Joan L Warren
Dados Biográficos
| ID | 5534948 |
|---|---|
| NOME | Joan L Warren |
| PRENOMES | Joan L |
| SOBRENOME | Warren |
| ASSINATURA | WARREN J L |
| AFILIAÇÕES | National Cancer Institute |
| ORCID | 0000-0002-6467-6769 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 35 |
| TOTAL DE CITAÇÕES | 0 |
| TOTAL COMO AUTOR | 35 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1967 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 0 |
Contemporary Patterns of End-of-Life Care Among Medicare Beneficiaries With Advanced Cancer
This study found persistent patterns of potentially aggressive care, but low uptake of supportive care, among Medicare decedents with advanced cancer. A multifaceted approach targeting patient-, physician-, and system-level factors associated with potentially aggressive care is imperative for improving quality of care at the end of life
Evaluation of the Completeness of Managed Care Data to Identify Cancer Diagnoses and Treatments for Patients in the Seer-Medicare Data
BACKGROUND: The utility of codes on Medicare Advantage (MA) data to capture cancer diagnoses and treatment for cancer patients is unknown. OBJECTIVE: This study compared cancer diagnoses and treatments on MA encounter data (MA data) with the Surveillance, Epidemiology, and End-Results (SEER) data. SUBJECTS: Subjects were patients enrolled in either MA or Medicare fee-for-service (MFFS) when diagnosed with incident breast, colorectal, prostate, or…
The Utility of Pathology Reports to Identify Persons With Cancer Recurrence
BACKGROUND: Cancer recurrence is an important measure of the impact of cancer treatment. However, no population-based data on recurrence are available. Pathology reports could potentially identify cancer recurrences. Their utility to capture recurrences is unknown. OBJECTIVE: This analysis assesses the sensitivity of pathology reports to identify patients with cancer recurrence and the stage at recurrence. SUBJECTS: The study includes patients wi…
New Opportunities for Cancer Health Services Research
BACKGROUND: The Surveillance, Epidemiology and End Results (SEER)-Medicare data combine clinical information from population-based cancer registries with Medicare claims. These data have been used in many studies to understand cancer screening, treatment, outcomes, and costs. However, until recently, these data included limited information related to the characteristics and outcomes of cancer patients residing in or admitted to nursing homes. OBJ…
Use of High-cost Systemic Treatments in Elderly mCRC Patients
Bradley, Cathy J. PhD*; Yabroff, K. Robin PhD†; Warren, Joan L. PhD†; Zeruto, Christopher BS‡; Chawla, Neetu PhD†; Lamont, Elizabeth B. MD§ Author Information
Creating a National Provider Identifier (NPI) to Unique Physician Identification Number (Upin) Crosswalk for Medicare Data
INTRODUCTION: Many health services researchers are interested in assessing long term, individual physician treatment patterns, particularly for cancer care. In 2007, Medicare changed the physician identifier used on billed services from the Unique Physician Identification Number (UPIN) to the National Provider Identifier (NPI), precluding the ability to use Medicare claims data to evaluate individual physician treatment patterns across this trans…
Trends in the Treatment of Metastatic Colon and Rectal Cancer in Elderly Patients
BACKGROUND: Little is known about the use and costs of antineoplastic regimens for elderly patients with metastatic colorectal cancer (mCRC). We report population-based trends over a 10-year period in the treatment, survival, and costs in mCRC patients, stratified by ages 65-74 and 75+. METHODS: We used Surveillance, Epidemiology, and End Results-Medicare data for persons diagnosed with metastatic colon (N=16117) or rectal cancer (N=4008) between…
Comparison of Seer Treatment Data With Medicare Claims
BACKGROUND: The population-based Surveillance, Epidemiology, and End Results (SEER) registries collect information on first-course treatment, including surgery, chemotherapy, radiation therapy, and hormone therapy. However, the SEER program does not release data on chemotherapy or hormone therapy due to uncertainties regarding data completeness. Activities are ongoing to investigate the opportunity to supplement SEER treatment data with other dat…
Sensitivity of Medicare Claims to Identify Cancer Recurrence in Elderly Colorectal and Breast Cancer Patients
BACKGROUND: Researchers are increasingly interested in using observational data to evaluate cancer outcomes following treatment, including cancer recurrence and disease-free survival. Because population-based cancer registries do not collect recurrence data, recurrence is often imputed from health claims, primarily by identifying later cancer treatments after initial treatment. The validity of this approach has not been established. RESEARCH DESI…
Validating Billing/Encounter Codes as Indicators of Lung, Colorectal, Breast, and Prostate Cancer Recurrence Using 2 Large Contemporary Cohorts
BACKGROUND: A substantial proportion of cancer-related mortality is attributable to recurrent, not de novo metastatic disease, yet we know relatively little about these patients. To fill this gap, investigators often use administrative codes for secondary malignant neoplasm or chemotherapy to identify recurrent cases in population-based datasets. However, these algorithms have not been validated in large, contemporary, routine care cohorts. OBJEC…
Identifying Specific Chemotherapeutic Agents in Medicare Data
BACKGROUND: Large health care databases are increasingly used to examine the dissemination and benefits and harms of chemotherapy treatment in routine practice, particularly among patients excluded from trials (eg, the elderly). Misclassification of chemotherapy could bias estimates of frequency and association, warranting an updated assessment. METHODS: We evaluated the validity of Medicare claims to identify receipt of chemotherapy and specific…
Comparison of Approaches for Estimating Prevalence Costs of Care for Cancer Patients
BACKGROUND: National prevalence costs of medical care can be key inputs in health policy decisions. Cost estimates vary across data sources, patient populations, and methods, however, the objective of this study was to compare 3 approaches for estimating the prevalence costs of colorectal cancer (CRC) care using different data sources, but similar patient populations and methods. METHODS: We identified prevalent CRC patients aged 65 and older fro…
Comparison of Approaches for Estimating Incidence Costs of Care for Colorectal Cancer Patients
BACKGROUND: Estimates of the costs of medical care vary across patient populations, data sources, and methods. The objective of this study was to compare 3 approaches for estimating the incidence costs of colorectal cancer (CRC) care using similar patient populations, but different data sources and methods. METHODS: We used 2 data sources, linked SEER-Medicare and Medicare claims alone, to identify newly diagnosed CRC patients aged 65 and older a…
Comparison of Cancer Diagnosis and Treatment in Medicare Fee-for-Service and Managed Care Plans
OBJECTIVE: To compare the Medicare managed care (MC) and fee-for-service (FFS) sectors on stage at diagnosis and treatment patterns for prostate, female breast, and colorectal cancers, and to examine patterns across MC plans. DATA: Surveillance, Epidemiology, and End Results-Medicare linked data. METHODS: Among cases diagnosed at ages 65-79 between 1998 and 2002, we selected all MC enrollees (n = 42,467) and beneficiaries in FFS (n = 82,998) who …
Response to Letter from Dr. Steven T. Fleming
Data Sources for Measuring Comorbidity
BACKGROUND: Identifying appropriate comorbidity data sources is a key consideration in health services and outcomes research. OBJECTIVE: Using cancer patients as an example, we compared comorbid conditions identified: 1) on the discharge facesheet versus full hospital medical record and 2) in the hospital record versus Medicare claims, both precancer diagnosis and associated with a cancer treatment-related index hospitalization. METHODS: We used …
Estimating Patient Time Costs Associated With Colorectal Cancer Care
BACKGROUND: Nonmedical costs of care, such as patient time associated with travel to, waiting for, and seeking medical care, are rarely measured systematically with population-based data. OBJECTIVES: The purpose of this study was to estimate patient time costs associated with colorectal cancer care. METHODS: We identified categories of key medical services for colorectal cancer care and then estimated patient time associated with each service cat…
Can Cancer Registry Data Be Used to Study Cancer Treatment
From the Applied Research Program, National Cancer Institute, Bethesda, Maryland. Address correspondence and reprint requests to: Joan L. Warren, PhD, Applied Research Program, National Cancer Institute, Executive Plaza North, Room 4005, 6130 Executive Blvd, MSC 7344, Bethesda, Maryland 20892-7344. E-mail: [email protected]
Assessing Comorbidity Using Claims Data
Comorbidity, additional disease beyond the condition under study that increases a patient's total burden of illness, is one dimension of health status. For investigators working with observational data obtained from administrative databases, comorbidity assessment may be a useful and important means of accounting for differences in patients' underlying health status. There are multiple ways of measuring comorbidity. This paper provides an overvie…
Overview of the Seer-Medicare Data
Background. The Surveillance, Epidemiology and End Results (SEER)-Medicare–linked database combines clinical information from population-based cancer registries with claims information from the Medicare program. The use of this database to study cancer screening, treatment, outcomes, and costs has grown in recent years. Research Design. This paper provides an overview of the SEER-Medicare files for investigators interested in using these data for…
Linking Physician Characteristics and Medicare Claims Data
BACKGROUND: Increasingly, investigators are using administrative databases to answer research questions requiring physician characteristics information. This article provides a roadmap for investigators who use Medicare data to answer such questions, focusing on use of the Surveillance, Epidemiology, and End Results (SEER)-Medicare files. METHODS: Three data sources that can be linked to identify physician characteristics-Medicare claims, the Uni…
Identifying Cancer Relapse Using Seer-Medicare Data
INTRODUCTION: Tumor registries capture valid information at the time of cancer diagnosis, but often do not conduct longitudinal follow-up evaluations. However, investigators may be interested in questions relating to subsequent relapsed disease. Linking administrative data to registry data, as in the creation of the SEER (Surveillance, Epidemiology, and End Results) and Medicare data set, can provide the ability to infer the occurrence of relapse…
Methodological Issues in the Use of Administrative Claims Data to Study Surveillance After Cancer Treatment
BACKGROUND: Administrative claims databases linked to tumor registry data provide an excellent opportunity for studying the follow-up care of cancer patients. RESEARCH DESIGN: Methodological principles of study design are reviewed, using examples drawn from the recently published literature. RESULTS: Most follow-up care is outpatient-based. Therefore, in studies using Medicare claims, the patient should be eligible for Medicare Part B and should …
Identifying and Measuring Hospital Characteristics Using the Seer-Medicare Data and Other Claims-Based Sources
The context in which health care is delivered may have an impact on the outcomes and processes of care. Researchers analyzing claims data that reflect care rendered at many institutions may wish to identify hospital characteristics such as bed size, teaching status, degree of specialization, and case volume to evaluate their influence on outcomes. The authors describe the resources available from administrative data for characterizing hospitals. …
Utility of the Seer-Medicare Data to Identify Chemotherapy Use
Background. Medicare claims include codes for chemotherapy administration and specific drugs given, and researchers are increasingly using these data to measure the use of chemotherapy. However, the validity and completeness of these data as a source of information has not been established. Objectives. This analysis is intended to assess the utility of the Medicare claims to capture chemotherapy use. Methods. Persons with breast, colorectal, and …
Sem obras proeminentes nesta página.
Problems of Emergency Admissions to London Hospitals
Difficulty in admitting or failure to admit patients considered to be in urgent need of care and treatment in hospital are frustrating experiences for general practitioners and disquietening and perplexing ones for patients and their relatives. Such episodes are likely to undermine confidence in the organization and administration of the health services. They are, therefore, worthy of detailed study. Previous surveys have shown that delay in hosp…
Racial Differences in the Treatment of Early-Stage Lung Cancer
BACKGROUND: If discovered at an early stage, non-small-cell lung cancer is potentially curable by surgical resection. However, two disparities have been noted between black patients and white patients with this disease. Blacks are less likely to receive surgical treatment than whites, and they are likely to die sooner than whites. We undertook a population-based study to estimate the disparity in the rates of surgical treatment and to evaluate th…
Use of Medicare Hospital and Physician Data to Assess Breast Cancer Incidence
OBJECTIVES: Health claims data have the potential of being an inexpensive, timely, and nationally representative source of information about cancer. This study examined the utility of Medicare hospital and physician data as an independent source to identify incident breast cancer cases. METHODS: Data came from Medicare and the National Cancer Institute's SEER cancer registries. From 1992, for women residing in the SEER states (n = 659,260), Medic…
Development of a comorbidity index using physician claims data
Accuracy and Completeness of Medicare Claims Data for Surgical Treatment of Breast Cancer
BACKGROUND: Although a number of studies have used Medicare claims data to study trends and variations in breast cancer treatment, the accuracy and completeness of information on surgical treatment for breast cancer in the Medicare data have not been validated. OBJECTIVES: This study assessed the accuracy and completeness of Medicare claims data for breast cancer surgery to determine whether Medicare claims can serve as a source of data to augmen…
Assessing Comorbidity Using Claims Data
Comorbidity, additional disease beyond the condition under study that increases a patient's total burden of illness, is one dimension of health status. For investigators working with observational data obtained from administrative databases, comorbidity assessment may be a useful and important means of accounting for differences in patients' underlying health status. There are multiple ways of measuring comorbidity. This paper provides an overvie…
Overview of the Seer-Medicare Data
Background. The Surveillance, Epidemiology and End Results (SEER)-Medicare–linked database combines clinical information from population-based cancer registries with claims information from the Medicare program. The use of this database to study cancer screening, treatment, outcomes, and costs has grown in recent years. Research Design. This paper provides an overview of the SEER-Medicare files for investigators interested in using these data for…
Linking Physician Characteristics and Medicare Claims Data
BACKGROUND: Increasingly, investigators are using administrative databases to answer research questions requiring physician characteristics information. This article provides a roadmap for investigators who use Medicare data to answer such questions, focusing on use of the Surveillance, Epidemiology, and End Results (SEER)-Medicare files. METHODS: Three data sources that can be linked to identify physician characteristics-Medicare claims, the Uni…
Identifying Cancer Relapse Using Seer-Medicare Data
INTRODUCTION: Tumor registries capture valid information at the time of cancer diagnosis, but often do not conduct longitudinal follow-up evaluations. However, investigators may be interested in questions relating to subsequent relapsed disease. Linking administrative data to registry data, as in the creation of the SEER (Surveillance, Epidemiology, and End Results) and Medicare data set, can provide the ability to infer the occurrence of relapse…
Methodological Issues in the Use of Administrative Claims Data to Study Surveillance After Cancer Treatment
BACKGROUND: Administrative claims databases linked to tumor registry data provide an excellent opportunity for studying the follow-up care of cancer patients. RESEARCH DESIGN: Methodological principles of study design are reviewed, using examples drawn from the recently published literature. RESULTS: Most follow-up care is outpatient-based. Therefore, in studies using Medicare claims, the patient should be eligible for Medicare Part B and should …
Identifying and Measuring Hospital Characteristics Using the Seer-Medicare Data and Other Claims-Based Sources
The context in which health care is delivered may have an impact on the outcomes and processes of care. Researchers analyzing claims data that reflect care rendered at many institutions may wish to identify hospital characteristics such as bed size, teaching status, degree of specialization, and case volume to evaluate their influence on outcomes. The authors describe the resources available from administrative data for characterizing hospitals. …
Utility of the Seer-Medicare Data to Identify Chemotherapy Use
Background. Medicare claims include codes for chemotherapy administration and specific drugs given, and researchers are increasingly using these data to measure the use of chemotherapy. However, the validity and completeness of these data as a source of information has not been established. Objectives. This analysis is intended to assess the utility of the Medicare claims to capture chemotherapy use. Methods. Persons with breast, colorectal, and …
Studying Radiation Therapy Using Seer-Medicare-Linked Data
BACKGROUND: Numerous studies have used the SEER or Medicare data to assess the use of radiation therapy. However, the completeness of these data has not been evaluated. METHODS: Using linked SEER-Medicare data, a cohort was created that included incident cases of breast, endometrial, lung, prostate, or rectal cancer from 1991 to 1996 in persons 65 years and older. For each of these cases, use of radiation therapy as an initial course of treatment…
Use of Seer-Medicare Data for Measuring Cancer Surgery
BACKGROUND: The accuracy and completeness of the SEER-Medicare data for measuring cancer-related therapy have not been extensively evaluated. OBJECTIVES: To investigate the best method for measuring cancer-related surgery among patients in the SEER-Medicare database. SUBJECTS: A total of 149,970 incident cases of breast, colorectal, endometrial, lung, pancreatic, and prostate cancer diagnosed between 1991 and 1993.MEASURES The most invasive surgi…
Measuring Breast, Colorectal, and Prostate Cancer Screening With Medicare Claims Data
BACKGROUND: Evaluating the use and effectiveness of cancer screening is an important component of cancer control programs. Medicare claims may be a useful source of data when screening older populations, but they are limited in terms of completeness and the ability to distinguish screening tests from those provided for diagnosis or surveillance. RESEARCH DESIGN: A review of the major screening modalities for breast, colorectal, and prostate cance…
Patient Demographic and Socioeconomic Characteristics in the Seer-Medicare Database
Users of the linked SEER-Medicare database commonly perform analyses that focus on the complex interactions among patient characteristics, cancer treatments, and outcomes. The authors review the source and scope of the patient-specific data elements, with a focus on three domains--demographic characteristics, socioeconomic characteristics, and survival status. They offer some concrete recommendations regarding the use of these data elements. In p…
Measuring Complications of Cancer Treatment Using the Seer-Medicare Data
BACKGROUND: The linkage of SEER registry data with Medicare claims allows the longitudinal tracking of health care and outcomes for patients after a cancer diagnosis. One category of outcomes amenable to research using Medicare claims is complications of cancer treatments: the unintentional, adverse side effects or sequelae of interventions used to treat or palliate cancer patients. RESEARCH DESIGN: The authors review some of the methods and limi…
Can Cancer Registry Data Be Used to Study Cancer Treatment
From the Applied Research Program, National Cancer Institute, Bethesda, Maryland. Address correspondence and reprint requests to: Joan L. Warren, PhD, Applied Research Program, National Cancer Institute, Executive Plaza North, Room 4005, 6130 Executive Blvd, MSC 7344, Bethesda, Maryland 20892-7344. E-mail: [email protected]
Estimating Patient Time Costs Associated With Colorectal Cancer Care
BACKGROUND: Nonmedical costs of care, such as patient time associated with travel to, waiting for, and seeking medical care, are rarely measured systematically with population-based data. OBJECTIVES: The purpose of this study was to estimate patient time costs associated with colorectal cancer care. METHODS: We identified categories of key medical services for colorectal cancer care and then estimated patient time associated with each service cat…
Data Sources for Measuring Comorbidity
BACKGROUND: Identifying appropriate comorbidity data sources is a key consideration in health services and outcomes research. OBJECTIVE: Using cancer patients as an example, we compared comorbid conditions identified: 1) on the discharge facesheet versus full hospital medical record and 2) in the hospital record versus Medicare claims, both precancer diagnosis and associated with a cancer treatment-related index hospitalization. METHODS: We used …
Response to Letter from Dr. Steven T. Fleming
Comparison of Cancer Diagnosis and Treatment in Medicare Fee-for-Service and Managed Care Plans
OBJECTIVE: To compare the Medicare managed care (MC) and fee-for-service (FFS) sectors on stage at diagnosis and treatment patterns for prostate, female breast, and colorectal cancers, and to examine patterns across MC plans. DATA: Surveillance, Epidemiology, and End Results-Medicare linked data. METHODS: Among cases diagnosed at ages 65-79 between 1998 and 2002, we selected all MC enrollees (n = 42,467) and beneficiaries in FFS (n = 82,998) who …
Comparison of Approaches for Estimating Prevalence Costs of Care for Cancer Patients
BACKGROUND: National prevalence costs of medical care can be key inputs in health policy decisions. Cost estimates vary across data sources, patient populations, and methods, however, the objective of this study was to compare 3 approaches for estimating the prevalence costs of colorectal cancer (CRC) care using different data sources, but similar patient populations and methods. METHODS: We identified prevalent CRC patients aged 65 and older fro…
Comparison of Approaches for Estimating Incidence Costs of Care for Colorectal Cancer Patients
BACKGROUND: Estimates of the costs of medical care vary across patient populations, data sources, and methods. The objective of this study was to compare 3 approaches for estimating the incidence costs of colorectal cancer (CRC) care using similar patient populations, but different data sources and methods. METHODS: We used 2 data sources, linked SEER-Medicare and Medicare claims alone, to identify newly diagnosed CRC patients aged 65 and older a…
Identifying Specific Chemotherapeutic Agents in Medicare Data
BACKGROUND: Large health care databases are increasingly used to examine the dissemination and benefits and harms of chemotherapy treatment in routine practice, particularly among patients excluded from trials (eg, the elderly). Misclassification of chemotherapy could bias estimates of frequency and association, warranting an updated assessment. METHODS: We evaluated the validity of Medicare claims to identify receipt of chemotherapy and specific…
Medicine (32 obras) · Internal Medicine (26 obras) · Internal Medicine (25 obras) · Cancer (23 obras) · Global Cancer Incidence and Screening (21 obras) · Family medicine (15 obras) · Epidemiology (12 obras) · Epidemiology (12 obras) · MEDLINE (12 obras) · Population (11 obras)