Evidence map›Paper›PMID 26628867›Full record

ArticleCurrent oncology (Toronto, Ont.)2015

Quality of end-of-life cancer care in Canada: a retrospective four-province study using administrative health care data.

L Barbera, H Seow, R Sutradhar, A Chu, F Burge, K Fassbender, K McGrail, B Lawson, Y Liu, R Pataky and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Current oncology (Toronto, Ont.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 2 pooled it
2.3field-weighted citation impact, top 12% 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

31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Observational
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 2 countries.

L BarberaOdette Cancer Centre, Department of Radiation Oncology, Toronto, ON; ; Department of Radiation Oncology, University of Toronto, Toronto, ON; ; Institute for Clinical Evaluative Sciences, Toronto, ON;
H SeowInstitute for Clinical Evaluative Sciences, Toronto, ON; ; Department of Oncology, McMaster University, Hamilton, ON;
R SutradharInstitute for Clinical Evaluative Sciences, Toronto, ON;
A ChuInstitute for Clinical Evaluative Sciences, Toronto, ON;
F BurgeDepartment of Family Medicine, Dalhousie University, Halifax, NS;
K FassbenderDepartment of Oncology, Division of Palliative Care Medicine, University of Alberta, Edmonton, AB;
K McGrailCentre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC;
B LawsonDepartment of Family Medicine, Dalhousie University, Halifax, NS;
Y LiuInstitute for Clinical Evaluative Sciences, Toronto, ON;
R PatakyCanadian Centre for Applied Research in Cancer Control, BC Cancer Research Centre, Vancouver, BC.
A PotapovDepartment of Oncology, Division of Palliative Care Medicine, University of Alberta, Edmonton, AB;
Institute for Clinical Evaluative Sciences · CADalhousie University · CAUniversity of Alberta · CACanadian Centre for Applied Research in Cancer Control · CAMcMaster University · CAThe Centre for Health (New Zealand) · NZUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe quality of data comparing care at the end of life (eol) in cancer patients across Canada is poor. This project used identical cohorts and definitions to evaluate quality indicators for eol care in British Columbia, Alberta, Ontario, and Nova Scotia.

methodsThis retrospective cohort study of cancer decedents during fiscal years 2004-2009 used administrative health care data to examine health service quality indicators commonly used and previously identified as important to quality eol care: emergency department use, hospitalizations, intensive care unit admissions, chemotherapy, physician house calls, and home care visits near the eol, as well as death in hospital. Crude and standardized rates were calculated. In each province, two separate multivariable logistic regression models examined factors associated with receiving aggressive or supportive care.

resultsOverall, among the identified 200,285 cancer patients who died of their disease, 54% died in a hospital, with British Columbia having the lowest standardized rate of such deaths (50.2%). Emergency department use at eol ranged from 30.7% in Nova Scotia to 47.9% in Ontario. Of all patients, 8.7% received aggressive care (similar across all provinces), and 46.3% received supportive care (range: 41.2% in Nova Scotia to 61.8% in British Columbia). Lower neighbourhood income was consistently associated with a decreased likelihood of supportive care receipt.

interpretationWe successfully used administrative health care data from four Canadian provinces to create identical cohorts with commonly defined indicators. This work is an important step toward maturing the field of eol care in Canada. Future work in this arena would be facilitated by national-level data-sharing arrangements.

Indexed as

health services researchPalliative carequality indicators

Identifiers

PMID26628867
PMCPMC4608400
OpenAlexW1764513046

What OpenQuestion holds

Textmetadata
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.