Common data determinants of recurrent cancer are broken, mislead researchers
Current algorithms used to pull the needle of patients with recurrent cancer from the haystack of patient databases are broken. Image: Flickr/jromero
In order to study the effectiveness or cost effectiveness of treatments for recurrent cancer, you first have to discover the patients in medical databases who have recurrent cancer. Generally studies do this with billing or treatment codes – certain codes should identify who does and does not have recurrent cancer. A recent study published in the journal Medical Care shows that the commonly used data determinants of recurrent cancer may be misidentifying patients and potentially leading researchers astray.
"For example, a study might look in a database for all patients who had chemotherapy and then another round of chemotherapy more than six months after the first, imagining that a second round defines recurrent disease. Or a study might look in a database for all patients with a newly discovered secondary tumor, imagining that all patients with a secondary tumor have recurrent disease. Our study shows that both methods are leave substantial room for improvement," says Debra Ritzwoller, PhD, health economist at the Kaiser Permanente Colorado Institute for Health Research and investigator at the University of Colorado Cancer Center.
The study used two unique datasets derived from HMO/Cancer Research Network and CanCORS/Medicare to check if the widely used algorithms in fact discovered the patients with recurrent disease that the algorithms were designed to detect. They did not. For example, a newly diagnosed secondary cancer may not mark a recurrence but may instead be a new cancer entirely; a second, later round of chemotherapy may be needed for continuing control of the de novo cancer, and not to treat recurrence.
For example, to discover recurrent prostate cancer, no combination of billing codes used in this large data set pointed with sensitivity and specificity to patients whom notes in the data showed had recurrent disease. The highest success of the widely used algorithms was predicting patients with recurrent lung, colorectal and breast cancer, with success rates only between 75 and 85 percent.
"We need to know who in these data sets has recurrent disease. Then we can do things like look at which treatments lead to which outcomes," Ritzwoller says. Matching patients to outcomes can help to decide who gets what treatment, and can help optimize costs in health care systems.
In a forthcoming paper, Ritzwoller and colleagues will suggest algorithms to replace these that have now proved inadequate.
More information: journals.lww.com/l… s.99357.aspx
Journal reference: Medical Care
Provided by University of Colorado Denver
- Plasma DNA level is a reliable marker of recurrent esophageal cancer, study finds Jul 25, 2008 | not rated yet | 0
- Study finds thalidomide shows promise for treatment of recurrent ovarian cancer Feb 27, 2008 | not rated yet | 0
- Certain head and neck cancer patients benefit from second round of treatment Jun 13, 2011 | not rated yet | 0
- Chemo may extend survival after breast cancer's return Dec 06, 2012 | not rated yet | 0
- New drug combination slows tumor growth for recurrent ovarian cancer Jun 06, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer May 24, 2013 | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer May 24, 2013 | 5 / 5 (1) | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer May 24, 2013 | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer May 24, 2013 | 5 / 5 (2) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer May 24, 2013 | 5 / 5 (4) | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
22 hours ago | 5 / 5 (6) | 5
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
22 hours ago | 5 / 5 (1) | 1
(HealthDay)—Animals make great companions for senior citizens, but elderly people who always drive with a pet in the car are far more likely to crash than those who never drive with a pet, researchers have ...
14 hours ago | not rated yet | 1
(Medical Xpress)—A research team, led by Jeremy Barr, a biology post-doctoral fellow, unveils a new immune system that protects humans and animals from infection.
May 20, 2013 | 4.8 / 5 (31) | 9 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
May 22, 2013 | 4.3 / 5 (6) | 6 |
Salamanders' immune systems are key to their remarkable ability to regrow limbs, and could also underpin their ability to regenerate spinal cords, brain tissue and even parts of their hearts, scientists have ...
May 20, 2013 | 4.9 / 5 (7) | 5 |