Evidence map›Paper›PMID 34997315›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2022

Patient-reported distress as an early warning sign of unmet palliative care needs and increased healthcare utilization in patients with advanced cancer.

Jordan D Hildenbrand, Hee S Park, David J Casarett, Cheyenne Corbett, Alicia M Ellis, Kris W Herring, Arif H Kamal, Steve Power, Jesse D Troy, Steven Wolf and 2 more

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–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

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Review
  7. Associations between symptoms with healthcare utilization and death in advanced cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Article
  8. 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

12 authors.

Jordan D HildenbrandDuke University School of Medicine, Durham, NC, USA.ORCID http://orcid.org/0000-0001-8462-7262
Hee S ParkDuke University, Durham, NC, USA.
David J CasarettDepartment of Palliative Care, Duke University, Durham, NC, USA.
Cheyenne CorbettDuke Cancer Patient Support Program, Durham, NC, USA.
Alicia M EllisDuke Cancer Institute, DUMC, Box 2715, Durham, NC, 27710, USA.
Kris W HerringDuke Cancer Institute, DUMC, Box 2715, Durham, NC, 27710, USA.
Arif H KamalDuke Cancer Institute, DUMC, Box 2715, Durham, NC, 27710, USA.
Steve PowerDuke Cancer Institute, DUMC, Box 2715, Durham, NC, 27710, USA.
Jesse D TroyDuke Cancer Institute, DUMC, Box 2715, Durham, NC, 27710, USA.
Steven WolfDuke Cancer Institute, DUMC, Box 2715, Durham, NC, 27710, USA.
Syed Y ZafarDuke Cancer Institute, DUMC, Box 2715, Durham, NC, 27710, USA.
Thomas W LeblancDuke Cancer Institute, DUMC, Box 2715, Durham, NC, 27710, USA. thomas.leblanc@duke.edu.ORCID http://orcid.org/0000-0002-0546-7895

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCancer patients' sources of distress are often unaddressed, and patient-reported distress data could be utilized to identify those with unmet and impending care needs. We explored the association between moderate/severe distress and healthcare utilization in a large sample of non-small cell lung cancer (NSCLC) and non-colorectal gastrointestinal cancer patients. METHODS AND MATERIALS: Adult patients treated between July 2013 and March 2019. Data from the NCCN Distress Thermometer (DT) and the accompanying "Problem List" were extracted from the EHR. A DT score of ≥ 4 indicates "actionable distress." Statistical analysis was performed using descriptive analysis for patient characteristics, clinical outcomes, and sources of distress. Generalized linear mixed models were fit to determine the relationship between distress and healthcare utilization (hospitalization, emergency department (ED) visit, or both).

resultsThe ten most frequently reported problems were from the Physical and Emotional domains of the Problem List. Distress was mostly related to physical symptoms (pain, fatigue) and emotional issues (worry, fears, sadness, nervousness). Patients with actionable distress generally reported more problems across all their visits. Actionable distress was associated with higher odds of the composite outcome measure of hospitalization or visiting the ED, within both the next 3 months (OR = 1.37; 95% CI = 1.19, 1.58; p < 0.001) and 6 months (OR = 1.19; 95% CI = 1.03, 1.37; p = 0.019).

conclusionPatients with significant distress had marked utilization of ED and inpatient services. DT scores are a source of untapped data in the EHR that can highlight patients in need of intervention, including palliative care and cancer support services.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsNeoplasmsHumansPalliative CarePatient Acceptance of Health CarePatient Reported Outcome MeasuresStress, PsychologicalCancerHealthcare utilizationPalliative carePatient-reported distress

Identifiers

PMID34997315

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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.