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Table 4 Test and performance characteristics of claims–based definitions for febrile neutropenia

From: Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases

   

Gold standard:

   

FN:

No FN:

 

FN:

No FN:

 

FN:

No FN:

 

FN:

No FN:

 

FN:

No FN:

 

Claims–Based Definitions:

FN:

47

7

FN:

55

16

FN:

28

0

FN:

55

23

FN:

71

130

  

No FN:

35

268

No FN:

27

259

No FN:

54

275

No FN:

27

252

No FN:

11

145

Test/Performance Characteristic*

  

Neutropenia, Primary Position

 

Neutropenia, Any Position

 

Neutropenia + Fever,Any Position

 

Neutropenia or Fever, Any Position

 

Neutropenia, Fever, or Infection, Any Position

 Patient Classification, %

                

  True–Positive

  

13% (10–17)

 

15% (11–19)

 

8% (5–11)

 

15% (11–19)

 

20% (16–24)

  False–Positive

  

2% (0–3)

 

4% (2–7)

 

0% (–––)

 

6% (4–9)

 

36% (31–42)

  True–Negative

  

75% (70–79)

 

73% (68–77)

 

77% (73–81)

 

71% (66–75)

 

41% (36–45)

  False–Negative

  

10% (7–13)

 

8% (5–10)

 

15% (11–18)

 

8% (5–10)

 

3% (1–5)

 Sensitivity, %

  

57% (46–68)

 

67% (56–77)

 

34% (24–45)

 

67% (56–77)

 

87% (79–94)

 Specificity, %

  

97% (96–99)

 

94% (91–97)

 

100% (–––)

 

92% (88–95)

 

53% (47–59)

 Positive Predictive Value (PPV), %

  

87% (78–95)

 

77% (68–87)

 

100% (–––)

 

71% (61–80)

 

35% (29–42)

 Negative Predictive Value (NPV), %

  

88% (85–92)

 

91% (87–94)

 

84% (80–87)

 

90% (87–94)

 

93% (89–97)

 Accuracy, %

  

88% (85–91)

 

88% (85–91)

 

85% (82–89)

 

86% (82–90)

 

61% (55–66)

 Likelihood ratio positive (LR+)

  

22.5 (12.3–68.5)

 

11.5 (7.6–20.4)

 

–––

 

8.0 (5.6–13.4)

 

1.8 (1.6–2.1)

 Likelihood ratio negative (LR–)

  

0.4 (0.3–0.6)

 

0.3 (0.2–0.5)

 

0.7 (0.6–0.8)

 

0.4 (0.3–0.5)

 

0.3 (0.1–0.4)

  1. FN: febrile neutropenia.
  2. *Value (95% CI).