Developing a cancer-specific trigger tool to identify treatment-related adverse events using administrative data

Area of Science:

• Oncology
• Health Services Research
• Medical Informatics

Background:

• Validated tools for identifying treatment-related adverse events in cancer care are limited.
• There is a need for methods to detect potential adverse events using administrative claims data.

Purpose of the Study:

• To develop and validate oncology-specific "triggers" for flagging potential adverse events in cancer patients.
• To utilize claims data for identifying adverse events across diverse cancer care settings.

Main Methods:

• A cohort of 322,887 adult patients undergoing initial cancer therapy (breast, colorectal, lung, prostate) from 2008-2014 was analyzed.
• Sixteen oncology-specific triggers were defined using diagnosis and procedure codes, requiring a temporal and logical link to treatment.
• Prevalence, risk factors, and variations by cancer type and metastatic status were examined.

Main Results:

• Cancer-specific triggers affected 19% of patients within the first year of treatment.
• Trigger prevalence varied significantly by cancer type and metastatic status, ranging from 6% (nonmetastatic prostate cancer) to 50% (metastatic lung cancer).
• Common triggers included abnormal serum bicarbonate, blood transfusion, and hypoxemia; triggers were more frequent in older, female, non-white patients, and those with lower socioeconomic status.

Conclusions:

• Oncology-specific triggers provide a promising approach for identifying potential patient safety events.
• This method facilitates the detection of adverse events in cancer patients across various care settings.
• The findings highlight disparities in trigger prevalence based on patient demographics and socioeconomic factors.