ArticleJournal of pain and symptom management2026
Validation of a Claims-Based Algorithm for Specialist Palliative Care Delivery in Metastatic Cancer.
Article in Journal of pain and symptom management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Palliative Care for Advanced Cancer in Medicare Advantage and Physician Networks.JAMA network open · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
contextThe lack of valid methods to identify specialist palliative care (PC) delivery in population-level data impedes comprehensive understanding of its use.
objectiveTo develop and validate a claims-based algorithm to identify receipt of specialist PC in Medicare beneficiaries with metastatic cancer.
methodsWe developed a claims-based algorithm to identify specialist PC, using a physician billing claim from a known PC clinician as the gold standard, retaining candidate variables with a positive predictive value (PPV) >60%. We evaluated algorithm performance and conducted simulation to measure bias resulting from algorithm use when examining the association between specialist PC and outcomes.
resultsWe identified 1,384,750 claims from 68,121 patients. The prevalence of specialist PC was 3.8% on the claim-level and 26.8% on the patient-level. The provider specialty code for "hospice and palliative care" (PPV 80.4%) and the diagnosis code Z51.5 for "encounter for palliative care" (PPV 67.5%) were included, where claims were counted as specialist PC if they had either variable. PPV and sensitivity of the algorithm were 68.0% and 83.0% respectively on a claim-level, and 78.4% and 88.3% respectively on a patient-level. Percent bias differed by outcome (hospice 4.2%, hospice enrollment ≥3 days 5.3%, intensive care unit use in the last 30 days of life -1.7%, chemotherapy use in the last 14 days of life -1.3%).
conclusionsA simple algorithm can identify receipt of specialist PC care in Medicare claims for patients with metastatic cancer with reasonable accuracy. Algorithm use results in potentially acceptable amounts of bias, depending on study aims.
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