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Assessment of the Social Security Administration Death Master File for Comparative Analysis Studies of Peripheral
Eric A Secemsky1, Eric Barrette2, Lindsay Bockstedt2
1Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Insights
The Social Security Administration Death Master File (SSADMF) reliably tracks all-cause mortality in peripheral vascular device studies. This study found the SSADMF provides comparable mortality data to more comprehensive sources for device safety evaluations.
Area of Science:
- Vascular Surgery
- Health Informatics
- Biostatistics
Background:
- The Social Security Administration Death Master File (SSADMF) is a widely used U.S. mortality data source.
- Concerns exist regarding the SSADMF's underreporting of mortality rates.
- Reliable mortality data is crucial for comparative effectiveness research in medical devices.
Purpose of the Study:
- To assess the reliability of the SSADMF for evaluating mortality in comparative peripheral vascular device studies.
- To compare mortality data from the SSADMF alone versus a combination of SSADMF and Medicare beneficiary records.
- To evaluate the safety of peripheral paclitaxel-coated devices.
Main Methods:
- Two versions of an administrative claims dataset were used, differing only in mortality data source.
- The SSADMF was the primary mortality source in one version; the other combined SSADMF with Medicare beneficiary records.
- Cox regression and inverse propensity treatment weighting were used to analyze mortality in patients undergoing femoropopliteal revascularization with drug-coated or non-drug-coated devices (2015-2019).
Main Results:
- Cumulative mortality incidences differed between the two data versions.
- No statistically significant difference was found in the hazard ratios of mortality between the SSADMF (1.05) and the combined Master Beneficiary Summary File/SSADMF (1.03) datasets (P = .63).
Conclusions:
- Despite known underreporting, the SSADMF provides a reliable source of all-cause mortality for comparative studies on peripheral vascular device safety.
- The SSADMF is a viable tool for linking to real-world data sources to assess device safety.
- Findings support the use of SSADMF in evaluating mortality for peripheral vascular device comparative effectiveness research.
Objectives:
The objective of this study was to assess the reliability the Social Security Administration Death Master File (SSADMF) for evaluating mortality in comparative peripheral vascular device studies.
Methods:
We leveraged 2 versions of an administrative claims data set that were identical except for the source of mortality data. The SSADMF was the primary source of mortality records in one version. The SSADMF was combined with mortality from Medicare beneficiary records in the other. Our study was set in the context of a comparative effectiveness analysis of recent Food and Drug Administration interest involving peripheral paclitaxel-coated devices. Mortality of patients with Medicare Advantage insurance coverage from 2015 to 2018 who underwent femoropopliteal artery revascularization with a drug-coated device (DCD) or non-DCD was assessed through 2019. Covariate differences between treatment groups were adjusted by inverse propensity treatment weighting. The hazard ratio of DCD to non-DCD mortality was estimated using Cox regression.
Results:
The cumulative incidences of mortality differed substantially between versions of the data. Nevertheless, we could not reject the null hypothesis that the hazard ratios of the SSADMF (1.05; 95% confidence interval 0.95-1.17) and the Master Beneficiary Summary File/SSADMF (1.03; 95% confidence interval 0.96-1.11) were the same (P = .63).
Conclusions:
The SSADMF is a common source of mortality records in the United States that can be linked to real-world data sources but is known to underreport mortality rates. We find that the SSADMF provides a reliable source of all-cause mortality for a comparative study assessing the safety of peripheral vascular devices.
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