Quantification of information gained by linking claims data to an electronic health record cohort of patients with metastatic breast cancer

Purpose: Linking claims data to electronic health record (EHR) data can improve completeness, often at a cost of decreased sample size. Quantifying information gained and differences in patient characteristics between EHR and EHR-claims linked cohorts may inform study design. Methods: : Using ConcertAI Patient360 EHR linked to multiple closed insurance claims sources, we compared an EHR cohort of patients with incident metastatic breast cancer (mBC) to an EHR-claims subcohort (requiring ≥90 days claims coverage). We analyzed diagnosis coverage, patient-time during lookback and follow-up, baseline characteristics, and rates of 14 adverse events (AEs). Analyses were age-stratified due to insurance coverage changes at age 65. Results: : For the EHR cohort (N = 6289), 1438 (23%) were in the EHR-claims subcohort. A greater proportion were aged ≥65 years in the EHR cohort (30%) than in the EHR-claims subcohort (17%). EHR-claims patients had longer observation periods and more unique diagnoses across both age groups. For most AEs, incidences were higher in both age groups in the EHR-claims subcohort than in EHR cohort. Conclusions: : EHR-claims provided more diagnoses and observation time, at the cost of a reduction in sample size and underrepresentation of patients ≥65 years. Differing age proportions support age-stratified or standardized analyses for EHR-claims data. Results aid interpretation of differences between EHR and EHR-claims results due to shifts in age, completeness of diagnosis history, and duration of observation.