Using clinical pathways to prospectively identify poor prognosis cancer patients: A preliminary analysis
| Autor: | Victoria H. Selesnick, Matthew Rice, Ariel Martin, Michael Scalzo, Joseph O. Jacobson, David M. Jackman, Joanna M. Hamilton, Abhijit Sanyal, James A. Tulsky, Jocelyn Siegel |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Journal of Clinical Oncology. 39:329-329 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | 329 Background: Cancer patients in the last year of life may have different clinical needs and evolving goals of care. Helping clinicians consistently identify such patients in a systematic and prospective fashion, at a discrete moment in the care trajectory, is an important step towards optimizing the care of these patients. Methods: Physician medical directors for each clinical pathway at our institution were tasked with identifying nodes within their respective treatment pathways associated with poor prognosis, specifically a median overall survival of < 12 months. This information was embedded into the underlying data model of the pathways platform, allowing us to determine how often clinicians navigated through poor prognosis nodes. Results: Pathways medical directors identified 44 nodes associated with poor prognosis. Some of these nodes encompassed a broader set of patients (metastatic pancreatic cancer, any line), whereas others were more specific (metastatic non-small cell lung cancer, squamous cell histology, second line or beyond). For the period 3/11/20 – 5/31/21, clinicians navigated in the platform for 11,057 unique patients. Of these, 1,234 (11.1%) unique patients were associated with poor prognosis nodes. Such navigations were much more common in patients with solid tumors (table). Conclusions: A well-maintained clinical pathways program can be a mechanism for defining clinical settings associated with poor prognosis and for routinely identifying patients in these settings. By embedding this into the pathways data model, we can provide physicians with important reminders and resources related to goals of care conversations, supportive care resources, and appropriate treatment options and clinical trials.[Table: see text] |
| Databáze: | OpenAIRE |
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