Overland Park, Kansas.
authors.forename: Matt
authors.initials: M
authors.lastname: Hall
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Kari
authors.initials: K
authors.lastname: Torp
authors.affiliation: Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Fisher
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Rochelle
authors.initials: R
authors.lastname: Bagatell
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Alix E
authors.initials: AE
authors.lastname: Seif
authors.affiliation: The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
authors.affiliation: Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
authors.forename: Alan
authors.initials: A
authors.lastname: Gamis
authors.affiliation: Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: David
authors.initials: D
authors.lastname: Rubin
authors.affiliation: The University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
authors.forename: Selina
authors.initials: S
authors.lastname: Luger
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Richard
authors.initials: R
authors.lastname: Aplenc
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D057186:Comparative Effectiveness Research; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D063005:Health Information Systems / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D055815:Young Adult
chemical_list: D003561:Cytarabine; D005047:Etoposide; D003630:Daunorubicin
keywords: accuracy; acute myeloid leukemia; chemotherapy; pediatrics