Evidence map›Paper›PMID 36503625›Full record

ArticleBMC palliative care2022

Palliative care outpatients in a German comprehensive cancer center-identifying indicators for early and late referral.

S Müller, M Fink, J Hense, M R Salvador Comino, M Schuler, M Teufel, M Tewes

Open access · goldAbstract read
In one paragraph

Article in BMC palliative care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Timely integration of palliative care. the reality check. a retrospective analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Article
  5. 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

7 authors at 2 institutions in 1 country.

S MüllerDepartment of Palliative Medicine, West German Cancer Center Essen, University Hospital Essen, 45147, Essen, Germany.
M FinkClinic of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-Klinikum Essen, 45147, Essen, Germany.
J HenseDepartment of Medical Oncology, West German Cancer Center Essen, University Hospital Essen, 45147, Essen, Germany.ORCID http://orcid.org/0000-0003-4679-2026
M R Salvador CominoDepartment of Palliative Medicine, West German Cancer Center Essen, University Hospital Essen, 45147, Essen, Germany.
M SchulerDepartment of Medical Oncology, West German Cancer Center Essen, University Hospital Essen, 45147, Essen, Germany.ORCID http://orcid.org/0000-0002-2166-3394
M TeufelClinic of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-Klinikum Essen, 45147, Essen, Germany.ORCID http://orcid.org/0000-0003-2120-1840
M TewesDepartment of Palliative Medicine, West German Cancer Center Essen, University Hospital Essen, 45147, Essen, Germany. mitra.tewes@uk-essen.de.ORCID http://orcid.org/0000-0001-8868-8329
Essen University Hospital · DEUniversity of Duisburg-Essen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDespite that early integration of palliative care is recommended in advanced cancer patients, referrals to outpatient specialised palliative care (SPC) frequently occur late. Well-defined referral criteria are still missing. We analysed indicators associated with early (ER) and late referral (LR) to SPC of an high volume outpatient unit of a comprehensive cancer center.

methodsCharacteristics, laboratory parameters and symptom burden of 281 patients at first SPC referral were analysed. Timing of referral was categorized as early, intermediate and late (> 12, 3-12 and < 3 months before death). Ordinal logistic regression analysis was used to identify factors related to referral timing. Kruskal-Wallis test was used to determine symptom severity and laboratory parameter in each referral category.

resultsLRs (50.7%) had worse scores of weakness, loss of appetite, drowsiness, assistance of daily living (all p < 0.001) and organisation of care (p < 0.01) in contrast to ERs. The mean symptom sum score was significantly higher in LRs than ERs (13.03 vs. 16.08; p < 0.01). Parameters indicative of poor prognosis, such as elevated LDH, CRP and neutrophil-to-lymphocyte ratio (NLR) (p < 0.01) as well as the presence of ascites (p < 0.05), were significantly higher (all p < 0.001) in LRs. In univariable analyses, psychological distress (p < 0.05) and female gender (p < 0.05) were independently associated with an ER.

conclusionA symptom sum score and parameters of poor prognosis like NLR or LDH might be useful to integrate into palliative care screening tools.

Indexed as

Hospice and Palliative Care NursingNeoplasmsAmbulatory CareFemaleHumansOutpatientsPalliative CareReferral and ConsultationAdvanced CancerOutpatientPalliative CareSymptom BurdenTiming of Referral

Identifiers

PMID36503625
PMCPMC9743520
OpenAlexW4311123005

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.