CED Data Sources (Text Version)

Slide Presentation from the AHRQ 2010 Annual Conference

On September 29, 2010, James Rollins made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (590 KB). Free PowerPoint® Viewer (Plugin Software Help).


Slide 1

Slide 1. CED Data Sources

CED Data Sources

AHRQ Annual Conference

September 2010

James A Rollins, MD, MSHA, PhD
Coverage and Analysis Group
Office of Clinical Standards and Quality
Centers for Medicare & Medicaid Services

Slide 2

Slide 2. Current CED Data Sources

Current CED Data Sources

  • ICD Registry
    Created by the American College of Cardiology Foundation
  • NOPR
    National Oncologic PET Registry

Slide 3

Slide 3. ICD Registry and Variables Collected

ICD Registry and Variables Collected

  • Demographic information:
    • Name
    • SSN
    • Patient ID
    • Date of Birth
    • Race
    • Ethnicity
    • Gender

Slide 4

Slide 4. History of Risk Factors

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

Slide 5

Slide 5. History and Risk Factors (cont.)

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)

Slide 6

Slide 6. History and Risk Factors (cont.)

History and Risk Factors (cont.)

  • Ischemic Heart Disease
  • Prior MI
  • Prior PCI
  • Prior CABG

Slide 7

Slide 7. Diagnostic Studies

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

Slide 8

Slide 8. Diagnostic Studies

Diagnostic Studies

  • Cardiac Rhythms
  • Abnormal Intraventricular Conduction

Slide 9

Slide 9. ICD Implant/Explant

ICD Implant/Explant

  • ICD Indication

Slide 10

Slide 10. NOPR Registry and Variables Collected

NOPR Registry and Variables Collected

  • Demographics:
    • Name
    • SSN
    • Patient's 5 Digit Zip Code
    • Date of birth
    • Race
    • Ethnicity
    • Gender
    • Date of Procedure
    • PET Facility ID#

Slide 11

Slide 11. Specific Reason for PET Study

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)

Slide 12

Slide 12. Cancer Type (ICD-9 Code)

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)

Slide 13

Slide 13. Cancer Type

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

Slide 14

Slide 14. Stage Before PET Scan

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

Slide 15

Slide 15. Patient Performance Status

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

Slide 16

Slide 16. Monitoring Treatment Responses

Monitoring Treatment Responses

  • Is the current ongoing treatment intended to be
    • Curative or palliative?

Slide 17

Slide 17. Management Plans

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

Slide 18

Slide 18. Management Plans (cont.)

Management Plan (cont.)

  • Treatment Goals:
    • Curative
    • Palliative
  • Types of Treatment:
    • Surgical
    • Chemotherapy
    • Radiation
    • Supportive Care
  • Will treatment be directly provided by you?

Slide 19

Slide 19. CED Data Sources

CED Data Sources

Current as of December 2010
Internet Citation: CED Data Sources (Text Version): Slide Presentation from the AHRQ 2010 Annual Conference. December 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/conference/2010/rollins/index.html