Developing a cancer-specific trigger tool to identify treatment-related adverse events using administrative data Journal Article
| Authors: | Weingart, S. N.; Nelson, J.; Koethe, B.; Yaghi, O.; Dunning, S.; Feldman, A.; Kent, D. M.; Lipitz-Snyderman, A. |
| Article Title: | Developing a cancer-specific trigger tool to identify treatment-related adverse events using administrative data |
| Abstract: | Background: As there are few validated tools to identify treatment-related adverse events across cancer care settings, we sought to develop oncology-specific “triggers” to flag potential adverse events among cancer patients using claims data. Methods: 322 887 adult patients undergoing an initial course of cancer-directed therapy for breast, colorectal, lung, or prostate cancer from 2008 to 2014 were drawn from a large commercial claims database. We defined 16 oncology-specific triggers using diagnosis and procedure codes. To distinguish treatment-related complications from comorbidities, we required a logical and temporal relationship between a treatment and the associated trigger. We tabulated the prevalence of triggers by cancer type and metastatic status during 1-year of follow-up, and examined cancer trigger risk factors. Results: Cancer-specific trigger events affected 19% of patients over the initial treatment year. The trigger burden varied by disease and metastatic status, from 6% of patients with nonmetastatic prostate cancer to 41% and 50% of those with metastatic colorectal and lung cancers, respectively. The most prevalent triggers were abnormal serum bicarbonate, blood transfusion, non-contrast chest CT scan following radiation therapy, and hypoxemia. Among patients with metastatic disease, 10% had one trigger event and 29% had two or more. Triggers were more common among older patients, women, non-whites, patients with low family incomes, and those without a college education. Conclusions: Oncology-specific triggers offer a promising method for identifying potential patient safety events among patients across cancer care settings. © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. |
| Keywords: | oncology; patient safety; epidemiology; quality of care; adverse event; trigger tool |
| Journal Title: | Cancer Medicine |
| Volume: | 9 |
| Issue: | 4 |
| ISSN: | 2045-7634 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2020-02-01 |
| Start Page: | 1462 |
| End Page: | 1472 |
| Language: | English |
| DOI: | 10.1002/cam4.2812 |
| PUBMED: | 31899856 |
| PROVIDER: | scopus |
| PMCID: | PMC7013078 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 March 2020 -- Source: Scopus |
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