Association between cancer-specific adverse event triggers and mortality: A validation study Journal Article


Authors: Weingart, S. N.; Nelson, J.; Koethe, B.; Yaghi, O.; Dunning, S.; Feldman, A.; Kent, D.; Lipitz-Snyderman, A.
Article Title: Association between cancer-specific adverse event triggers and mortality: A validation study
Abstract: Background: As there are few validated measures of patient safety in clinical oncology, creating an efficient measurement instrument would create significant value. Accordingly, we sought to assess the validity of a novel patient safety measure by examining the association of oncology-specific triggers and mortality using administrative claims data. Methods: We examined a retrospective cohort of 322 887 adult cancer patients enrolled in commercial or Medicare Advantage products for one year after an initial diagnosis of breast, colorectal, lung, or prostate cancer in 2008-2014. We used diagnosis and procedure codes to calculate the prevalence of 16 cancer-specific "triggers"–events that signify a potential adverse event. We compared one-year mortality rates among patients with and without triggers by cancer type and metastatic status using logistic regression models. Results: Trigger events affected 19% of patients and were most common among patients with metastatic colorectal (41%) and lung (50%) cancers. There was increased one-year mortality among patients with triggers compared to patients without triggers across all cancer types in unadjusted and multivariate analyses. The increased mortality rate among patients with trigger events was particularly striking for nonmetastatic prostate cancer (1.3% vs 7.5%, adjusted odds ratio 1.96 [95% CI 1.49-2.57]) and nonmetastatic colorectal cancer (4.1% vs 11.7%, 1.44 [1.19-1.75]). Conclusions: The association between adverse event triggers and poor survival among a cohort of cancer patients supports the validity of a cancer-specific, administrative claims-based trigger tool. © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Keywords: oncology; epidemiology; quality of care; adverse events; trigger tool
Journal Title: Cancer Medicine
Volume: 9
Issue: 12
ISSN: 2045-7634
Publisher: Wiley Blackwell  
Date Published: 2020-06-01
Start Page: 4447
End Page: 4459
Language: English
DOI: 10.1002/cam4.3033
PUBMED: 32285614
PROVIDER: scopus
PMCID: PMC7300390
DOI/URL:
Notes: Article -- Export Date: 1 July 2020 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors