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Laboratory results and International Classification of Diseases (ICD) codes are often used to define toxicities in real\u2010world settings; optimal use of this information for research remains unclear. In 854 women receiving adjuvant chemotherapy for stage I\u2013IIIA breast cancer with abstracted medical record data at Kaiser Permanente Washington, we defined three chemotherapy\u2010related hematologic toxicities (anemia, neutropenia, and thrombocytopenia) using laboratory data, ICD codes, and a combination of both during and up to 1 month after chemotherapy. Cutpoints for laboratory values corresponding to grades 1\u20133 were derived from Common Terminology Criteria for Adverse Events. We examined sensitivity, specificity, and positive predictive value (PPV), comparing laboratory and ICD definitions to chart review. Chart review identified 180 women with anemia, 168 with neutropenia, and 21 with thrombocytopenia. Grade\u20101+ showed the highest sensitivity for all toxicities (range: 0.84\u20130.95) but lowest specificity (range: 0.45\u20130.86) and PPV (range: 0.14\u20130.47). Grade\u20103+ showed the lowest sensitivity for all toxicities (range: 0.13\u20130.59) and highest specificity (range: 0.85\u20131.00) and PPV (range: 0.63\u20130.82). ICD and grade\u20102+ each showed balanced performance across toxicities, with ICD having slightly higher sensitivity (range: 0.62\u20130.76) than grade\u20102+ (range: 0.48\u20130.77). Combining grade\u20102+ and ICD improved sensitivity (range: 0.76\u20130.93) for all toxicities without much loss of specificity (range: 0.64\u20130.98), and no change to PPV. In conclusion, ICD and grade\u20102+ showed moderate\u2010to\u2010good performance for defining hematologic toxicities; the combination of laboratory data (especially grade\u20102+) and ICD showed better performance than either source alone.<\/jats:p>","DOI":"10.1002\/ijc.70266","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T13:35:02Z","timestamp":1764336902000},"page":"1481-1488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of methods to identify chemotherapy\u2010related hematologic toxicities in real\u2010world settings"],"prefix":"10.1002","volume":"158","author":[{"given":"Peng","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center  New York New York USA"},{"name":"Department of Population Health Sciences Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Bhimani","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Blinder","sequence":"additional","affiliation":[{"name":"Department of Medicine Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Burganowski","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute Kaiser Permanente Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac J.","family":"Ergas","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace B.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Griggs","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Health Management and Policy University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narre","family":"Heon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Kolevska","sequence":"additional","affiliation":[{"name":"Department of Oncology Kaiser Permanente Medical Center  Vallejo California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuriy","family":"Kotsurovskyy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candyce H.","family":"Kroenke","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"},{"name":"Kaiser Permanente School of Medicine  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile. 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