ArticleCancer2017
The relationship between physical and psychological symptoms and health care utilization in hospitalized patients with advanced cancer.
Article in Cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 119 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
119 citing papers in PubMed, 6 syntheses or guidelines pooled it, 232 citations in OpenAlex.
- Creative Arts Therapy for Anxiety, Depression, and Quality of Life in Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Psycho-oncology · 2026Pooled it
- Perioperative Trends in Distress Among Cancer Patients: A Systematic Review and Meta-Analysis.Cancer medicine · 2025Pooled it
- Common patient-reported sources of cancer-related distress in adults with cancer: A systematic review.Cancer medicine · 2024Pooled it
- Psychological problems among cancer patients in relation to healthcare and societal costs: A systematic review.Psycho-oncology · 2021Pooled it
- Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2019Guideline
- The Effectiveness of Immersive Virtual Reality as A Complementary Approach and a New Direction in Cancer Related Fatigue Management.Integrative cancer therapiesPooled it
- Patient-reported outcomes of rezvilutamide versus bicalutamide in combination with androgen deprivation therapy in high-volume metastatic hormone-sensitive prostate cancer patients (CHART): a randomized, phase 3 study.Signal transduction and targeted therapy · 2024Trial
- Trial
- Association of Remote Patient-Reported Outcomes and Step Counts With Hospitalization or Death Among Patients With Advanced Cancer Undergoing Chemotherapy: Secondary Analysis of the PROStep Randomized Trial.Journal of medical Internet research · 2024Trial
- Remote Patient-Reported Outcomes and Activity Monitoring to Improve Patient-Clinician Communication Regarding Symptoms and Functional Status: A Randomized Controlled Trial.JCO oncology practice · 2023Trial
- Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial.Palliative medicine · 2022Trial
- Relationships Between Advanced Cancer Patients' Worry About Dying and Illness Understanding, Treatment Preferences, and Advance Care Planning.Journal of pain and symptom management · 2021Trial
- Pilot Randomized Trial of a Transdisciplinary Geriatric and Palliative Care Intervention for Older Adults With Cancer.Journal of the National Comprehensive Cancer Network : JNCCN · 2020Trial
- Cost-effectiveness of the Collaborative Care to Preserve Performance in Cancer (COPE) trial tele-rehabilitation interventions for patients with advanced cancers.Cancer medicine · 2020Trial
- Healthcare service utilization and work-related productivity in reflexology intervention for advanced breast cancer women.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2019Trial
- Randomized Trial of a Tailored Cognitive-Behavioral Therapy Mobile Application for Anxiety in Patients with Incurable Cancer.The oncologist · 2019Trial
- Pilot randomized trial of an electronic symptom monitoring intervention for hospitalized patients with cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2019Trial
- Distinct Symptom Occurrence Subgroups Among Patients With Colorectal Cancer: Differences in Social Determinants of Health and Diet Quality.Research in nursing & health · 2026Article
- Prioritizing clinical utility to use allostatic load as a biomarker of the consequences of stress.GeroScience · 2026Article
- Symptom Clusters by Edmonton Symptom Assessment System in Radiotherapy and Palliative Care Clinic.Medicina (Kaunas, Lithuania) · 2026Article
59 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPatients with advanced cancer often experience frequent and prolonged hospitalizations; however, the factors associated with greater health care utilization have not been described. We sought to investigate the relation between patients' physical and psychological symptom burden and health care utilization.
methodsWe enrolled patients with advanced cancer and unplanned hospitalizations from September 2014-May 2016. Upon admission, we assessed physical (Edmonton Symptom Assessment System [ESAS]) and psychological symptoms (Patient Health Questionnaire 4 [PHQ-4]). We examined the relationship between symptom burden and healthcare utilization using linear regression for hospital length of stay (LOS) and Cox regression for time to first unplanned readmission within 90 days. We adjusted all models for age, sex, marital status, comorbidity, education, time since advanced cancer diagnosis, and cancer type.
resultsWe enrolled 1,036 of 1,152 (89.9%) consecutive patients approached. Over one-half reported moderate/severe fatigue, poor well being, drowsiness, pain, and lack of appetite. PHQ-4 scores indicated that 28.8% and 28.0% of patients had depression and anxiety symptoms, respectively. The mean hospital LOS was 6.3 days, and the 90-day readmission rate was 43.1%. Physical symptoms (ESAS: unstandardized coefficient [B], 0.06; P < .001), psychological distress (PHQ-4 total: B, 0.11; P = .040), and depression symptoms (PHQ-4 depression: B, 0.22; P = .017) were associated with longer hospital LOS. Physical (ESAS: hazard ratio, 1.01; P < .001), and anxiety symptoms (PHQ-4 anxiety: hazard ratio, 1.06; P = .045) were associated with a higher likelihood for readmission.
conclusionsHospitalized patients with advanced cancer experience a high symptom burden, which is significantly associated with prolonged hospitalizations and readmissions. Interventions are needed to address the symptom burden of this population to improve health care delivery and utilization. Cancer 2017;123:4720-4727. © 2017 American Cancer Society.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.