%0 Journal Article
%T Comorbidity Assessment in the National Cancer Database for Patients With Surgically Resected Breast, Colorectal, or Lung Cancer (AFT-01, -02, -03)
%A Am
%A Benjamin D. Kozower
%A Caprice C. Greenberg
%A Chung-Yuan Hu
%A Daniel P. McKellar
%A George J. Chang
%A George J. Stukenborg
%A Jessica R. Schumacher
%A Louise C. Walter
%A Melisa L. Wong
%A Timothy L. McMurry
%A a B. Francescatti
%J General Information | Journal of Oncology Practice
%D 2018
%R https://doi.org/10.1200/JOP.18.00175
%X INTRODUCTION Section: ChooseTop of pageAbstractINTRODUCTION <<PATIENTS AND METHODSRESULTSDISCUSSIONREFERENCES Health services research commonly leverages data from large cancer registries to examine practice patterns,1-4 disparities,5-7 and outcomes.8-10 Such studies rely on accurate and complete measurement of comorbidities to account for patient differences or to understand the impact of comorbidities on clinical outcomes. Furthermore, comorbidities can affect treatment decision making, toxicity, and overall survival (OS),11-17 making accurate measurement central to research. In the National Cancer Database (NCDB), which captures approximately 70% of newly diagnosed patients in the United States,18,19 comorbidity is assessed using the Charlson-Deyo Comorbidity Index (CCI)20,21 mapped from up to 10 International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes typically from discharge abstracts or billing face sheets.22 The accuracy of the CCI variable available in the NCDB is often perceived to be limited, but data regarding its accuracy are limited. One recent study23 compared the prevalence of comorbidities reported in the NCDB with comorbidities in a separate Surveillance, Epidemiology, and End Results (SEER)-Medicare cohort of matched patients with breast, colorectal, or lung cancer. The comorbidities reported in the NCDB and SEER-Medicare database were similar overall except for congestive heart failure, chronic pulmonary disease, and renal disease, which were consistently underreported in the NCDB.23 Although this study compared comorbidities in matched cohorts, a direct evaluation of comorbidity assessment in the NCDB using data from the same cohort of patients was not possible. As part of an American College of Surgeons Commission on Cancer (CoC) Special Study,24,25 comorbidities were re-abstracted from original medical records for more than 30,000 patients with surgically resected breast, colorectal, or lung cancer. The Special Study thus provided a unique opportunity to directly evaluate comorbidity assessment in the NCDB. Therefore, the purpose of this study was to determine the accuracy of comorbidity assessment in the NCDB compared with a gold standard of medical record abstraction. In addition, we compared the performance of three different methods for adjusting for comorbidity in postoperative survival models. PATIENTS AND METHODS Section: ChooseTop of pageAbstractINTRODUCTIONPATIENTS AND METHODS <<RESULTSDISCUSSIONREFERENCES Data Source The NCDB, sponsored by American College of Surgeons and
%U http://ascopubs.org/doi/full/10.1200/JOP.18.00175