Quantification of information gained by linking claims data to an
electronic health record cohort of patients with metastatic breast
cancer
Abstract
Purpose: Linking claims data to electronic health record (EHR)
data can improve completeness, often at a cost of decreased sample size.
Quantifying information gained and differences in patient
characteristics between EHR and EHR-claims linked cohorts may inform
study design. Methods: Using ConcertAI Patient360 EHR linked to
multiple closed insurance claims sources, we compared an EHR cohort of
patients with incident metastatic breast cancer (mBC) to an EHR-claims
subcohort (requiring ≥90 days claims coverage). We analyzed diagnosis
coverage, patient-time during lookback and follow-up, baseline
characteristics, and rates of 14 adverse events (AEs). Analyses were
age-stratified due to insurance coverage changes at age 65.
Results: For the EHR cohort (N = 6289), 1438 (23%) were in the
EHR-claims subcohort. A greater proportion were aged ≥65 years in the
EHR cohort (30%) than in the EHR-claims subcohort (17%). EHR-claims
patients had longer observation periods and more unique diagnoses across
both age groups. For most AEs, incidences were higher in both age groups
in the EHR-claims subcohort than in EHR cohort. Conclusions:
EHR-claims provided more diagnoses and observation time, at the cost of
a reduction in sample size and underrepresentation of patients ≥65
years. Differing age proportions support age-stratified or standardized
analyses for EHR-claims data. Results aid interpretation of differences
between EHR and EHR-claims results due to shifts in age, completeness of
diagnosis history, and duration of observation.