Table 2.
Comparison of receipt of breast cancer surgery in the registry and in the insurance claims stratified by key characteristics
| Claims Yes, Registry Yes | Claims Yes, Registry No | Claims No, Registry Yes | Claims No, Registry No | Sensitivity (95% CI)a | Specificitya (95% CI) | PPV (95% CI)a | NPVa (95% CI) | Kappa (95% CI) | |
|---|---|---|---|---|---|---|---|---|---|
| Overall | 23,125 | 487 | 1,681 | 1,526 | 97.9% (97.7%, 98.1%) | 46.6% (46.8%, 49.3%) | 93.2% (93.0%, 93.4%) | 75.8% (74.0%, 77.5%) | 0.54 (0.53, 0.56) |
| Key populations | |||||||||
| Rural | 5,166 | 102 | 366 | 328 | 98.1% (97.6%, 98.4%) | 47.3% (43.5%, 51.1%) | 93.4% (92.9%, 93.8%) | 76.3% (72.3%, 79.8%) | 0.54 (0.51, 0.58) |
| Black patients | 3,631 | 140 | 331 | 360 | 96.3% (95.6%, 96.9%) | 52.1% (48.3%, 55.9%) | 91.7% (91.0%, 92.2%) | 72.0% (68.3%, 75.4%) | 0.54 (0.51, 0.58) |
| Insurance typeb | |||||||||
| Commercial | 5,401 | 137 | 428 | 73 | 97.5% (97.0%, 97.9%) | 14.6% (11.6%, 18.0%) | 92.7% (92.4%, 92.9%) | 34.8% (28.9%, 41.1%) | 0.16 (0.12, 0.20) |
| Medicaid | 603 | 40 | 252 | 80 | 93.8% (91.6%, 95.5%) | 24.1% (19.6%, 29.1%) | 70.5% (69.2%, 71.8%) | 66.7% (58.4%, 74.1%) | 0.21 (0.14, 0.27) |
| Medicare | 15,147 | 254 | 882 | 1,135 | 98.4% (98.1%, 98.5%) | 56.3% (54.1%, 58.5%) | 94.5% (94.2%, 94.7%) | 81.7% (79.7%, 83.5%) | 0.63 (0.61, 0.65) |
| Year of diagnosis | |||||||||
| 2003–2005 | 1,503 | 66 | 126 | 153 | 95.8% (94.7%, 96.7%) | 54.8% (48.8%, 60.8%) | 92.3% (91.3%, 93.1%) | 69.9% (64.2%, 75.0%) | 0.57 (0.52, 0.61) |
| 2006–2009 | 5,331 | 149 | 469 | 354 | 97.3% (96.8%, 97.7%) | 43.0% (39.6%, 46.5%) | 91.9% (91.5%, 92.3%) | 70.4% (66.6, 73.9%) | 0.46 (0.42, 0.50) |
| 2010–2013 | 9,147 | 133 | 700 | 535 | 98.6% (98.3%, 98.8%) | 43.3% (40.5%, 46.1%) | 92.9% (92.6%, 93.2%) | 80.1% (77.1%, 82.8%) | 0.52 (0.49, 0.55) |
| 2014–2017 | 7,144 | 139 | 386 | 484 | 98.1% (97.7%, 98.4%) | 55.6% (52.3%, 59.0%) | 94.9% (94.5%, 95.2%) | 77.7% (74.5%, 80.58) | 0.61 (0.58, 0.64) |
aSensitivity is defined as the probability of having a surgery identified in the registry given that there is an insurance claim for surgery. Positive Predictive Value (PPV) is defined as the probability of having an insurance claim for surgery given a flag for surgery in the registry. Specificity is defined as the probability for not having a recorded surgery in the registry given that there was no claim for surgery. Negative Predictive Value is defined as the probability for not having a claim for surgery given that there was no surgery recorded in the registry
bMedicare and commercial claims available 2003–2017, Medicaid claims available 2003–2012
PPV Positive predictive value, NPV negative predictive value