Exploration of PCORnet Data Resources for Assessing Use of Molecular-Guided Cancer Treatment.

Autor:	Carnahan RM; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA., Waitman LR; Department of Internal Medicine, College of Medicine, University of Kansas, Kansas City, KS., Charlton ME; Department of Epidemiology, College of Public Health, and the Iowa Cancer Registry, University of Iowa, Iowa City, IA., Schroeder MC; Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA., Bossler AD; Department of Pathology, College of Medicine, University of Iowa, Iowa City, IA., Campbell WS; Department of Pathology and Microbiology, College of Medicine, University of Nebraska, Omaha, NE., Campbell JR; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE., McDowell BD; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA., Smith NC; Institute for Clinical and Transitional Science, University of Iowa, Iowa City, IA., Gryzlak BM; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA., Chrischilles EA; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA.
Jazyk:	angličtina
Zdroj:	JCO clinical cancer informatics [JCO Clin Cancer Inform] 2020 Aug; Vol. 4, pp. 724-735.
DOI:	10.1200/CCI.19.00142
Abstrakt:	Purpose: Examine the ability of PCORnet data resources to investigate molecular-guided cancer treatment. Patients and Methods: Patients (N = 86,154) had single primary solid tumors (diagnosed 2013-2017) from hospital oncology registries linked to the PCORnet Common Data Model (CDM) at 11 medical institutions. Molecular and anatomic test procedures and oral and infused therapies were identified with Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, RxNorm Concept Unique Identifier, and National Drug Codes from CDM tables. Chart review (2 institutions, n = 213) for advanced colorectal cancer and Medicare claims linkages (7 institutions, n = 1,731) for breast cancer explored options for increasing electronic data capture. Results: Molecular testing prevalence detected via analyte-specific molecular CPT/HCPCS codes was 5.5% (n = 4,784); for the nonspecific anatomic pathology codes, for which only some testing is performed to guide therapy selection, it was an additional 44.8% (n = 38,610). Molecular-guided therapy prevalence was 5% (n = 4,289). Testing and treatment were most common with stage IV disease and varied across cancer types and study institutions (testing, 0%-10.4%; treatment, 0.8%-8.4%). Therapy-concordant test results were found in charts for all 36 treated patients with colorectal cancer at the 2 institutions, 3 (8.3%) of whom received treatment outside the institution. Breast cancer Medicare claims linkage increased rates of identified testing from 62.7%-98.9% and treatment from 3.9%-8.2%. Conclusion: Although a minority of patients received molecular-guided therapies, the majority had testing that could guide cancer treatment. Claims data extended electronic data capture for therapies and test orders but often was uninformative for types of test ordered. Test results continue to require text data curation from narrative pathology reports.
Databáze:	MEDLINE
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