April 21, 2012Journal of the American Society of Nephrology
Validation of Reported Predialysis Nephrology Care of Older Patients Initiating Dialysis
Key result
The CMS Medical Evidence Report showed substantial disagreement with Medicare physician claims regarding the timing of first predialysis nephrologist care (48.2% agreement, κ=0.29).
Population
80,509 patients aged ≥67 years who initiated dialysis between July 2005 and December 2008 with ≥2 years of…
Comparison
CMS Medical Evidence Report ascertainment of… vs Medicare physician claims data
Design
Cohort
Authors
Discussion
Loading...
Member takes
Implication
Disagreement between data sources cautions against single-source reliance for predialysis timing; leaves open validated ascertainment methods.
Study Design
Type
Cohort (n=80,509)
Structured PICO
P
Population
80,509 patients aged ≥67 years initiating dialysis with ≥2 years of Medicare coverage, evaluated for the accuracy of reported predialysis nephrology care.
E
Exposure
CMS Medical Evidence Report (form CMS-2728) ascertainment of timing of first nephrologist consultation
C
Comparator
Medicare physician claims data (first observed outpatient nephrologist consultation)
O
Outcome
Agreement between the two sources of ascertainment regarding the timing of first predialysis nephrology care
Main Result
Effect estimate: κ=0.29
There is substantial disagreement between the CMS Medical Evidence Report and Medicare claims regarding the timing of first predialysis nephrology care, highlighting potential inaccuracies in public health surveillance data.
Cite This Study
Kim et al. (2012) conducted a cohort in Initiating dialysis (n=80,509). CMS Medical Evidence Report (form CMS-2728) vs. Medicare physician claims was evaluated on Agreement on timing of first predialysis nephrology care (four periods) (κ=0.29). The CMS Medical Evidence Report showed substantial disagreement with Medicare physician claims regarding the timing of first predialysis nephrologist care (48.2% agreement, κ=0.29).