Publication Date:
2020-11-05
Description:
Background and aims: Marked improvements in pediatric oncology care for children with acute lymphoblastic leukemia (ALL) and leukemia emphasize the importance of appropriate follow-up care for childhood cancer survivors (CCS) to monitor for late effects. The electronic health record (EHR) sparks unique approaches to construct, maintain, and leverage CCS cohorts to improve care. The primary purpose of this study is to utilize a novel approach to integrate EHR and cancer registry data to construct a CCS cohort for ALL and lymphoma survivors. Data mining in the EHR facilitates stratification of patients into risk cohorts and identification of high risk patients with inadequate subspecialty survivorship care Methods Cancer registry data from January 1, 1994 to November 30, 2012 provided a base cohort from which pediatric oncology clinic visits were extracted from the EHR. Explanatory variables included gender, race/ethnicity, risk stratification, distance to the medical center, rural-urban commuting area code, and area deprivation index as a measure of socioeconomic status. Primary outcomes included date of last clinic visit to determine appropriate follow-up, defined as being seen in a subspecialty clinic between five and seven years after initial diagnosis. Patients who died or relapsed during the seven year follow-up period were excluded from the analysis. Results Between January 1, 1994 and November 30, 2012, there were 262 pediatric oncology patients evaluated at our institution and reported in the cancer registry who were alive and without evidence of recurrence seven years after initial diagnosis. Of these patients, 22% of patients (n=57) were considered to have inadequate follow-up care. In univariate analysis, younger age (p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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