Evidence map›Paper›PMID 34139251›Full record

ArticleUrology2021

Using an Automated Electronic Health Record Score To Estimate Life Expectancy In Men Diagnosed With Prostate Cancer In The Veterans Health Administration.

Simon John Christoph Soerensen, I-Chun Thomas, Bogdana Schmidt, Timothy J Daskivich, Ted A Skolarus, Christian Jackson, Thomas F Osborne, Glenn M Chertow, James D Brooks, David H Rehkopf and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Disparities With Systemic Therapies for Black Men Having Advanced Prostate Cancer: Where Do We Stand?Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024
    Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Simon John Christoph SoerensenDepartment of Urology, Stanford University School of Medicine, Stanford, CA; Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
I-Chun ThomasVeterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Bogdana SchmidtDepartment of Urology, Stanford University School of Medicine, Stanford, CA.
Timothy J DaskivichDivision of Urology, Cedars-Sinai Medical Center, Los Angeles, CA.
Ted A SkolarusDepartment of Urology, Dow Division of Health Services Research, University of Michigan Medical School, VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Ann Arbor, MI.
Christian JacksonDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA.
Thomas F OsborneVeterans Affairs Palo Alto Health Care System, Palo Alto, CA; Department of Radiology, Stanford University School of Medicine, Stanford, CA.
Glenn M ChertowDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA; Department of Medicine, Stanford University School of Medicine, Stanford, CA.
James D BrooksDepartment of Urology, Stanford University School of Medicine, Stanford, CA.
David H RehkopfDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA; Department of Medicine, Stanford University School of Medicine, Stanford, CA.
John T LeppertVeterans Affairs Palo Alto Health Care System, Palo Alto, CA; Department of Medicine, Stanford University School of Medicine, Stanford, CA. Electronic address: jleppert@stanford.edu.

Funding

De-implementation of low value castration for men with prostate cancerR37CA222885 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SAINI, SAMEER DEV, SKOLARUS, TED ALBERT · 2018 to 2023
$3.6M
Mentoring Patient-Oriented Clinical Investigators in NephrologyK24DK085446 · NIDDK · STANFORD UNIVERSITY · PI CHERTOW, GLENN MATTHEW · 2010 to 2022
$1.4M
Refining castration use for recurrent prostate cancerR01CA242559 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SKOLARUS, TED ALBERT, TSODIKOV, ALEXANDER · 2020 to 2023
$1.4M
Personalized Life Expectancy to Encourage High Value Prostate Cancer CareI01HX002126 · VA · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · PI LEPPERT, JOHN THOMAS · 2018 to 2021
–
HSRD VA I01 HX002126NCI NIH HHS R01 CA242559NCI NIH HHS R37 CA222885NIDDK NIH HHS K24 DK085446
6 · The paper itself

Abstract

objectivesTo determine if an automatically calculated electronic health record score can estimate intermediate-term life expectancy in men with prostate cancer to provide guideline concordant care.

methodsWe identified all men (n = 36,591) diagnosed with prostate cancer in 2013-2015 in the VHA. Of the 36,591, 35,364 (96.6%) had an available Care Assessment Needs (CAN) score (range: 0-99) automatically calculated in the 30 days prior to the date of diagnosis. It was designed to estimate short-term risks of hospitalization and mortality. We fit unadjusted and multivariable Cox proportional hazards regression models to determine the association between the CAN score and overall survival among men with prostate cancer. We compared CAN score performance to two established comorbidity measures: The Charlson Comorbidity Index and Prostate Cancer Comorbidity Index (PCCI).

resultsAmong 35,364 men, the CAN score correlated with overall stage, with mean scores of 46.5 ( ± 22.4), 58.0 ( ± 24.4), and 68.1 ( ± 24.3) in localized, locally advanced, and metastatic disease, respectively. In both unadjusted and adjusted models for prostate cancer risk, the CAN score was independently associated with survival (HR = 1.23 95%CI 1.22-1.24 & adjusted HR = 1.17 95%CI 1.16-1.18 per 5-unit change, respectively). The CAN score (overall C-Index 0.74) yielded better discrimination (AUC = 0.76) than PCCI (AUC = 0.65) or Charlson Comorbidity Index (AUC = 0.66) for 5-year survival.

conclusionThe CAN score is strongly associated with intermediate-term survival following a prostate cancer diagnosis. The CAN score is an example of how learning health care systems can implement multi-dimensional tools to provide fully automated life expectancy estimates to facilitate patient-centered cancer care.

Indexed as

Life ExpectancyAgedCohort StudiesElectronic Health RecordsHumansMaleProstatic NeoplasmsSurvival AnalysisUnited StatesUnited States Department of Veterans Affairs

Identifiers

PMID34139251
PMCPMC8429253

What OpenQuestion holds

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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.