--- title: "Identify personalized med use in breast cancer. | Sutter Health" description: "Describe agreement, sensitivity & specificity of admin claims compared with medical records for two pairs of targeted tests and treatments for breast cancer." url: "https://www.sutterhealth.org/research/publications/identify-use-of-personalized-med-in-breast-cancer-1055312577" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Identify personalized med use in breast cancer. # Tradeoffs of using administrative claims and medical records to identify the use of personalized medicine for patients with breast cancer. Liang SY, Phillips KA, Wang G, Keohane C, Armstrong J, Morris WM, & Haas JS. _Med Care. 49(6):e1-8. doi: 10.1097/MLR.0b013e318207e87e._ 2011-06-01 ## Abstract BACKGROUND: Administrative claims and medical records are important data sources to examine healthcare utilization and outcomes. Little is known about identifying personalized medicine technologies in these sources. OBJECTIVES: To describe agreement, sensitivity, and specificity of administrative claims compared with medical records for 2 pairs of targeted tests and treatments for breast cancer. RESEARCH DESIGN: Retrospective analysis of medical records linked to administrative claims from a large health plan. We examined whether agreement varied by factors that facilitate tracking in claims (coding and cost) and that enhance medical record completeness (records from multiple providers). SUBJECTS: Women (35 to 65 y of age) with incident breast cancer diagnosed in 2006 to 2007 (n=775). MEASURES: Use of human epidermal growth factor receptor 2 (HER2) and gene expression profiling (GEP) testing, trastuzumab, and adjuvant chemotherapy in claims and medical records. RESULTS: Agreement between claims and records was substantial for GEP, trastuzumab, and chemotherapy, and lowest for HER2 tests. GEP, an expensive test with unique billing codes, had higher agreement (91.6% vs. 75.2%), sensitivity (94.9% vs. 76.7%), and specificity (90.1% vs. 29.2%) than HER2, a test without unique billing codes. Trastuzumab, a treatment with unique billing codes, had slightly higher agreement (95.1% vs. 90%) and sensitivity (98.1% vs. 87.9%) than adjuvant chemotherapy. CONCLUSIONS: Higher agreement and specificity were associated with services that had unique billing codes and high cost. Administrative claims may be sufficient for examining services with unique billing codes. Medical records provide better data for identifying tests lacking specific codes and for research requiring detailed clinical information. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/?term=Tradeoffs+of+Using+Administrative+Claims+and+Medical+Record) ![Su-Ying Liang, Ph.D.](https://dyn.mktgcdn.com/p/cRIUee_GK3HEL1Wq8svqoUApvABjlwVVA-KUHVGzuNw/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Su-Ying Liang, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/su-ying-liang-phd-1049681030) ## Research topics - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Linking electronic health records to better understand breast cancer patient pathways within and between two health systems.](https://www.sutterhealth.org/research/publications/link-ehrs-understand-breast-cancer-pathways-1055312796) Thompson CA, Kurian AW, Luft HS. eGEMs (Generating Evidence & Methods to improve patient outcomes). 3(1). 2015 Mar 01 - Publication ### [Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.](https://www.sutterhealth.org/research/publications/characteristics-cancer-screening-asian-american-1055312854) Thompson CA, Gomez SL, Chan A, Chan JK, McClellan SR, Chung S, Olson C, Nimbal V, Palaniappan L. Cancer Epidemiol Biomarkers Prev. 23(11):2208-17. doi: 10.1158/1055-9965.EPI-14-0487. 2014 Nov 01 - Publication ### [The centralization of robotic surgery in high-volume centers for endometrial cancer patients--a study of 6560 cases in the U.S.](https://www.sutterhealth.org/research/publications/central-robotic-surery-centers-endometrial-cancer-1055312938) Chan JK, Gardner AB, Taylor K, Blansit K, Thompson CA, Brooks R, Yu X, Kapp DS. Gynecol Oncol. 2015 Jul;138(1):128-32. doi: 10.1016/j.ygyno.2015.04.031. Epub 2015 Apr 28. 2015 Jul 01 - Publication ### [Physicians' perceptions of shared decision-making behaviours: a qualitative study demonstrating the continued chasm between aspirations and clinical practice.](https://www.sutterhealth.org/research/publications/doctors-perceptions-shared-dec-making-behs-1055312533) Zeuner R, Frosch DL, Kuzemchak MD, Politi MC. Health Expect. 18(6):2465-76. doi: 10.1111/hex.12216. Epub 2014 Jun 17. 2015 Dec 01 - Publication ### [Redefining risk and benefit: understanding the decision to undergo contralateral prophylactic mastectomy.](https://www.sutterhealth.org/research/publications/risk-benefit-contralateral-prophylactic-mastectomy-1055312871) Rendle KA, Halley MC, May SG, Frosch DL. Qual Health Res. pii: 1049732314557085. \[Epub ahead of print\] 2014 Nov 04 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/identify-use-of-personalized-med-in-breast-cancer-1055312577#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Identify personalized med use in breast cancer."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/identify-use-of-personalized-med-in-breast-cancer-1055312577#medicalscholarlyarticle","name":"Tradeoffs of using administrative claims and medical records to identify the use of personalized medicine for patients with breast cancer.","headline":"Identify personalized med use in breast cancer.","abstract":"BACKGROUND: Administrative claims and medical records are important data sources to examine healthcare utilization and outcomes. Little is known about identifying personalized medicine technologies in these sources. OBJECTIVES: To describe agreement, sensitivity, and specificity of administrative claims compared with medical records for 2 pairs of targeted tests and treatments for breast cancer. RESEARCH DESIGN: Retrospective analysis of medical records linked to administrative claims from a large health plan. We examined whether agreement varied by factors that facilitate tracking in claims (coding and cost) and that enhance medical record completeness (records from multiple providers). SUBJECTS: Women (35 to 65 y of age) with incident breast cancer diagnosed in 2006 to 2007 (n=775). MEASURES: Use of human epidermal growth factor receptor 2 (HER2) and gene expression profiling (GEP) testing, trastuzumab, and adjuvant chemotherapy in claims and medical records. RESULTS: Agreement between claims and records was substantial for GEP, trastuzumab, and chemotherapy, and lowest for HER2 tests. GEP, an expensive test with unique billing codes, had higher agreement (91.6% vs. 75.2%), sensitivity (94.9% vs. 76.7%), and specificity (90.1% vs. 29.2%) than HER2, a test without unique billing codes. Trastuzumab, a treatment with unique billing codes, had slightly higher agreement (95.1% vs. 90%) and sensitivity (98.1% vs. 87.9%) than adjuvant chemotherapy. CONCLUSIONS: Higher agreement and specificity were associated with services that had unique billing codes and high cost. Administrative claims may be sufficient for examining services with unique billing codes. Medical records provide better data for identifying tests lacking specific codes and for research requiring detailed clinical information.","description":"Describe agreement, sensitivity & specificity of admin claims compared with medical records for two pairs of targeted tests and treatments for breast cancer.","keywords":["All Cancer","Health Services","Medical Informatics","Women's Health"],"datePublished":"2011-06-01","url":"https://www.sutterhealth.org/research/publications/identify-use-of-personalized-med-in-breast-cancer-1055312577","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"DOI","value":"10.1097/MLR.0b013e318207e87e"}],"sameAs":["https://doi.org/10.1097/MLR.0b013e318207e87e"],"isPartOf":{"@type":"Periodical","name":"Med Care"},"author":[{"@type":"Person","@id":"https://www.sutterhealth.org/research/investigators/su-ying-liang-phd-1049681030","name":"Liang SY","url":"https://www.sutterhealth.org/research/investigators/su-ying-liang-phd-1049681030"},{"@type":"Person","name":"Phillips KA"},{"@type":"Person","name":"Wang G"},{"@type":"Person","name":"Keohane C"},{"@type":"Person","name":"Armstrong J"},{"@type":"Person","name":"Morris WM"},{"@type":"Person","name":"Haas JS"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"All Cancer","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22All+Cancer%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Medical Informatics","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Medical+Informatics%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Women's Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Women%27s+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/identify-use-of-personalized-med-in-breast-cancer-1055312577","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/identify-use-of-personalized-med-in-breast-cancer-1055312577#breadcrumblist"}}} ```