Are we ready to predict late effects? A systematic review of clinically useful prediction models. Issue 6 (April 2015)

• Record Type: Journal Article
• Authors: Salz, Talya; Baxi, Shrujal S.; Raghunathan, Nirupa; Onstad, Erin E.; Freedman, Andrew N.; Moskowitz, Chaya S.; Dalton, Susanne Oksbjerg; Goodman, Karyn A.; Johansen, Christoffer; Matasar, Matthew J.; de Nully Brown, Peter; Oeffinger, Kevin C.; Vickers, Andrew J.
• Is Part Of: European journal of cancer. Volume 51:Issue 6(2015:Apr.)
• Page Start: 758
• Page End: 766
• Publication Date: 2015-04
• Subjects: Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2015.02.002
• Languages: English
• ISSNs: 0959-8049

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st145">Abstract</title> <sec> <title id="st090">Background</title> <p id="sp0005">After completing treatment for cancer, survivors may experience late effects: consequences of treatment that persist or arise after a latent period.</p> </sec> <sec> <title id="st095">Purpose</title> <p id="sp0010">To identify and describe all models that predict the risk of late effects and could be used in clinical practice.</p> </sec> <sec> <title id="st100">Data sources</title> <p id="sp0015">We searched Medline through April 2014.</p> </sec> <sec> <title id="st105">Study selection</title> <p id="sp0020">Studies describing models that (1) predicted the absolute risk of a late effect present at least 1 year post-treatment, and (2) could be used in a clinical setting.</p> </sec> <sec> <title id="st110">Data extraction</title> <p id="sp0025">Three authors independently extracted data pertaining to patient characteristics, late effects, the prediction model and model evaluation.</p> </sec> <sec> <title id="st115">Data synthesis</title> <p id="sp0030">Across 14 studies identified for review, nine late effects were predicted: erectile dysfunction and urinary incontinence after prostate cancer; arm lymphoedema, psychological morbidity, cardiomyopathy or heart failure and cardiac event after breast cancer; swallowing dysfunction after head and neck cancer; breast cancer after Hodgkin lymphoma and thyroid cancer after childhood cancer. Of these, four late effects are persistent effects of treatment and five appear after a latent period. Two studies were externally validated. Six studies were designed to inform decisions about treatment rather than survivorship care. Nomograms were the most common clinical output.</p> </sec> <sec> <title id="st120">Conclusion</title> <p id="sp0035">Despite the call among survivorship experts for risk stratification, few published models are useful for risk-stratifying prevention, early detection or management of late effects. Few models address serious, modifiable late effects, limiting their utility. Cancer survivors would benefit from models focused on long-term, modifiable and serious late effects to inform the management of survivorship care.</p> </sec> </abstract>