Evidence map›Paper›PMID 30826736›Full record

Observational studyBMJ supportive & palliative care2022

Palliative care and imaging utilisation for patients with cancer.

Kesav Raghavan, Timothy P Copeland, Michael Rabow, Maya Ladenheim, Angela Marks, Steven Z Pantilat, David O'Riordan, David Seidenwurm, Benjamin Franc

Abstract readObservational Study
In one paragraph

Observational study in BMJ supportive & palliative care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. 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

9 authors.

Kesav RaghavanRadiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA kesav.raghavan@ucsf.edu.ORCID http://orcid.org/0000-0002-1682-0228
Timothy P CopelandRadiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
Michael RabowPalliative Care Program, University of California San Francisco, San Francisco, California, USA.
Maya LadenheimPalliative Care Program, University of California San Francisco, San Francisco, California, USA.
Angela MarksPalliative Care Program, University of California San Francisco, San Francisco, California, USA.
Steven Z PantilatPalliative Care Program, University of California San Francisco, San Francisco, California, USA.
David O'RiordanPalliative Care Program, University of California San Francisco, San Francisco, California, USA.
David SeidenwurmMedical Imaging, Sutter Health, Sacramento, California, USA.
Benjamin FrancRadiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.

Funding

NRSA Training CoreTL1TR001883 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ALEX BUI, Nina Thawata Harawa · 2016 to 2026
$8.6M
NCATS NIH HHS TL1 TR001883
6 · The paper itself

Abstract

objectiveThis observational study explores the association between palliative care (PC) involvement and high-cost imaging utilisation for patients with cancer patients during the last 3 months of life.

methodsAdult patients with cancer who died between 1 January 2012 and 31 May 2015 were identified. Referral to PC, intensity of PC service use, and non-emergent oncological imaging utilisation were determined. Associations between PC utilisation and proportion of patients imaged and mean number of studies per patient (mean imaging intensity (MII)) were assessed for the last 3 months and the last month of life. Similar analyses were performed for randomly matched case-control pairs (n = 197). Finally, the association between intensity of PC involvement and imaging utilisation was assessed.

results3784 patients were included, with 3523 (93%) never referred to PC and 261 (7%) seen by PC, largely before the last month of life (61%). Similar proportions of patients with and without PC referral were imaged during the last 3 months, while a greater proportion of patients with PC referral were imaged in the last month of life. PC involvement was not associated with significantly different MII during either time frame. In the matched-pairs analysis, a greater proportion of patients previously referred to PC received imaging in the period between the first PC encounter and death, and in the last month of life. MII remained similar between PC and non-PC groups. Finally, intensity of PC services was similar for imaged and non-imaged patients in the final 3 months and 1 month of life. During these time periods, increased PC intensity was not associated with decreased MII.

conclusionsPC involvement in end-of-life oncological care was not associated with decreased use of non-emergent, high-cost imaging. The role of advanced imaging in the PC setting requires further investigation.

Indexed as

Hospice and Palliative Care NursingHospice CareNeoplasmsTerminal CareAdultHumansPalliative CareRetrospective Studiesend of life careimagingoncologypalliative careresource utilization

Identifiers

PMID30826736
PMCPMC6773516

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Registered trials

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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.