Evidence map›Paper›PMID 25926135›Full record

ArticleCancer2015

Health care utilization and end-of-life care for older patients with acute myeloid leukemia.

Areej R El-Jawahri, Gregory A Abel, David P Steensma, Thomas W LeBlanc, Amir T Fathi, Timothy A Graubert, Daniel J DeAngelo, Martha Wadleigh, Karen K Ballen, Julia E Foster and 5 more

Abstract read
In one paragraph

Article in Cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 4 pooled it
11.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 4 syntheses or guidelines pooled it, 144 citations in OpenAlex.

  1. Pooled it
  2. A systematic review of health state utility values for older people with acute myeloid leukaemia.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
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  14. Novel Systemic Anticancer Treatments and Health Services Use at the End of Life Among Adults With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025
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  18. Challenges in hospice and end-of-life care in the transfusion-dependent patient.Hematology. American Society of Hematology. Education Program · 2024
    Review
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8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Areej R El-JawahriDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Gregory A AbelDana-Farber Cancer Institute, Center for Outcomes and Policy Research, Harvard Medical School, Boston, Massachusetts.
David P SteensmaDana-Farber Cancer Institute, Center for Outcomes and Policy Research, Harvard Medical School, Boston, Massachusetts.
Thomas W LeBlancDivision of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, North Carolina.
Amir T FathiDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Timothy A GraubertDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Daniel J DeAngeloDana-Farber Cancer Institute, Center for Outcomes and Policy Research, Harvard Medical School, Boston, Massachusetts.
Martha WadleighDana-Farber Cancer Institute, Center for Outcomes and Policy Research, Harvard Medical School, Boston, Massachusetts.
Karen K BallenDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Julia E FosterDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Eyal C AttarDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Philip C AmreinDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Andrew M BrunnerDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Richard M StoneDana-Farber Cancer Institute, Center for Outcomes and Policy Research, Harvard Medical School, Boston, Massachusetts.
Jennifer S TemelDepartment of Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Harvard University · USDana-Farber Cancer Institute · USDuke University · USMassachusetts General Hospital · US

Funding

Optimizing Palliative and End of Life Care for Patients with CancerK24CA181253 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI TEMEL, JENNIFER SUE · 2014 to 2018
$737k
NCI NIH HHS K24 CA 181253NCI NIH HHS K24 CA181253
6 · The paper itself

Abstract

backgroundHealth care utilization in older adults (age ≥60 years) with acute myeloid leukemia (AML) has not been well studied.

methodsWe conducted a retrospective analysis of 330 consecutive older patients who were diagnosed with AML between May 1, 2005 and December 23, 2011, at 2 hospitals in Boston to examine their health care utilization and end-of-life care. Using multivariable logistic and linear regression models adjusting for covariates, we also compared health care utilization between patients who received intensive induction chemotherapy (n = 197; cytarabine/ anthracycline combination) versus nonintensive chemotherapy (n = 133; single-agent therapy).

resultsThe median number of hospitalizations for the entire cohort was 4.2 (range, 1-18 hospitalizations). Patients who died spent a mean of 28.3% of their life after diagnosis in the hospital and 13.8% of their life attending outpatient clinic appointments. Although the majority of patients (87.9%) died during the 2-year follow-up period, a minority received palliative care (16.2%) or hospice (23.1%) services. Within 30 days of death, 84.5% of patients were hospitalized, and 61% died in the hospital. Among the patients who died, those who received intensive induction therapy (vs nonintensive therapy) spent 30% more of their life after diagnosis in the hospital (P < .0001) and were less likely to receive hospice services (odds ratio, 0.45; P = .05).

conclusionsThe current findings highlight the intensity of health care utilization among older patients with AML, regardless of treatment modality. Despite the poor prognosis, palliative care and hospice services are rarely used. Future work should study novel health care delivery models to optimize care throughout the course of illness and at the end of life.

Indexed as

Patient Acceptance of Health CareTerminal CareAgedFemaleHumansLeukemia, Myeloid, AcuteLogistic ModelsMaleMiddle AgedRetrospective Studiesacute myeloid leukemiaend-of-life carehealth care utilizationpalliative care

Identifiers

PMID25926135
PMCPMC4418225
OpenAlexW1527947800

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.