Development, Validation, and Dissemination of a Breast Cancer Recurrence Detection and Timing Informatics Algorithm

Area of Science:

• Oncology
• Medical Informatics
• Health Services Research

Background:

• Breast cancer recurrence detection and timing are critical for patient management and outcomes research.
• Existing methods for identifying recurrence from large datasets have limitations.
• There is a need for generalizable algorithms utilizing common data models.

Purpose of the Study:

• To develop and validate a generalizable informatics algorithm for detecting breast cancer recurrence.
• To develop and validate an algorithm for estimating the timing of breast cancer recurrence.
• To compare the performance of the developed algorithms with existing methods.

Main Methods:

• Utilized a common data model pooling health insurance claims and electronic health records data from the Cancer Research Network Virtual Data Warehouse (VDW).
• Developed two models: one for recurrence detection (maximizing area under the ROC curve) and one for timing (minimizing average absolute error).
• Validated algorithms using VDW data against a gold standard of chart-confirmed recurrences from a third site.

Main Results:

• The detection model achieved high performance with area under the ROC curve (AUROC) values of 0.939 in training and 0.956 and 0.900 in validation datasets.
• Timing models demonstrated average absolute prediction errors ranging from 10.8% to 12.6%, significantly lower than previously reported algorithms.
• The developed algorithms identified similar covariates but differed substantially from prior recurrence detection and timing studies.

Conclusions:

• It is feasible to reliably detect breast cancer recurrence using data from electronic medical records and insurance claims.
• The developed informatics tools offer a robust method for large-scale research on breast cancer patient quality, effectiveness, and outcomes.
• These algorithms can facilitate novel research into the long-term management and care of breast cancer survivors experiencing recurrence.