• Hsien Seow, Peter Tanuseputro, Lisa Barbera, Craig C Earle, Dawn M Guthrie, Sarina R Isenberg, Rosalyn A Juergens, Jeffrey Myers, Melissa Brouwers, Semra Tibebu, and Rinku Sutradhar.
• Department of Oncology, McMaster University, Hamilton, ON, Canada.
• Palliat Med. 2021 Oct 1; 35 (9): 1713-1723.

BackgroundPredictive cancer tools focus on survival; none predict severe symptoms.AimTo develop and validate a model that predicts the risk for having low performance status and severe symptoms in cancer patients.DesignRetrospective, population-based, predictive study.Setting/ParticipantsWe linked administrative data from cancer patients from 2008 to 2015 in Ontario, Canada. Patients were randomly selected for model derivation (60%) and validation (40%). Using the derivation cohort, we developed a multivariable logistic regression model to predict the risk of an outcome at 6 months following diagnosis and recalculated after each of four annual survivor marks. Model performance was assessed using discrimination and calibration plots. Outcomes included low performance status (i.e. 10-30 on Palliative Performance Scale), severe pain, dyspnea, well-being, and depression (i.e. 7-10 on Edmonton Symptom Assessment System).ResultsWe identified 255,494 cancer patients (57% female; median age of 64; common cancers were breast (24%); and lung (13%)). At diagnosis, the predicted risk of having low performance status, severe pain, well-being, dyspnea, and depression in 6-months is 1%, 3%, 6%, 13%, and 4%, respectively for the reference case (i.e. male, lung cancer, stage I, no symptoms); the corresponding discrimination for each outcome model had high AUCs of 0.807, 0.713, 0.709, 0.790, and 0.723, respectively. Generally these covariates increased the outcome risk by >10% across all models: lung disease, dementia, diabetes; radiation treatment; hospital admission; pain; depression; transitional performance status; issues with appetite; or homecare.ConclusionsThe model accurately predicted changing cancer risk for low performance status and severe symptoms over time.

17 keywords...

hide…