监测,流行病学,最终结果 (SEER) 和医疗保险索赔衍生子宫癌治疗数据之间的协议
Ashley S Felix1, Jiahao Ping2, Caitlin E Meade1
1The Ohio State University Columbus, OH United States.
概括
SEER和医疗保险数据显示,对于子宫癌治疗方法的一致性很高,支持它们在生存研究中的联合使用. 一致性因治疗和患者因素而异,随着时间的推移,一些一致性下降.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 与SEER-Medicare相关的数据库被广泛用于子宫癌研究.
- 之前的研究并没有关注SEER和Medicare治疗数据索赔之间的一致性.
- 了解数据协议对于准确的治疗模式和生存分析至关重要.
研究的目的:
- 评估SEER和Medicare关于子宫癌治疗的索赔之间的协议.
- 为了确定这两个数据源之间的分歧的预测因素.
- 基于SEER与医疗保险的治疗数据来比较生存结果.
主要方法:
- 利用SEER-Medicare链接的数据库,用于被诊断为子宫癌的患者 (2000-2019).
- 计算了kappa统计数据,以评估对子宫切除术,双边salpingo-oophorectomy (BSO),淋巴切除术,放射治疗 (EBRT,VBT) 和化疗的同意.
- 采用后勤回归来找出不同意见的预测因素,以及考克斯回归来比较生存率.
主要成果:
- 大多数治疗方法的SEER和Medicare索赔之间观察到很高的一致性 (kappa范围:0.71-0.85).
- 协议因治疗而异,用BSO进行子宫切除最低,用淋巴切除和化疗最高.
- 时间趋势显示,近年来淋巴切除术,EBRT和VBT的同意率下降;黑人种族,年轻年龄,高风险组织学和晚期预测了更高的不同意见.
结论:
- 对于子宫癌的SEER和Medicare数据之间的整体治疗协议很高.
- 尽管存在一些差异,但这两种数据来源都是可靠的,可以用于治疗生存分析.
- 这些发现支持在妇科瘤学研究中继续使用SEER-Medicare链接数据库.
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