Validation of an Algorithm to Identify HR+/HER2- Metastatic Breast Cancer in Claims Data
Author(s)
Chin A1, Ip Q1, Wu X1, Lyle D2
1Komodo Health, San Francisco, CA, USA, 2NeoGenomics, Fort Myers, FL, USA
Presentation Documents
OBJECTIVES: For therapeutic areas without a specific corresponding ICD code, validated claims-based definitions are needed to study patient populations in claims databases. This study aimed to validate an existing claims-based algorithm to identify patients with hormone-receptor-positive/human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC).
METHODS: This retrospective cohort study used genomics data from NeoGenomics to validate an existing claims-based identification algorithm in the Komodo Research Dataset. mBC patients were identified with 2+ BC claims between January 2016 and August 2023 and 2+ secondary neoplasm claims 30 days before or any time after the first BC claim (mBC diagnosis). HR+/HER2- status was defined as 1+ HR+ treatment claim and no HER2+ treatment claims during the study period. Demographics were evaluated on the first therapy start date after mBC diagnosis. Cases that met the algorithm were then validated against genomics data. Specifically, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) test results prior to mBC diagnosis were used to determine HER2 status; estrogen receptor (ER)/progesterone receptor (PR) test data were used to determine HR status (positive, negative, or unclear). Patients with unclear results were excluded. Overall and subgroup positive predictive values (PPV) and 95% confidence intervals (CI) were calculated.
RESULTS: Genomics data was obtained and reviewed for 2,215 patients who met the claims-based algorithm.
Of these patients, the mean age was 57 years (30% over 64 years) and 41% were white. Half of patients were commercially insured (51%); about one-third were covered by Medicare (30%). PPV of the HR+/HER2- mBC identification algorithm was 90% (95% CI 89–92%). The algorithm had higher PPV for patients who were white (92%), ≥65 years (92%), and ≥75 years (94%); and lower PPV among patients who were black or African American (84%).CONCLUSIONS: The results demonstrate that the claims-based identification algorithm was highly accurate for identifying HR+/HER2 - mBC patients.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 6, S1 (June 2024)
Code
EPH56
Topic
Epidemiology & Public Health
Topic Subcategory
Disease Classification & Coding
Disease
Oncology