OBJECTIVES: Borderline or poor @entity159 ( @entity159 ) @entity1 comprise a significant proportion of those diagnosed with @entity1149 ( @entity1149 ), but are often excluded from clinical trials. It is difficult to draw conclusions about the benefit of therapy in borderline @entity159 @entity1 due to lack of reliable @entity159 assessments, and small clinical trial samples. Retrospective population-based secondary analyses may allow investigators to study under-represented populations in clinical trials. We hypothesized that @entity1 with poor functional status derive benefit from chemotherapy compared good functional status, but that the magnitude of the benefit is lower compared to @entity1 with good functional status. By utilizing a "disability status" (DS) measure as a proxy for @entity159 , we offer a reliable mechanism for @entity1 stratification that can be implemented in administrative claims data. METHODS: Medicare beneficiaries diagnosed with @entity1149 between 2001 and 2005 were selected from the Surveillance, Epidemiology and End Results database linked to Medicare claims. Disability status, a previously developed and validated claims-based proxy for baseline @entity159 , was implemented. @entity1 were assigned to good versus poor DS. Cox proportional hazard models were used to examine the differential effects of chemotherapy for the two DS groups on all-cause mortality, controlling for @entity5 and @entity1 characteristics. RESULTS: Most @entity1 in the cohort (n=21,019) were >= 75 years of age (59%), and non-Hispanic white (85%); 91% were assigned to good DS; 38% received chemotherapy. Chemotherapy had a strong protective effect among good DS @entity1 (hazard ratio, 0.43; CI 0.42-0.45; p<0.001), with a slightly smaller effect for poor DS (hazard ratio, 0.50; CI 0.44-0.57). CONCLUSIONS: Chemotherapy improves survival for advanced NSCLC @entity1 with poor DS but to a lower magnitude than for good DS @entity1 . The DS measure opens the door to assess outcomes for @entity5 @entity1 with poor functional status using insurance claims data.

Assessing functional status and the survival benefit of chemotherapy for XXXX using administrative claims data.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['advanced non-small cell lung cancer', 'AdvNSCLC'] @entity159 :: ('MESH:D013226', 'Disease') :: ['PS', 'performance status'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'cancer']
@entity1149 :: (MESH:D002289,Disease) :: ['advanced non-small cell lung cancer']
