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Skeletal-related events and mortality among men diagnosed with advanced prostate cancer: The impact of alternative measures of radiation to the bone.

Abstract Skeletal-related events (SREs), which include radiation to the bone (RtB), can occur among patients with bone metastasis (BM). There is a recognized potential for misclassification of RtB when using claims data. We compared alternative measures of RtB to better understand their impact on SRE prevalence and SRE-related mortality.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos one
Publication Year Start




PMID- 28419139
OWN - NLM
STAT- In-Process
DA  - 20170418
LR  - 20170418
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 4
DP  - 2017
TI  - Skeletal-related events and mortality among men diagnosed with advanced prostate 
      cancer: The impact of alternative measures of radiation to the bone.
PG  - e0175956
LID - 10.1371/journal.pone.0175956 [doi]
AB  - PURPOSE/OBJECTIVE(S): Skeletal-related events (SREs), which include radiation to 
      the bone (RtB), can occur among patients with bone metastasis (BM). There is a
      recognized potential for misclassification of RtB when using claims data. We
      compared alternative measures of RtB to better understand their impact on SRE
      prevalence and SRE-related mortality. METHODS AND MATERIALS: We analyzed data for
      stage IV prostate cancer (PCa) cases identified between 2005 and 2009 in the
      Surveillance, Epidemiology, and End Results registry linked with Medicare claims.
      We created two measures of RtB: 1) a literature-based measure requiring the
      presence of a prior claim with a BM code; 2) a new measure requiring either that 
      the BM code coincided with the radiation episode or that the duration of the
      radiation episode was less than or equal to 4 weeks. We estimated adjusted hazard
      ratios of an SRE using both measures among stratified samples: no metastasis
      (M0), metastasis to bone (M1b) and other sites (M1c). RESULTS: The study sample
      included 5,074 men with stage IV PCa (median age 77 years), of whom 22% had M0,
      54% had M1b, and 24% had M1c disease at time of PCa diagnosis. Based on
      Approaches 1 and 2, the proportion with probable RtB was 5% and 8% among M0, 30% 
      and 30% among M1b, and 25% and 27% among M1c patients. Among M0 patients, the
      adjusted hazard ratio (AHR) associated with an SRE was 1.27 when using Approach 1
      (95% confidence interval, CI: 0.95-1.7) and 1.49 when using Approach 2 (95% CI:
      1.14-1.96). However, the impact of SREs on mortality did not differ between both 
      approaches among M1b and M1c patients. CONCLUSION: We found that alternative
      measures used to define RtB as SRE in claims data impact conclusions regarding
      the effect of SREs on mortality among M0 but not M1 patients.
FAU - Onukwugha, Eberechukwu
AU  - Onukwugha E
AUID- ORCID: http://orcid.org/0000-0001-8547-1810
AD  - University of Maryland School of Pharmacy, Baltimore, MD, United States of
      America.
FAU - Kwok, Young
AU  - Kwok Y
AD  - University of Maryland School of Medicine, Baltimore, MD, United States of
      America.
FAU - Ciezki, Jay P
AU  - Ciezki JP
AD  - Cleveland Clinic Radiation Oncology, Cleveland, OH, United States of America.
FAU - Yong, Candice
AU  - Yong C
AD  - University of Maryland School of Pharmacy, Baltimore, MD, United States of
      America.
FAU - Plaisant, Catherine
AU  - Plaisant C
AD  - University of Maryland College Park, College Park, MD, United States of America.
FAU - Reddy, Chandana A
AU  - Reddy CA
AD  - Cleveland Clinic Radiation Oncology, Cleveland, OH, United States of America.
FAU - Mullins, C Daniel
AU  - Mullins CD
AD  - University of Maryland School of Pharmacy, Baltimore, MD, United States of
      America.
FAU - Seal, Brian
AU  - Seal B
AD  - Bayer HealthCare, Whippany, New Jersey, United States of America.
FAU - Valderrama, Adriana
AU  - Valderrama A
AD  - Bayer HealthCare, Whippany, New Jersey, United States of America.
FAU - Hussain, Arif
AU  - Hussain A
AD  - University of Maryland School of Medicine, Baltimore, MD, United States of
      America.
AD  - Veterans Affairs Medical Center, Baltimore, MD, United States of America.
LA  - eng
PT  - Journal Article
DEP - 20170418
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
EDAT- 2017/04/19 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/19 06:00
PHST- 2016/09/03 [received]
PHST- 2017/04/03 [accepted]
AID - 10.1371/journal.pone.0175956 [doi]
AID - PONE-D-16-35445 [pii]
PST - epublish
SO  - PLoS One. 2017 Apr 18;12(4):e0175956. doi: 10.1371/journal.pone.0175956.
      eCollection 2017.

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