Table 3.
Four Medicare Claims-Based Algorithms for Classifying SEER-Registered Myeloid Leukemia Cases in 2000–2005
| Claims-based Algorithms | SEER Registereda
|
Not Registered (n= 253,107) n (%) | |||
|---|---|---|---|---|---|
| All ML (n=4,708) n (%) | AML (n=3,365) n (%) | CML (n=1,343) n (%) | Other Hematologic Malignancies (n=14,297) n (%) | ||
| No ML claims | 333 (7) | 187 (6) | 146 (+11) | 11,589 (81) | 252,632 (100) |
| 1 or more ML claims (1+) | 4,375 (93) | 3,178 (94) | 1,197 (89) | 2,708 (19) | 475 (<1) |
| & a second ML claim 1 to 12 months after 1st claim or death or hospice entry within 3 months (2+) | 4,266 (91) | 3,140 (93) | 1,120 (83) | 2,047 (14) | 147 (<1) |
| & a blood count (BC) within 12 months before 1st claim (2+BC) | 4,260 (90) | 3,137 (93) | 1,117 (83) | 2,041 (14) | 143 (<1) |
| & a bone marrow (BM) biopsy within 12 months before 1st claim (2+BCBM) b | 4,190 (89) | 3,123 (93) | 1,061 (79) | 1,921 (13) | 107 (<1) |
| 2+BCBM using only CML claims | 1,551 (33) | 546 (16) | 1,005 (75) | 606 (4) | 44 (<1) |
| 2+BCBM using only AML claims | 3,414 (73) | 3,088 (92) | 326 (24) | 1515 (11) | 65 (<1) |
Persons registered with ML were separated into AML and CML categories based on first diagnosis. Individuals with Other Hematologic Malignancies were coded with a non-myeloid malignant disease using an ICD-O-3 code between 9800 and 9989. The validation samples (All ML, AML, CML and Other Hematologic Malignancies) excluded persons with claims for ML or unspecified leukemia or anemia within 1st data year (i.e., prevalent cases). Persons in the Not Registered group may have been registered for a hematological malignancy prior to 1999 or for other cancers.
For the ML 2+BCBM algorithm, sensitivity is 89.00% (4,190/4,708) and specificity is 99.96% ((253,107-107)/253,107). Sensitivities for the 2+BCBM AML and CML algorithms are 92% (3,088/3,365) and 75% (1,061/1,343), respectively.