Using Big Data to Characterize Uveal Tumor Treatment Pathways and Their Complications in a Cohort of Commercially Insured Patients

Characterizing treatment pathways in a large national commercial payer dataset may provide insight to the way that health care is experienced at the patient level according to a study presented at the 37^th ASRS Annual Meeting by Dr. Prithvi Mruthyunjaya, MD, MHS, Associate Professor of Ophthalmology, Director, Ocular Oncology Service, and Director, Vitreoretinal Surgery Fellowship at Stanford Medicine.

In this study, researchers identified 27,234 adult patients with a new diagnosis of an eye tumor from the Truven multi-state commercial payer database – a database containing over seven million records between 2007 and 2015. They applied treatment codes to identify both primary and secondary surgical and clinical procedures.  International Classification for Diseases (ICD) codes were used to assess any diagnosis that were consistent with post-treatment retinopathy. The researchers used survival models were to appraise the risk of enucleation and retinopathy based on patients’ treatment pathways.

The study results showed that 3,085 individual patients were identified as having malignant uveal and retinal neoplasms in 2,271 (74%) and 807 (26%) cases, respectively.  Moreover, a total of 2,751 patients were administered treatment with the either plaque brachytherapy (PBT) (n=1,521), enucleation (n=604), transpupillary thermotherapy (TTT) (n=380), or proton beam radiation (PrBR) (n=246). Moreover, 486 (32%) patients initially treated with PBT developed post-radiation retinopathy within five years post-treatment, and patients treated with PBT were more likely to develop any form of retinopathy compared to patients treated with PrBR (HR=2.27, 95% CI, 1.54 to 3.34).

“Characterizing treatment pathways in a large national commercial payer dataset offers insight to the way that health care is experienced at the patient level and is agnostic to the limitations of single center and multi-center studies,” the authors wrote in a summation of their study. “UM patients will develop post treatment retinopathy and require secondary enucleation at variable rates based on the primary treatment employed.”

Read more at: https://meeting2019.asrs.org/ondemand#/ondemand/papers/using-big-data-to-characterize-uveal-tumor-treatment-pathways-and-their-com-638

Mruthyunjaya P. Does Diabetic Status Influence the Rate of Cataract Surgery Following Pars Plana Vitrectomy Surgery?  Presented at the 37^th ASRS Annual Meeting; July 26-30, 2019; Chicago, IL.