Table 3.
Agreement of post-PET plan and claims-inferred actions at 30 days by cancer type
| Bladder | Kidney | Ovary | Pancreas | Prostate | SCL* | Stomach | P-value† | |
|---|---|---|---|---|---|---|---|---|
| Patients (total), n | 1,127 | 1,070 | 2,075 | 862 | 1,974 | 720 | 632 | |
| Systemic therapy only planned, n | 261 | 222 | 811 | 265 | 428 | 226 | 134 | |
| PPV, % | 66.7 | 40.1§ | 65.0 | 65.3 | 64.7 | 64.6 | 51.5 | <0.0001 |
| Raw Agreement,% | 71.2 | 73.7 | 71.1 | 69.8 | 71.6 | 69.3 | 65.7 | 0.025 |
| Kappa | 0.33 | 0.22 | 0.40 | 0.34 | 0.31 | 0.34 | 0.17 | <0.0001 |
| Radiation only planned, n | 71 | 48 | 46 | 48 | 273 | 65 | 34 | |
| PPV, % | 74.6 | 66.7 | 67.4 | 64.6 | 56.1 | 78.4 | 35.3 | 0.002 |
| Raw Agreement, % | 89.4 | 92.4 | 96.9 | 91.8 | 87.3 | 85.3 | 95.3 | <0.0001 |
| Kappa | 0.42 | 0.41 | 0.48 | 0.42 | 0.48 | 0.42 | 0.23 | 0.027 |
| Surgery only planned, n | 50 | 51 | 87 | 33 | 33 | 6 | 37 | |
| PPV, % | 44.0 | 54.9 | 57.5 | 33.3 | 27.3 | 33.3 | 35.3 | 0.020 |
| Raw Agreement, % | 84.5 | 88.9 | 89.5 | 89.2 | 91.5 | 93.9 | 86.7 | <0.0001 |
| Kappa | 0.14 | 0.27 | 0.27 | 0.14 | 0.07 | 0.07 | 0.16 | <.0001 |
| Biopsy planned, n | 150 | 146 | 176 | 74 | 248 | 60 | 85 | |
| PPV, % | 64.7 | 62.3 | 55.1 | 58.1 | 48.0 | 58.3 | 48.2 | 0.015 |
| Raw Agreement, % | 74.4 | 78.6 | 80.5 | 82.3 | 81.2 | 88.5 | 75.2 | <0.0001 |
| Kappa | 0.27 | 0.32 | 0.23 | 0.27 | 0.28 | 0.40 | 0.21 | <.0001 |
| Watching, n | 473 | 529 | 804 | 368 | 884 | 318 | 320 | |
| PPV, % | 70.8 | 80.9 | 74.1 | 73.4 | 73.3 | 68.2 | 66.3 | <0.0001 |
| Raw Agreement, % | 71.0 | 67.0 | 69.1 | 69.6 | 68.2 | 69.4 | 60.8 | 0.001 |
| Kappa | 0.41 | 0.34 | 0.38 | 0.39 | 0.37 | 0.38 | 0.21 | <0.0001 |
PPV: positive predictive value, i. e. proportion of NOPR patient with the plan showing claims confirming actual management.
Raw agreement: percentage of patients whose plans agree with claim for or without a specified action.
Kappa: raw agreement, adjusted for agreement by chance assuming independence of plan and actual management.
SCL: Small cell lung
A Medicare Part D drugs claims sample of a 40% sample of Medicare beneficiaries was available at Dartmouth. 45% of NOPR patients for all cancer types and indications were successfully linked to their Part D claims. We found for kidney cancer patients with chemotherapy only 6 of 222 patients had claims not previously identified.
p-values were calculated for between cancer type differences.
Appendix 3 includes results for agreements at 30 days with 95% confidence intervals plus at 60 days along with 95% confidence intervals.