To assess concordance between Medicare claims and Surveillance, Epidemiology, and End Results (SEER) reports of incident BM among prostate cancer (PCa) patients. The prevalence and consequences of bone metastases (BM) have been examined across tumor sites using healthcare claims data however the reliability of these claims-based BM measures has not been investigated. This retrospective cohort study utilized linked registry and claims (SEER-Medicare) data on men diagnosed with incident stage IV M1 PCa between 2005 and 2007. The SEER-based measure of incident BM was cross-tabulated with three separate Medicare claims approaches to assess concordance. Sensitivity, specificity and positive predictive value (PPV) were calculated to assess the concordance between registry- and claims-based measures. Based on 2,708 PCa patients in SEER-Medicare, there is low to moderate concordance between the SEER- and claims-based measures of incident BM. Across the three approaches, sensitivity ranged from 0.48 (0.456 – 0.504) to 0.598 (0.574 - 0.621), specificity ranged from 0.538 (0.507 - 0.569) to 0.620 (0.590 - 0.650) and PPV ranged from 0.679 (0.651 - 0.705) to 0.690 (0.665 - 0.715). A comparison of utilization patterns between SEER-based and claims-based measures suggested avenues for improving sensitivity. Claims-based measures using BM ICD 9 coding may be insufficient to identify patients with incident BM diagnosis and should be validated against chart data to maximize their potential for population-based analyses.

/pdf/concordance-between-administrative-claims-and-registry-data-223arkiryd.pdf

Concordance between administrative claims and registry data for identifying metastasis to the bone: an exploratory analysis in prostate cancer

Superiority of denosumab to zoledronic acid for prevention of skeletal-related events: A combined analysis of 3 pivotal, randomised, phase 3 trials

Finding the differences and similarities between two datasets is a common analytics task. With temporal event sequence data, this task is complex because of the many ways single events and event sequences can differ between the two datasets (or cohorts) of records: the structure of the event sequences (e.g., event order, co-occurring events, or event frequencies), the attributes of events and records (e.g., patient gender), or metrics about the timestamps themselves (e.g., event duration). In exploratory analyses, running statistical tests to cover all cases is time-consuming and determining which results are significant becomes cumbersome. Current analytics tools for comparing groups of event sequences emphasize a purely statistical or purely visual approach for comparison. This paper presents a taxonomy of metrics for comparing cohorts of temporal event sequences, showing that the problem-space is bounded. We also present a visual analytics tool, CoCo (for "Cohort Comparison"), which implements balanced integration of automated statistics with an intelligent user interface to guide users to significant, distinguishing features between the cohorts. Lastly, we describe two early case studies: the first with a research team studying medical team performance in the emergency department and the second with pharmacy researchers.

/pdf/cohort-comparison-of-event-sequences-with-balanced-ioke91t901.pdf

Cohort Comparison of Event Sequences with Balanced Integration of Visual Analytics and Statistics

BACKGROUND: Patients with bone metastasis secondary to prostate or breast cancer or multiple myeloma are predisposed to skeletal-related events (SREs), such as surgery or radiation to the bone, pathologic fracture, and spinal cord compression. Inpatient costs of these and other SREs represent an estimated 49%-59% of total costs related to SREs. However, information on payer costs for hospitalizations associated with SREs is limited, especially for costs associated with specific SREs by tumor type. OBJECTIVE: To examine costs from a payer perspective for SRE-associated hospitalizations among patients with multiple myeloma or bone metastasis secondary to prostate or breast cancer.

https://www.jmcp.org/doi/pdf/10.18553/jmcp.2010.16.9.693

Payer Costs for Inpatient Treatment of Pathologic Fracture, Surgery to Bone, and Spinal Cord Compression Among Patients with Multiple Myeloma or Bone Metastasis Secondary to Prostate or Breast Cancer

Dasatinib (BMS-354825, Sprycel®) is an oral, multitargeted inhibitor of receptor tyrosine kinases (RTKs), including BCR-ABL fusion protein, stem cell factor receptor (c-KIT), platelet-derived growth factor receptor (PDGFR), and Src family kinases (SFKs). Several early- and late-phase clinical trials for chronic myelogeneous leukaemia (CML) have demonstrated the direct inhibition of BCR-ABL fusion protein and SFKs, which led to dasatinib approval by the Food and Drug Administration (FDA) and the European Union for the treatment of imatinib-resistant or -intolerant CML, and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). Phase III dose-optimization study was performed to compare different regimens, stating that dasatinib 100 mg once daily is now the recommended schedule for patients with chronic CML, and 140 mg once daily for patients with accelerated phase or myeloid or lymphoid blast phase CML, and for patients with Ph+ ALL until progression. Because of the myriad of critical roles of SFKs in biological processes, SFKs inhibition could induce numerous biological responses. Ongoing clinical trials evaluate dasatinib in the treatment of several solid tumours, including gastrointestinal stromal tumours (GIST), prostate cancer, malignant pleural mesothelioma, sarcomas, NSCLC, colorectal cancer, glioblastoma and other haematologic malignances as multiple myeloma. Ongoing pre-clinical studies assess the therapeutic potential of dasatinib in other solid tumours, including melanoma, head and neck cancer, breast cancer and ovarian cancer. Dasatinib is generally well tolerated. Myelosuppression is the common adverse event which is, however, reversible by dose reduction, discontinuation, or interruption. Thrombocytopenia is more significant than neutropenia and associated to gastrointestinal bleeding and CNS haemorrhage. The most common non-haematologic adverse events include gastrointestinal symptoms (diarrhoea, nausea, vomiting, abdominal pain and anorexia), headache, peripheral edema, and pleural effusion. In respect of these encouraging studies investigating dasatinib in the treatment of patients with GIST, prostate cancer, multiple myeloma and sarcomas, ongoing phase III clinical trials warrant the drug evaluation as recommended agent for the treatment of these diseases, also in association with chemotherapy or other targeted therapies.

Dasatinib: an anti-tumour agent via Src inhibition.

Objectives To examine the economic burden of skeletal-related events (SREs) and to assess the frequency of different types of SREs in this population. Study design Retrospective claims analysis. Methods Data were obtained from i3's Lab Rx Database from May 1, 2000, through March 31, 2005. Patients included had at least 2 claims with a diagnosis of prostate cancer, at least 2 subsequent claims with a diagnosis of bone metastasis, and at least 1 SRE on or after the date of the initial diagnosis of bone metastasis. Descriptive statistics for 342 patients who fit all inclusion and exclusion criteria are provided, along with Kaplan-Meier curves, which were used to estimate annual costs, adjusting for the censoring of the data. Results Patients most frequently had radiation therapy (89%), followed by pathologic fracture (23%) and bone surgery (12%). Among patients diagnosed as having at least 1 SRE, 78% experienced 1 type of SRE, 17% had 2 types of SREs, and 5% had 3 or more distinct types of SREs. The mean costs associated with SREs in the year after the initial diagnosis of an SRE, adjusted for the censoring of the data, was $12,469, with the highest costs associated with radiation therapy ($5930), followed by pathologic fracture ($3179) and bone surgery ($2218). Conclusion This study of patients with prostate cancer and bone metastases revealed that the annual economic effect of medically treating SREs for these patients was $12,469.

The cost of treating skeletal-related events in patients with prostate cancer

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The cost of treating skeletal-related events in patients with prostate cancer