To develop and validate Medicare claims‐based approaches for identifying abnormal screening mammography interpretation.
Mammography data and linked Medicare claims for 387,709 mammograms performed from 1999 to 2005 within the Breast Cancer Surveillance Consortium ().
Split‐sample validation of algorithms based on claims for breast imaging or biopsy following screening mammography.
Medicare claims and mammography data were pooled at a central Statistical Coordinating Center.
Presence of claims for subsequent imaging or biopsy had sensitivity of 74.9 percent (95 percent confidence interval , 74.1–75.6) and specificity of 99.4 percent (95 percent , 99.4–99.5). A classification and regression tree improved sensitivity to 82.5 percent (95 percent , 81.9–83.2) but decreased specificity (96.6 percent, 95 percent , 96.6–96.8).
Medicare claims may be a feasible data source for research or quality improvement efforts addressing high rates of abnormal screening mammography.