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

Autor: Stephan Dunning, Saul N. Weingart, Albert Feldman, Omar Yaghi, Benjamin Koethe, Allison Lipitz-Snyderman, David M. Kent, Jason Nelson
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Cancer Research
medicine.medical_specialty
Blood transfusion
Drug-Related Side Effects and Adverse Reactions
medicine.medical_treatment
adverse event
trigger tool
Antineoplastic Agents
Disease
Medical Oncology
Risk Assessment
lcsh:RC254-282
03 medical and health sciences
Patient safety
Prostate cancer
0302 clinical medicine
Risk Factors
quality of care
Neoplasms
Internal medicine
Epidemiology
medicine
patient safety
Humans
Radiology
Nuclear Medicine and imaging
Radiation Injuries
Adverse effect
Original Research
Aged
Retrospective Studies
business.industry
Clinical Cancer Research
Cancer
Middle Aged
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Radiation therapy
030104 developmental biology
030220 oncology & carcinogenesis
oncology
Female
epidemiology
business
Administrative Claims
Healthcare
Follow-Up Studies
Zdroj: Cancer Medicine, Vol 9, Iss 4, Pp 1462-1472 (2020)
Cancer Medicine
ISSN: 2045-7634
Popis: Background As there are few validated tools to identify treatment‐related adverse events across cancer care settings, we sought to develop oncology‐specific “triggers” to flag potential adverse events among cancer patients using claims data. Methods 322 887 adult patients undergoing an initial course of cancer‐directed therapy for breast, colorectal, lung, or prostate cancer from 2008 to 2014 were drawn from a large commercial claims database. We defined 16 oncology‐specific triggers using diagnosis and procedure codes. To distinguish treatment‐related complications from comorbidities, we required a logical and temporal relationship between a treatment and the associated trigger. We tabulated the prevalence of triggers by cancer type and metastatic status during 1‐year of follow‐up, and examined cancer trigger risk factors. Results Cancer‐specific trigger events affected 19% of patients over the initial treatment year. The trigger burden varied by disease and metastatic status, from 6% of patients with nonmetastatic prostate cancer to 41% and 50% of those with metastatic colorectal and lung cancers, respectively. The most prevalent triggers were abnormal serum bicarbonate, blood transfusion, non‐contrast chest CT scan following radiation therapy, and hypoxemia. Among patients with metastatic disease, 10% had one trigger event and 29% had two or more. Triggers were more common among older patients, women, non‐whites, patients with low family incomes, and those without a college education. Conclusions Oncology‐specific triggers offer a promising method for identifying potential patient safety events among patients across cancer care settings.
A claims‐based trigger tool was developed to identify potential adverse events and medical errors among 320 000 patients with breast, colorectal, lung, and prostate cancers. During an initial year of therapy, cancer‐specific trigger events affected 19% of patients and varied by disease and metastatic status, from 6% of patients with nonmetastatic prostate cancer to 41% and 50% of those with metastatic colorectal and lung cancers, respectively.
Databáze: OpenAIRE
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