Evidence map›Paper›PMID 34413108›Full record

ArticleBMJ open2021

Health care utilisation preceding relapse or second malignant neoplasm after childhood acute lymphoblastic leukaemia: a population-based matched cohort study.

Karen Schow Jensen, Birgitte Klug Albertsen, Henrik Schrøder, Alina Zalounina Falborg, Kjeld Schmiegelow, Steen Rosthøj, Michael Thude Callesen, Peter Vedsted

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 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
0.3field-weighted citation impact, top 36% 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, 1 citations in OpenAlex.

  1. 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

8 authors at 5 institutions in 1 country.

Karen Schow JensenDepartment of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark kascje@rm.dk.ORCID 0000-0002-0811-8818
Birgitte Klug AlbertsenDepartment of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Henrik SchrøderDepartment of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Alina Zalounina FalborgResearch Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
Kjeld SchmiegelowDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
Steen RosthøjDepartment of Paediatrics and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark.
Michael Thude CallesenHans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Peter VedstedResearch Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
Aarhus University Hospital · DKAarhus University · DKAalborg University Hospital · DKOdense University Hospital · DKUniversity of Copenhagen · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate health care utilisation including both primary and secondary health care 6 months before the diagnosis of a relapse or a second malignant neoplasm (SMN) in survivors of childhood acute lymphoblastic leukaemia (ALL). DESIGN AND

settingA Danish population-based matched cohort study linking multiple nationwide registries.

participantsParticipants were recruited from a total of 622 childhood ALL 2.5-year event-free survivors diagnosed between 1994 and 2015. Cases were survivors developing a relapse or an SMN and references were survivors still in first remission. Each case was matched with five references on age, sex, treatment protocol and risk group. PRIMARY OUTCOME MEASURES: Consultations in general practice and hospital the last 6 months before relapse or SMN. Cases and references were compared with monthly incidence rate ratios (IRRs) from negative binomial regression models.

resultsOf the 622 childhood ALL survivors, 60 (9.6%) developed a relapse (49) or an SMN (11) and 295 matched references were identified. Health care utilisation in general practice increased among cases the last month before the event compared with references with an IRR of 2.71 (95% CI 1.71 to 4.28). Data showed a bimodal structure with a significantly increased number of visits 4, 5 and 6 months before the event. Hospital health care utilisation increased 2 months before the event in cases with an IRR of 5.01 (3.78 to 6.63) the last month before the event and an IRR of 1.94 (1.32 to 2.85) the second-last month comparing cases and references.

conclusionsSurvivors of childhood ALL developing a relapse or an SMN have a short period of increased health care utilisation before diagnosis. At hospital, this might be explained by pre-diagnostic examinations. In general practice, data suggest a bimodal structure with children later developing a relapse having more contacts also half a year before the relapse, suggesting that there could be early warnings.

Indexed as

Neoplasms, Second PrimaryPrecursor Cell Lymphoblastic Leukemia-LymphomaChildCohort StudiesHumansPatient Acceptance of Health CareRecurrenceleukaemiapaediatric oncologyprimary care

Identifiers

PMID34413108
PMCPMC8378397
OpenAlexW3193752957

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.