Impact of Lookback Duration on the Performance of a Claims-Based Frailty Proxy in Women With Stage I-III Breast Cancer.

Details

• Alternative Title:
  Pharmacoepidemiology and Drug Safety, 2025, v. 34, no. 2: Impact of Lookback Duration on the Performance of a Claims-Based Frailty Proxy in Women With Stage I-III Breast Cancer.
• Journal Article:
  Pharmacoepidemiology and Drug Safety
• Personal Author:
  Duchesneau, Emilie D. ; Stürmer, Til ; Reeder-Hayes, Katherine ; Kim, Dae Hyun ; Edwards, Jessie K. ; Faurot, Keturah R. ; Lund, Jennifer L.
• Description:
  Frailty is an important prognostic indicator in older women with breast cancer. The Faurot frailty index, a validated claims-based frailty proxy measure, uses healthcare billing codes during a user-specified ascertainment window to predict frailty. We assessed how the duration of frailty ascertainment affected the ability of the Faurot frailty index to predict one-year mortality in women with stage I-II breast cancer.
  
  We included 128 857 women (66+ years) with stage I-III breast cancer in the SEER-Medicare database (2003-2019). The Faurot frailty index was calculated using 3-, 6-, 8-, and 12-month ascertainment windows prior to diagnosis or using all-available lookback. Associations between the Faurot frailty index using each window and one-year all-cause mortality were estimated using Kaplan-Meier curves. Discrimination of one-year mortality risk was assessed using C-statistics.
  
  Five percent of women died during the year following diagnosis. Higher Faurot scores were associated with increased mortality risk for all frailty ascertainment windows. Differences in one-year mortality risk for women with high vs. low Faurot frailty scores were reduced when using all-available lookback (16% vs. 2%, difference = 15%, 95% CI 0.14-0.15) compared to shorter windows (e.g., 8 months: 25% vs. 2%, difference = 23%, 95% CI 0.22-0.24). C-statistics ranged from 0.758 (all-available lookback) to 0.770 (12 months) and were robust in subgroups defined by age, race, ethnicity, region, stage, and cancer subtype.
  
  The Faurot frailty index performed well across 3- to 12-month frailty ascertainment windows in women with breast cancer. Researchers should employ this index to address confounding by frailty in studies of cancer populations.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Female
  • Breast Neoplasms
  • Aged
  • Frailty
  • SEER Program
  • Medicare
  • Aged, 80 and over
  • Neoplasm Staging
  • Time Factors
  More +
• Keywords:
  • breast cancer
  • claims data
  • frailty
  • SEER-Medicare
  • validation
• Source:
  Pharmacoepidemiology and Drug Safety, 2025, v. 34, no. 2
• DOI:
  https://doi.org/10.1002/pds.70103
• ISSN:
  1053-8569 ; 1099-1557
• Pubmed ID:
  39821599
• Pubmed Central ID:
  PMC11912347
• Document Type:
  Text
• Funding:
  UL1TR002489/TR/NCATS NIH HHSUnited States/ ; UM1 TR004406/TR/NCATS NIH HHSUnited States/ ; UL1 TR002489/TR/NCATS NIH HHSUnited States/ ; School of Medicine, University of North Carolina at Chapel Hill/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; R01AG056479/AG/NIA NIH HHSUnited States/ ; R01 AG056479/AG/NIA NIH HHSUnited States/ ; T32 CA116339/CA/NCI NIH HHSUnited States/ ; P30 AG066615/AG/NIA NIH HHSUnited States/ ; HHSN261201000140C/CA/NCI NIH HHSUnited States/ ; K24 AG073527/AG/NIA NIH HHSUnited States/ ; K24AG073527/AG/NIA NIH HHSUnited States/ ; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill/ ; HHSN261201000035C/PC/NCI NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/ ; U58 DP003862/DP/NCCDPHP CDC HHSUnited States/ ; P30AG066615/AG/NIA NIH HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  e70103 (21 pdf pages)
• Volume:
  34
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/261762/cdc_261762_DS1.pdf
• File Type:
  [PDF - 855.81 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:33b9c4bbe931590e048dc543a3d6d2c698d28490883b37adf318cc4b9f01b3d4749767233c7c147fa374512c9945415d8a6965738e6235c956de766c5a9de171