Development and validation of a claims-based approach to proxy ECOG performance status across ten tumor groups

J Comp Eff Res. 2018 Mar;7(3):193-208. doi: 10.2217/cer-2017-0040. Epub 2018 Mar 13.

Abstract

Aim: To develop a claims-based prediction model of poor performance status (PS) in commercially insured and Medicare supplemental beneficiaries with cancer.

Patients & methods: Retrospective analysis was conducted of electronic medical records (EMR) from community oncology practices linked to MarketScan claims. Multivariable logistic regression predicted PS scores from the EMR using claims-based diagnostic and procedure codes.

Results: The study included 8442 patients diagnosed with cancer from 2007 to 2015. Overall, 8.1% of patients had poor EMR-based PS. Bootstrapping results from the final model showed sensitivity and specificity of approximately 75% with a predicted probability cutpoint = 0.078, c-statistic = 0.821 and pseudo-R2 = 0.25.

Conclusion: Patients with poor PS can be identified in claims data. This prediction model enables future studies evaluating cancer treatments and outcomes to account for PS.

Keywords: cancer; claims data; performance status; validation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Advance Directives
  • Aged
  • Aged, 80 and over
  • Delivery of Health Care / statistics & numerical data
  • Electronic Health Records
  • Female
  • Health Status*
  • Humans
  • Insurance Claim Review
  • Logistic Models
  • Male
  • Medicare / statistics & numerical data
  • Middle Aged
  • Neoplasms / therapy*
  • Retrospective Studies
  • Sensitivity and Specificity
  • United States