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Analytic Support for Researchers:
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SEER-Medicare: Defining the Date of Diagnosis & Treatment
The SEER program collects month and year of diagnosis. Therefore researchers sometimes
are uncertain how to assign an exact date of diagnosis, often used as the index date for a
period of observation. The figure below demonstrates the agreement between the SEER and
Medicare claims regarding the month of diagnosis. There was nearly 90% agreement within
one month of diagnosis.
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In other cases, researchers wish to assign a date when treatment began. For most
cases, the Medicare claims can be used to identify the date for the first cancer-related
treatment. However, not all persons will have a Medicare claim. In the event that there
is no Medicare claim, researchers can impute a date from the SEER month of diagnosis, by
assigning a point during the month of diagnosis, usually either the first or last day or
midpoint. Use of sensitivity analysis can help to evaluate what impact, if any, use of
different dates of diagnosis has on research findings.
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