Trends colliding: aging comprehensive family physicians and the growing complexity of their patients
Premji K, Glazier RH, Green ME, Khan S, Schultz S, Mathews M, Nastos S, Frymire E, Ryan BL. Can Fam Physician. 2025 Jun 16.
Purpose — There is increasing interest in using administrative data to examine treatment-related complications that lead to emergency department (ED) visits or hospitalizations (H). The purpose of this study was to evaluate the reliability of billing codes for identifying chemotherapy-related acute care visits (CRVs) among women with early-stage breast cancer.
Materials and Methods — The cohort was identified by using deterministically linked health databases and consisted of women who were diagnosed with early-stage breast cancer who started adjuvant chemotherapy between 2007 and 2009 in Ontario, Canada. A random sample of 496 patient cases was chosen as the validation cohort. Sensitivity (SN) and specificity (SP) were calculated for three scenarios: chemotherapy-related ED visit, chemotherapy-related H, and febrile neutropenia (FN)–related visit. For FN-related visits, three definitions were considered: general, moderate, and strict.
Results — The administrative cohort consisted of 8,359 patients, 43.4% of whom had at least one ED or H, including 1,496 women who had multiple visits that resulted in 6,293 unique visits. Of these, 73.1% were considered CRVs. The algorithm performed well in identifying CRVs that included H either from ED (SN, 90%; SP, 100%) or directly from home (SN, 91%; SP, 93%), but less well for ED visits that did not result in H (SN, 65%; SP, 80%). Depending on which FN algorithm was used, 4.8% to 24% of visits were considered related. The moderate FN algorithm provided the best tradeoff between SN (69% to 97%) and SP (83% to 98%).
Conclusion — Administrative data can be valuable in evaluating chemotherapy-related serious events. Algorithm validation in other cohorts is needed.
Krzyzanowska MK, Enright K, Moineddin R, Yun L, Powis M, Ghannam M, Grunfeld E. J Oncol Pract. 2018; 14(1):e51-8. Epub 2017 Nov 20.
The ICES website uses cookies. If that’s okay with you, keep on browsing, or learn more about our Privacy Policy.