Cohort Definition Name : Earliest event of Urothelial carcinoma
Contributor name : Jill Hardin’
Contributor OrcId :
Logic Description : Earliest event of Urothelial Carcinoma indexed on diagnosis Indexed on Primary or malignant urothelial bladder cancer diagnosis cohort exit is the end of continuous observation.
Recommended study application : target
Assertion statement : This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Target Clinical Description : Urothelial carcinoma (or transitional cell carcinoma) are tumors arising in urothelial cells that line the mucosal surfaces of the urinary tract. The majority of urothelial carcinomas (90-95%) are in the lower urinary tract (bladder, urethra); and the rest (5-10%) are in the upper tract (renal pelvis, ureter)
"Evaluation conclusion : We developed four prevalent cohort definitions for urothelial cancer (URO) using concept sets which incorporated all those found from the literature review and from the analysis of PHOEBE and orphan concepts in cohort diagnostics. We performed the evaluation across a network of claim data sources and 1 EHR US data source. The data sources are: IBM® MarketScan® Commercial Database (CCAE), Optum’s longitudinal EHR repository (Optum EHR), Optum’s Clinformatics® Data Mart (DOD), IBM® MarketScan® Multi-State Medicaid Database (MDCD), IBM® MarketScan® Medicare Supplemental Database (MDCR), Japan Claims Database (JMDC), Clinical Practice Research Datalink (CPRD) , IQVIA® Australia Longitudinal Patient Data (LPD) database (Australia), IQVIA® Disease Analyzer (DA) France database (France), QVIA® Disease Analyzer (DA) Germany database (Germany), IQVIA® Adjudicated Health Plan Claims Data (formerly PharMetrics Plus) - US database (PharMetrics), IQVIA® Ambulatory EMR (EMR). The algorithms retrieve subjects from all 11 databases tested. We found there was no need to correct for index date misclassification. We also found the use of secondary malignancy codes did not increase the number of subjects identified. Hence we recommend use of this definition.
Performance characteristics were determined for 8 of the 11 databases. The remaining databases did not contain enough subjects to produce an accurate diagnostic model. Using one code, sensitivity ranged from about 61% in Germany to about 99% in SES while positive predictive value ranged from about 68% in CCAE to about 87% in MDCR. Using two codes, sensitivity decreased, ranging from about 23% in Germany to about 91% in JMDC while positive predictive value increased, ranging from 90% in JMDC to about 99% in SES.