{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:34:33Z","timestamp":1760315673543,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,6,18]],"date-time":"2007-06-18T00:00:00Z","timestamp":1182124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2007,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND.<\/jats:title><jats:p>Failure to obtain the requisite follow\u2010up of patients with abnormal mammograms may delay cancer diagnosis and impact outcome. Up to 20% of women do not receive timely recommended follow\u2010up. The current study tested the accuracy of the linkage of payer claims and clinical data to identify the appropriate treatment for patients with abnormal mammograms.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS.<\/jats:title><jats:p>Electronic medical records in a staff model practice that was affiliated with a single health payer were scanned to identify the Breast Imaging Reporting and Data System (BI\u2010RADS\u00ae) code for all mammograms. For each woman with a BI\u2010RADS code 0, 3, 4, or 5 mammogram, the payer claims were searched for follow\u2010up breast procedures (imaging, biopsy, and surgery) occurring within 2 months for BI\u2010RADS code 0, 4, and 5 mammograms and within 8 months for BI\u2010RADS code 3 mammograms. For women with &gt;1 abnormal mammogram during the study period, only follow\u2010up for the first abnormal mammogram was examined. The medical records of cases defined by claims as not having recommended follow\u2010up care were reviewed to determine the accuracy of claims analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>A total of 17,329 women underwent 23,721 mammograms between January 1, 2001 and December 31, 2003. BI\u2010RADS codes 0, 3, 4, or 5 occurred in 1490 mammograms (6.3%). Among 1206 women with a first abnormal mammogram who were eligible for claims follow\u2010up, 16% did not receive recommended follow\u2010up care. Medical record review demonstrated that the claims search accurately identified follow\u2010up care in 97% of these cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>Administrative claims supplemented with BI\u2010RADS data were found to accurately identify the follow\u2010up care of patients with abnormal mammograms. Case management using this method may assist physicians in ensuring that all patients receive appropriate care. Cancer 2007. \u00a9 2007 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.22808","type":"journal-article","created":{"date-parts":[[2007,6,18]],"date-time":"2007-06-18T11:48:42Z","timestamp":1182167322000},"page":"518-524","source":"Crossref","is-referenced-by-count":3,"title":["Linked claims and medical records for cancer case management"],"prefix":"10.1002","volume":"110","author":[{"given":"Margaret 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