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Table 1 Characteristics of included studies (N = 21)

From: Methodological approaches to measuring the incidence of unplanned emergency department presentations by cancer patients receiving systemic anti-cancer therapy: a systematic review

Authors

Study objective

Study design

Single / multi-site / population

Country

Dates of recruitment

ED presentations per participant case

Risk of biasb

Barbera et al. [29]a

Evaluate the impact of ESAS screening on ED visits

Retrospective cohort

Population

Canada

Jan 2007—Dec 2009

 

Low

Eskander et al. [30]

Assess the rate of unplanned hospitalisations and ED visits in the treatment period for patients with HNSCC being treated with curative intent

Retrospective cohort

Population

Canada

Jan 2008—Dec 2012

1.13 ED visits per participant case

Low

Kamat et al. [28]

Report treatment patterns; the source, setting, and division of costs; and survival outcomes

Retrospective cohort

Population

US

Jan 2007—Dec 2011

0.8 ED visits per participant case (1st line treatment)

0.6 ED visits per participant case (2nd line treatment)

Low

Korytowsky et al. [31]

Evaluate HRU rates and total cost of care from a US payer perspective among patients with aNSCLC treated with ST

Retrospective cohort

Population

Not specified

Mar 2013—Dec 2016

0.77 ED visits per participant case (pre-IO)

0.66 ED visits per participant case (post-IO)

Low

Li et al. [32]

Compare medical costs and healthcare resource utilisation for patients using everolimus-based therapy vs chemotherapy

Retrospective cohort

Population

US

Jul 2012—Mar 2014

0.10 ED visits per person (line 1)

Low

Mehra et al. [33]a

Analyse patterns of healthcare resource utilisation and costs among a large group of commercially-insured patients receiving docetaxel for APC

Retrospective cohort

Population

US

Jan 2003—Dec 2009

 

Low

Williams et al. [34]a

Evaluate concordance of treatment regimens received (hormone therapy, chemotherapy, and targeted therapies) with NCCN guidelines for older women with early-stage breast cancer; understand categories of discordant treatments; and determine the impact of discordance on health care utilisation (hospitalisations and ED visits) and spending

Retrospective cohort

Population

US

2012—2015

 

Low

Colligan et al. [35]a

Estimate the impacts of two programs and assess their relative effectiveness to inform future models to reduce utilisation and spending in cancer patients

Retrospective cohort

Multi

US

2010—2015

 

Moderate

Dufton et al. [36]

Explore socio-demographic [46] and disease related characteristics of cancer patients presenting to an ED within 28 days of receiving infusional, systemic anti-cancer therapy in a Day Oncology Unit, in order to identify those at greater risk of making an unplanned ED presentation

Retrospective cohort

Single

AUS

Dec 2014—Nov 2017

0.88 ED visits per participant case

Moderate

Enright et al. [37]

Examine the frequency of ER&Hs associated with chemotherapy

Retrospective cohort

Population

Canada

Jan 2007—Dec 2009

0.35 ED visits per participant case

Moderate

Fisher et al. [38]

Compare health care resource use, treatment patterns, and economic outcomes among patients with cancer receiving intravenous chemotherapy

Retrospective cohort

Population

US

Jan 2006—Aug 2012

0.3 ED visits per participant case (treated in physician office) 0.8 ED visits per participant case (treated in hospital outpatient setting)

Moderate

Harrison et al. [39]

Assess the frequency and severity of patient-reported, chemotherapy- related toxicities in adults receiving their first cycle of chemotherapy for cancer, compared with the frequency of toxicities documented by clinicians. Second, assess factors are associated with unplanned health care service use resulting from toxicities reported by patients after first-cycle chemotherapy

Cross-sectional

Single

US

Not stated

NA

Moderate

Minami et al. [40]a

Clarify the frequency with which Japanese lung cancer

patients visit the ED after hours

Retrospective cohort

Single

Japan

Jan 2008—Jun 2012

 

Moderate

Peyrony et al. [41]

Estimate the frequency with which patients with cancer undergoing ICB at our institution present to the ED

Retrospective cohort

Single

France

Jan 2012—Jun 2017

NA

Moderate

Hoverman et al. [42]

Evaluate the impact of Innovent on Level I Pathway compliance within TXO, implement PSS, measure the rate and costs associated with chemotherapy-related ER visits and in-patient use, and assess chemotherapy costs

Prospective cohort

Population

US

Jun 2010—May 2012

0.21 ED visits per participant case (baseline)

0.11 ED visits per participant case (Innovent)

High

Pittman et al.[43]

Analyse the reasons why patients present to the ED and to determine what factors are associated with ED visits and hospital admissions after curative chemotherapy for breast cancer

Retrospective cohort

Single

Canada

2011 and 2012

0.59 ED visits per participant case

Moderate

Schwartzberg et al. [44]

Compare the incidence of CINV and its associated healthcare resource utilisation with NK1 receptor antagonist or non-NK1 receptor antagonist

Retrospective cohort

Population

US

Jun 2013—Dec 2013

0.19 ED visits per participant case

Moderate

Tang et al. [12]

Study ED usage by early breast cancer patients undergoing chemotherapy in an Australian academic hospital setting, and to describe factors associated with ED presentations and hospital admissions

Retrospective cohort

Single

AUS

Jan 2014—31 Dec

0.62 ED visits per participant case

Moderate

Ward et al. [45]

Describe the proportion of monthly treatment costs borne by four major financing agents and identify the monthly costs for each element of health care in this cohort

Prospective cohort

Multi

AUS

Jan 2009—Oct 2010

0.74 ED visits per participant case

Moderate

Baenda-Canada et al. [46]

Analyse need for extraordinary health-care attention

Prospective cohort

Single

Not specified

Jan 2007—Mar 2011

0.14 ED visits per participant case

High

Livingstone et al. [47]

Assess the characteristics of unplanned ED presentations and care pathway

Retrospective cohort

Multi

AUS

Jan 2007—Dec 2007

0.57 ED visits per participant case

High

  1. aED presentations per participant case unable to be calculated as study only reports the number of unique individuals that made on or more ED presentation and not the total number of ED presentations made
  2. bNewcastle Ottawa Scores correspond to high, moderate or low according to the number of stars received as 0–4, 5–6, or 7–8, respectively
  3. Abbreviations: ESAS Edmonton Symptom Assessment Scale, ED Emergency Department, ER&H Emergency Room and Hospitalisation, HNSCC Head and neck squamous cell carcinoma, TXO Texas Oncology, PSS Patient Support Services, HRU Healthcare resource utilisation, aNSCLC Advanced non-small cell lung cancer, ST Systemic antineoplastic therapy, APC Advanced prostate cancer, ICB Immune checkpoint blockade, CINV Chemotherapy induced nausea and vomiting, NK1 Neurokinin-1, NCCN National Comprehensive Cancer Network, NA - Not applicable