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JNCI Journal of the National Cancer Institute 2006 98(18):1335-1338; doi:10.1093/jnci/djj363
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© 2006 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

BRIEF COMMUNICATION

Measuring Disease-Free Survival and Cancer Relapse Using Medicare Claims From CALGB Breast Cancer Trial Participants (Companion to 9344)

Elizabeth B. Lamont, James E. Herndon, II, Jane C. Weeks, I. Craig Henderson, Craig C. Earle, Richard L. Schilsky, Nicholas A. Christakis
For the Cancer and Leukemia Group B

Affiliations of authors: Massachusetts General Hospital Cancer Center and Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA (EBL); Departments of Medicine (EBL, JCW, CCE) and Health Care Policy (EBL, NAC), Harvard Medical School, Boston, MA; Cancer and Leukemia Group B Statistical Center, Duke University Medical Center, Durham, NC (JEH); Department of Medicine, Dana-Farber Cancer Institute, Boston, MA (JCW, CCE); Department of Medicine, University of California, San Francisco, CA (ICH); Cancer and Leukemia Group B Central Office and Department of Medicine, University of Chicago, Chicago, IL (RLS)

Correspondence to: Elizabeth B. Lamont, MD, MS, Department of Health Care Policy, Harvard Medical School, 180 A Longwood Ave., Boston, MA 02115 (e-mail: lamont{at}hcp.med.harvard.edu).

To determine the accuracy with which Medicare claims data measure disease-free survival in elderly Medicare beneficiaries with cancer, we performed a criterion validation study. We merged gold-standard clinical trial data of 45 elderly patients with node-positive breast cancer who were treated on the Cancer and Leukemia Group B (CALGB) adjuvant breast trial 9344 with Centers for Medicare and Medicaid Services (CMS) data files and compared the results of a CMS-based algorithm with the CALGB disease-free survival information to determine sensitivity and specificity. For 5-year disease-free survival, the sensitivity of the CMS-based algorithm was 100% (95% confidence interval [CI] = 81% to 100%), the specificity was 97% (95% CI = 83% to 100%), and the area under the receiver operator curve was 97% (95% CI = 90% to 100%). For 2-year disease-free survival, the test characteristics were less favorable: sensitivity was 83% (95% CI = 36% to 100%), specificity was 95% (95% CI = 83% to 100%), and area under the receiver operator curve was 84% (95% CI = 66% to 100%).


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