Background: Clinical RWD derived from EHRs is becoming increasingly important for clinical research, trial design, regulatory decisions etc. These applications require identification of lines of therapy (LoT) which are typically not captured in EHR and must be abstracted from other clinical and medication data. EHR data has significant missingness which can be complemented with other data sources such as medical claims data. In this study, we demonstrate how our proprietary line of therapy algorithms for solid cancers show significant improvements when built using integrated EHR and claims data when compared to EHR data alone. Methods: For this analysis, ConcertAI’s RWD360 dataset integrated with a large administrative open-claims dataset (>90% overlap) for 14 solid cancer indications (Breast, Bladder, Lung, Prostate, Pancreas, Melanoma, Liver, Head & Neck, Renal, Colorectal, Melanoma, Ovarian, Thyroid, Endometrial) was used. The date of advanced/metastatic diagnosis used as the index date for LoTs was derived from the EHR data and medications from both EHR and claims data were used. We ran our LoT algorithms on EHR data with and without claims data and evaluated the impact of integrating claims data on the quantity and quality of LoT output. Results: The inclusion of medication data from claims significantly increased (7-22%) the number of patients for which LoTs could be extracted from the EHR data. Furthermore, we observed increases in number of lines per patient, length of lines and medications per line across cohorts. The distance between index date and 1st line start date was shortened in a subset (2-12%) of patients as a result. In a small fraction of cases, we even observed removal of false lines as some of the lines moved to adjuvant/neoadjuvant setting by filling in missing medication from claims. Overall, 7-39% patients in the LoT cohorts were impacted by addition of claims. Results for a few cancer types are presented in Table 1. We also compared the top LoTs derived from the integrated dataset against the standard of care for that cancer and observed very good concordance. Conclusions: Deriving LoTs by integrating data from multiple data sources such as EHR and claims can significantly improve its accuracy.

Pts, patients.