Table 1:

Non-VA and VA-specific algorithms selected from literature to compare performance

Algorithm	Notes
NON-VA ALGORITHM 1 (FOR CASE IDENTIFICATION)5 Two-part algorithm. Both parts of the algorithm are required. Parts 1 and 2 have to be fulfilled separately and sequentially. Part 1: ≥2 ICD-9-CM codes for multiple myeloma (203.0x) AND ≥1 procedure code for bone marrow aspirate, biopsy, or interpretation OR ≥2 distinct procedure code for diagnostic tests (the tests must be different) Part 2: ≥2 ICD-9-CM codes for multiple myeloma (203.0x) 5 to 90 days after procedures identified in part 1 Index date: Date of diagnosis in Oncology EMR database without preceding treatment code.	Original data sources: Henry Ford Health System, Optum Research Database Inclusion criteria: ≥18 years ≥2 ICD-9-CM(203.0) codes or ICD-10-CM (C90.0) for MM bone marrow aspirate, biopsy, or interpretation CPT 38220, 38221, 88305 HCPCS: G0364 diagnostic CPT: 82784, 83883, 86334, 84165, 84166, 77074 Chemotherapy: thalidomide, lenalidomide, bortezomib, cyclophosphamide, doxorubicin, melphalan, vincristine, carmustine, cisplatin, interferon, etoposide, thiotepa, and/or dexamethasone
NON-VA ALGORITHM 2 (FOR NEWLY DIAGNOSED AND INITATING TREATMENT)5 Two-part algorithm. Both parts of the algorithm are required. Parts 1 and 2 have to be fulfilled separately and sequentially. Part 1: ≥2 ICD-9-CM codes for multiple myeloma (203.0x) AND ≥1 procedure code for bone marrow aspirate, biopsy, or interpretation b OR ≥1 procedure code for two diagnostic tests c (the tests must be different) Part 2: ≥2 ICD-9-CM codes for multiple myeloma (203.0x) 5 to 90 days after procedures identified in part 1 AND ≥1 prescription claim for a multiple myeloma therapy Index date: Not explicitly discussed. Used date of first treatment for our study.	Original data sources: Henry Ford Health System, Optum Research Database Inclusion criteria: ≥18 years ≥2 ICD-9-CM(203.0) or ICD-10-CM (C90.0) codes for MM Exclusion criteria: Patients without a documented height or weight bone marrow aspirate, biopsy, or interpretation CPT 38220, 38221, 88305 HCPCS: G0364 diagnostic CPT: 82784, 83883, 86334, 84165, 84166, 77074 Chemotherapy: thalidomide, lenalidomide, bortezomib, cyclophosphamide, doxorubicin, melphalan, vincristine, carmustine, cisplatin, interferon, etoposide, thiotepa, and/or dexamethasone
VA ALGORITHM 1 (FOR NEWLY DIAGNOSED AND INITIATING TREATMENT)12 (2) (ICD)-O3 codes 9732/3 within VACCR, excluded patients who didn’t receive chemotherapy within 6 months of diagnosis. Index date: Date of first treatment	Original data sources: Cancer Registry Inclusion criteria: International Classification of Diseases (ICD)-O3 codes 9732/3 Exclusion criteria: Patients that didn’t receive chemotherapy within 6 months of MM diagnosis (We removed exclusion of patients who received transplant to make algorithm broader and more comparable to others in our study)
VA ALGORITHM 2 (FOR NEWLY DIAGNOSED AND INITIATING TREATMENT)2 (4) 3 ICD9–203.0 (or ICD10 C90) codes and at least 2 dates where MM treatment observed; 2nd treatment date must be within 6 months of 1st Index date: Date of first continuous treatment	Data source: VA Corporate Data Warehouse Inclusion criteria: 3 dates for MM diagnosis, 2 dates on which MM treatment was observed. Veterans with at least 1 inpatient/outpatient visit each year within 3 years prior to start of MM treatment Exclusion criteria: Veterans with one or more MM treatment codes in the CMS data prior to or up to six months after the index date