Evidence map›Paper›PMID 33931242›Full record

ArticleGynecologic oncology2021

Continuity of care and receipt of aggressive end of life care among women dying of ovarian cancer.

Megan A Mullins, Julie J Ruterbusch, Philippa Clarke, Shitanshu Uppal, Michele L Cote, Lauren P Wallner

Open access · greenAbstract read
In one paragraph

Article in Gynecologic oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 24% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Duration of palliative care involvement and immunotherapy treatment near the end of life among patients with cancer who died in-hospital.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    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

6 authors at 3 institutions in 1 country.

Megan A MullinsCenter for Improving Patient and Population Health and Rogel Cancer Center, University of Michigan, Ann Arbor, MI, United States of America. Electronic address: mamull@umich.edu.
Julie J RuterbuschWayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI, United States of America.
Philippa ClarkeDepartment of Epidemiology and Institute for Social Research, University of Michigan, Ann Arbor, MI, United States of America.
Shitanshu UppalDepartment of Gynecologic Oncology, University of Michigan, Ann Arbor, MI, United States of America.
Michele L CoteWayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI, United States of America.
Lauren P WallnerDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, United States of America.
University of Michigan–Ann Arbor · USThe Barbara Ann Karmanos Cancer Institute · USWayne State University · US

Funding

Interdisciplinary Research Training Center in Cancer Care DeliveryT32CA236621 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Lauren P Wallner · 2020 to 2026
$2.8M
NCI NIH HHS T32 CA236621
6 · The paper itself

Abstract

objectiveTo evaluate the association between post-diagnosis continuity of care and receipt of aggressive end of life care among women dying of ovarian cancer.

methodsThis retrospective claims analysis included 6680 Medicare beneficiaries over age 66 with ovarian cancer who survived at least one year after diagnosis, had at least 4 outpatient evaluation and management visits and died between 2000 and 2016. We calculated the Bice-Boxerman Continuity of Care Index (COC) for each woman, and split COC into tertiles (high, medium, low). We compared late or no hospice use, >1 emergency department (ED) visit, intensive care unit (ICU) admission, >1 hospitalization, terminal hospitalization, chemotherapy, and invasive and/or life extending procedures among women with high or medium vs. low COC using multivariable adjusted logistic regression.

resultsIn this sample, 49.8% of women received aggressive care in the last month of life. Compared to women with low COC, women with high COC had 66% higher odds of chemotherapy (adjusted OR 1.66 CI 1.23-2.24) in the last two weeks of life. Women with high COC also had 16% greater odds of not enrolling in hospice compared to women with low COC (adjusted OR 1.16 CI 1.01-1.33). COC was not associated with late enrollment in hospice, hospital utilization, or aggressive procedures.

conclusionsCOC at the end of life is complicated and may pose unique challenges in providing quality end of life care. Future work exploring the specific facets of continuity associated with quality end of life care is needed.

Indexed as

AgedAged, 80 and overContinuity of Patient CareEmergency Service, HospitalFemaleHospice CareHospitalizationHumansIntensive Care UnitsMedicareOvarian NeoplasmsRetrospective StudiesSEER ProgramTerminal CareUnited StatesContinuity of careHospice careOvarian cancerTerminal care

Identifiers

PMID33931242
PMCPMC8222069
OpenAlexW3159872562

What OpenQuestion holds

Textmetadata
LicenceTDM
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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.