Impact of Lookback Duration on the Performance of a Claims‐Based Frailty Proxy in Women With Stage I–III Breast Cancer
Pharmacoepidemiology and Drug Safety,
Год журнала:
2025,
Номер
34(2)
Опубликована: Янв. 16, 2025
Frailty
is
an
important
prognostic
indicator
in
older
women
with
breast
cancer.
The
Faurot
frailty
index,
a
validated
claims-based
proxy
measure,
uses
healthcare
billing
codes
during
user-specified
ascertainment
window
to
predict
frailty.
We
assessed
how
the
duration
of
affected
ability
index
one-year
mortality
stage
I-II
included
128
857
(66+
years)
I-III
cancer
SEER-Medicare
database
(2003-2019).
was
calculated
using
3-,
6-,
8-,
and
12-month
windows
prior
diagnosis
or
all-available
lookback.
Associations
between
each
all-cause
were
estimated
Kaplan-Meier
curves.
Discrimination
risk
C-statistics.
Five
percent
died
year
following
diagnosis.
Higher
scores
associated
increased
for
all
windows.
Differences
high
vs.
low
reduced
when
lookback
(16%
2%,
difference
=
15%,
95%
CI
0.14-0.15)
compared
shorter
(e.g.,
8
months:
25%
23%,
0.22-0.24).
C-statistics
ranged
from
0.758
(all-available
lookback)
0.770
(12
months)
robust
subgroups
defined
by
age,
race,
ethnicity,
region,
stage,
subtype.
performed
well
across
3-
Researchers
should
employ
this
address
confounding
studies
populations.
Язык: Английский
Frailty Trajectories Following Adjuvant Chemotherapy and Mortality in Older Women With Breast Cancer
JAMA Network Open,
Год журнала:
2025,
Номер
8(3), С. e250614 - e250614
Опубликована: Март 12, 2025
Importance
Frailty
assessed
at
a
single
time
point
is
associated
with
mortality
in
older
women
breast
cancer.
Little
known
about
how
changes
frailty
following
cancer
treatment
initiation
affect
mortality.
Objective
To
evaluate
the
association
between
claims-based
trajectories
adjuvant
chemotherapy
and
5-year
stage
I
to
III
Design,
Setting,
Participants
This
longitudinal
cohort
study
used
Surveillance,
Epidemiology,
End
Results
registries
linked
Medicare
claims
data
(claims
from
2003-2019).
Women
aged
65
years
or
diagnosed
2004
2017
were
included.
Eligible
underwent
surgery
followed
by
as
initial
treatment.
A
landmark
design
was
identify
during
year
initiation.
Continuous
enrollment
fee-for-service
180
days
before
diagnosis
through
360
(landmark)
required.
who
died
disenrolled
excluded.
Analyses
conducted
September
2022
March
2024.
Exposures
Claims-based
identified
using
Faurot
index,
validated
proxy
for
based
on
demographics
diagnosis,
procedure,
durable
medical
equipment
claims.
The
index
calculated
every
30
(360
after
initiation).
trajectory
clusters
K-means
clustering.
Main
Outcomes
Measures
Associations
estimated
Kaplan-Meier
analysis.
In
total,
20
292
(median
[IQR]
age,
70
[67-74]
years)
identified.
analysis
resulted
6
clusters:
3
robust
(16
120
[79.4%])
resilient
(3259
[16.1%])
nonresilient
(913
[4.5%]).
Five-year
higher
belonging
compared
those
(52.1%
vs
20.3%;
difference,
31.8%;
95%
CI,
29.0%-36.2%).
Conclusions
Relevance
this
of
cancer,
long-term
survival.
Future
research
should
assess
interventions
survival
patient-centered
outcomes
population.
Язык: Английский
Longitudinal trajectories of a claims-based frailty measure during adjuvant chemotherapy in women with stage I-III breast cancer
The Oncologist,
Год журнала:
2024,
Номер
29(10), С. e1291 - e1301
Опубликована: Май 8, 2024
Abstract
Background
Frailty
is
a
dynamic
syndrome
characterized
by
reduced
physiological
reserve
to
maintain
homeostasis.
Prospective
studies
have
reported
frailty
worsening
in
women
with
breast
cancer
during
chemotherapy,
improvements
following
treatment.
We
evaluated
whether
the
Faurot
index,
validated
claims-based
measure,
could
identify
changes
chemotherapy
treatment
and
identified
predictors
of
trajectory
patterns.
Methods
included
(65+
years)
stage
I-III
undergoing
adjuvant
SEER-Medicare
database
(2003-2019).
estimated
index
(range:
0-1;
higher
scores
indicate
greater
frailty)
at
initiation,
4
months
postinitiation,
10
postinitiation.
Changes
were
compared
matched
noncancer
comparator
cohort.
patterns
trajectories
year
initiation
using
K-means
clustering.
Results
Twenty-one
thousand
five
hundred
ninety-nine
initiated
chemotherapy.
Mean
increased
from
0.037
0.055
postchemotherapy
fell
0.049
Noncancer
comparators
experienced
small
increase
over
time
(0.055-0.062).
6
patterns:
robust
group
(78%),
2
resilient
groups
(16%),
3
nonresilient
(6%).
Black
claims
for
home
hospital
beds,
wheelchairs,
Parkinson’s
disease
more
likely
experience
trajectories.
Conclusions
observed
that
are
consistent
prior
clinical
measures
Our
study
demonstrates
feasibility
indices
assess
Язык: Английский
Assessing the Benefits and Harms of Pharmacotherapy in Older Adults with Frailty: Insights from Pharmacoepidemiologic Studies of Routine Health Care Data
Drugs & Aging,
Год журнала:
2024,
Номер
41(7), С. 583 - 600
Опубликована: Июль 1, 2024
Язык: Английский
Longitudinal Changes in a Claims-Based Frailty Proxy Measure Compared to Concurrent Changes in the Fried Frailty Phenotype
The Journals of Gerontology Series A,
Год журнала:
2024,
Номер
79(9)
Опубликована: Июль 12, 2024
Abstract
Background
Frailty
is
a
dynamic
aging-related
syndrome,
but
measuring
frailty
transitions
challenging.
The
Faurot
index
validated
Medicare
claims-based
proxy
based
on
demographic
and
billing
information.
We
evaluated
whether
3-year
changes
in
the
were
consistent
with
concurrent
phenotype
cohort
of
older
adults.
Methods
used
longitudinal
data
from
National
Health
Aging
Trends
Study
(NHATS)
claims
linkage
(2010–2018).
identified
adults
(66+
years)
2011
2015
NHATS
cohorts
at
least
1
year
fee-for-service
continuous
enrollment
(N
=
6
951).
described
annual
mean
for
up
to
3
years,
phenotype.
Results
At
baseline,
32%
robust,
48%
prefrail,
19%
frail
Mean
who
robust
baseline
worsened
increased
over
years
(0.09–0.25).
Similarly,
those
prefrail
experienced
an
increase
(0.14–0.26).
Improvements
did
not
correspond
decreases
frailty.
Older
whose
improved
time
had
lower
score
than
stable
or
worsening
Conclusions
increases
index.
Our
results
suggest
that
may
be
identify
clinically
meaningful
Язык: Английский