Identifying homogeneous healthcare use profiles and treatment sequences by combining sequence pattern mining with care trajectory clustering in kidney cancer patients on oral anticancer drugs: A case study

Abstract

Objective We evaluated the ability of a coupled pattern-mining and clustering method to identify homogeneous groups of subjects in terms of healthcare resource use, prognosis and treatment sequences, in renal cancer patients beginning oral anticancer treatment. Methods Data were retrieved from the permanent sample of the French medico-administrative database. We applied the CP-SPAM algorithm for pattern mining to healthcare use sequences, followed by hierarchical clustering on principal components (HCPC). Results and conclusion We identified 127 individuals with renal cancer with a first reimbursement of an oral anticancer drug between 2010 and 2017. Clustering identified three groups of subjects, and discrimination between these groups was good. These clusters differed significantly in terms of mortality at six and 12 months, and medical follow-up profile (predominantly outpatient or inpatient care, biological monitoring, reimbursement of supportive care drugs). This case study highlights the potential utility of applying sequence-mining algorithms to a large range of healthcare reimbursement data, to identify groups of subjects homogeneous in terms of their care pathways and medical behaviors.

Hospital Care Trajectories of Older Adults with Cancer and the Associated Clinical Profiles: linking a French Prospective Cohort Study and a Clinical Data Warehouse

“…Notably, they did not consider individual trajectories (except for living situations), nor did they further characterize the hospital care consumption with regards to the associated patients’ profiles. Other studies applied automatic clustering to claims data from all-age patients with specific tumor sites and treatment settings, and found similar patterns of health care utilization (7, 23, 24). The absence of associations between age and geriatric parameters and cluster A (“ inpatient care with cancer surgery ”) in the present study suggests that patients, despite having older age and/or geriatric impairments, are still offered surgical opportunities to treat their cancer.…”