Download - Current CED Data Sources
![Page 1: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/1.jpg)
CED Data SourcesAHRQ Annual Conference
September 2010
James A Rollins, MD, MSHA, PhDCoverage and Analysis Group
Office of Clinical Standards and QualityCenters for Medicare & Medicaid Services
1
l
![Page 2: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/2.jpg)
Current CED Data Sources
• ICD Registry
Created by the American College of Cardiology Foundation
• NOPR
National Oncologic PET Registry
2
![Page 3: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/3.jpg)
ICD Registry and Variables Collected
• Demographic informationName
SSN
Patient ID
Date of Birth
Race
Ethnicity
Gender
3
![Page 4: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/4.jpg)
History of Risk Factors
• History of Heart Failure• Duration of Symptoms• Prior hospitalization for HFM, Timeframe• NYHA Functional Classification• Prior Heart Transplant • Non-Ischemic Dilated Cardiomyopathy
Timeframe• Syncope, Family Hx of Sudden Death
4
![Page 5: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/5.jpg)
History and Risk Factors (cont.)
• On Transplant Waiting List• Atrial Fibrillation/Flutter• Ventricular Tachycardia (Hemodynamic
instability)• Cardiac Arrest• Syndrome w/Risk of sudden death• Previous ICD (date, implant site, reason,
primary or secondary prevention
5
![Page 6: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/6.jpg)
History and Risk Factors (cont.)
• Ischemic Heart Disease• Prior MI• Prior PCI• Prior CABG
6
![Page 7: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/7.jpg)
Diagnostic Studies
• LVEF Assessed• Electrophysiologic Study (study timeframe,
ventricular arrhythmias induced, VT ablation performed, EP study findings)
• Lead ECG w/Automated Measurements• PR interval• QRS duration
7
![Page 8: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/8.jpg)
Diagnostic Studies
• Cardiac Rhythms• Abnormal Intraventricular Conduction
8
![Page 9: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/9.jpg)
ICD Implant/Explant
• ICD Indication
9
![Page 10: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/10.jpg)
NOPR Registry and Variables Collected
• DemographicsName
SSN
Patient’s 5 Digit Zip Code
Date of birth
Race
Ethnicity
Gender
Date of Procedure
PET Facility ID# 10
![Page 11: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/11.jpg)
Specific Reason for PET Study
• Restaging• Suspected Recurrence• Monitoring Treatment Response
during chemotherapy
during radiation therapy
during combined modality therapy
Diagnosis (Leukemia only)
Diagnosis/Paraneoplastic (Leukemia only)
Initial Staging (Leukemia only)11
![Page 12: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/12.jpg)
Cancer Type (ICD-9 Code)Stomach (151)
Small Intestine (152)
Anus (154)
Liver and intrahepatic bile ducts
(155)
Gall bladder & extrahepatic bile
duct (156)
Pancreas (157)
Retroperitoneum and
peritoneum (158)
Lung, small cell (162)
Pleura (163)
Thymus, heart, mediastinum (164)
Kaposi sarcoma (176)
Uterus, unspecified (179)
Uterus, body (182)
Prostate (185)
Testis (186)
Penis and male genitalia
(187)
Bladder (188)
Kidney and other urinary tract (189)
Eye (190)
Primary Brain (191)
Leukemia (204-208)
Neuroendocrine tumor (209)
Metastatic cancer unknown (203)12
![Page 13: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/13.jpg)
Cancer Type
• Has this cancer diagnosis been pathologically proven?
• Unknown primaries: Dominant site of pathologically proven or strongly suggested metastatic disease
e.g., Lymph node, lung, liver, brain, bone, other
13
![Page 14: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/14.jpg)
Stage Before PET Scan
• No evidence of disease• Localized only• Regional by direct extension or lymph node• Distant metastasis with single suspect site• Distant metastasis with multiple susp. sites• Unknown or uncertain
14
![Page 15: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/15.jpg)
Patient Performance Status
• Asymptomatic, fully active• Symptomatic, fully ambulatory• Symptomatic in bed <50% of the day• Symptomatic in bed >50% of the day• Bedridden, completely disabled
15
![Page 16: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/16.jpg)
Monitoring Treatment Responses
• Is the current ongoing treatment intended to be – Curative or palliative?
16
![Page 17: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/17.jpg)
Management Plans
• If PET were not available, what management strategy would be used?
Observation (with close follow up)
Additional Imaging (CT, MRI, other NIT)
Tissue Biopsy (surgical, percutaneous, endoscopic
Treatment
17
![Page 18: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/18.jpg)
Management Plan (cont.)
• Treatment GoalsCurative
Palliative
Types of Treatment
Surgical
Chemotherapy
Radiation
Supportive Car
Will treatment be directly provided by you?18
![Page 19: Current CED Data Sources](https://reader036.vdocuments.site/reader036/viewer/2022062422/56813160550346895d97d7d3/html5/thumbnails/19.jpg)
CED Data Sources
• The website for the source to Medicare data is http://www.resdac.umn.edu/
19