Exclusion criteria: evaluating the impact of enrollment requirements in SEER-Medicare research

Academic Article


  • Background: Enrollment criteria are routinely utilized in patient selection in SEER-Medicare but little is known about how this may be impacting research outcomes. This study evaluated demographics and survival among pancreatic cancer patients who are included and excluded from SEER-Medicare analyses. Methods: Patients ≥66 years old with pancreatic cancer were identified (SEER-Medicare, 2008–2015). Two patient cohorts were compared: included (continuous enrollment in Medicare Parts A and B and no enrollment in Medicare Advantage), and excluded. Mortality was assessed using a Standardized Mortality Ratio. Results: Among 49,017 patients with pancreatic cancer, 59.5% were in the included cohort. The excluded cohort was younger (median age 74 vs. 77) with more male (49.9% vs. 47.8%), non-white (33.0% vs. 21.3%) and urban-dwelling patients (91.0% vs. 85.0%). Those excluded had a higher mortality risk (SMR 1.06, 95%CI 1.04–1.07). Conclusions: There are significant differences in patient demographics and mortality among those who are and are not routinely included in SEER-Medicare analyses and our study provides a critical opportunity to quantify this potential bias.
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    Author List

  • Papageorge MV; Ng SC; Sachs TE; Kenzik KM