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Erschienen in:
17.08.2016 | Healthcare Policy and Outcomes
Comparison of Comorbid Medical Conditions in the National Cancer Database and the SEER–Medicare Database
Erschienen in: Annals of Surgical Oncology | Ausgabe 13/2016
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Background
Physicians routinely factor comorbidities into diagnostic and treatment decisions. Analyses of treatment patterns and outcomes using the National Cancer Data Base (NCDB) usually adjust for comorbidities; however, the completeness of comorbidity ascertainment in the NCDB has never been assessed. We compared the prevalence of comorbidities captured in the NCDB and Surveillance, Epidemiology, and End Results (SEER)–Medicare among female breast, non-small-cell lung, and colorectal cancer patients aged ≥66.
Methods
In the NCDB, ten fields were searched for comorbidities. In the SEER–Medicare dataset, Medicare claims were used to identify comorbidities for two time periods: 12 months prior to diagnosis (Prior) and Index claim alone. Chi-square tests were used to compare comorbidity prevalence using propensity score-matched subsamples from each dataset. Kaplan–Meier survival analyses by Charlson–Deyo comorbidity score and data source were conducted.
Results
Comorbidity prevalence in NCDB did not differ significantly from that identified in SEER–Medicare Index claims across all three cancer sites, except for congestive heart failure, chronic pulmonary disease, and renal disease. However, when compared to the prevalence identified through SEER–Medicare Prior claims, comorbidity prevalence in the NCDB was lower. Overall survival rates by NCDB comorbidity scores were nearly identical to those based on SEER–Medicare Index claims but were lower than those based on SEER–Medicare Prior claims, particularly in higher comorbidity score categories.
Conclusions
The study found overall similarity of comorbidity prevalence between NCDB and SEER–Medicare Index claims, but much less similarity between NCDB and SEER–Medicare Prior claims. Future researchers should understand the limitation of comorbidities ascertained in the NCDB and interpret results accordingly.