Literature DB >> 19904563

Promoting evidence-based management of anemia in cancer patients: concurrent and discriminant validity of RESPOND, a web-based clinical guidance system based on the EORTC guidelines for supportive care in cancer.

Joanna Van Erps1, Matti Aapro, Karen MacDonald, Pierre Soubeyran, Matthew Turner, Hans Warrinnier, Tara Albrecht, Ivo Abraham.   

Abstract

GOAL OF WORK: The goal of this study is to test the validity of RESPOND, a web-based decision support system to assess and manage anemia in cancer patients as per the European Organisation for Research and Treatment of Cancer (EORTC) guidelines. The intraclass correlation metrics for the algorithmic definitions were reported previously. Reported here are the concurrent validity, the extent to which clinicians' anemia management is guidelines-congruent when using the system; and discriminant validity, the extent to which clinicians practice in congruence with guidelines when vs. when not using the system. PATIENTS AND METHODS: Hybrid matched design with precohort (retrospective; clinicians not using RESPOND) and postcohort (prospective; clinicians using RESPOND) of anemic patients matched on cancer type and chemotherapy regimen and followed up over 4 months after treatment initiation with erythropoietic proteins (34 patients per cohort; total N = 68). Congruence scores quantified the extent to which anemia management was congruent with the EORTC guidelines (range 0-10). MAIN
RESULTS: Hemoglobin (Hb) increased significantly for both cohorts, but the postcohort group showed more rapid rate of Hb increase over time (p < 0.006), higher Hb by visit 4 (p = 0.007), and greater Hb increase by visit 4 (p = 0.006). Concurrent validity was high with mean postcohort congruence scores of 8.18 +/- 1.38. Discriminant validity was inferred from statistically significant differences in mean congruence scores between cohorts (p < 0.001) and from the postcohort having odds ratios of 3.64 for patients to reach Hb >or= 11 g/dL and 2.91 to achieve Hb >or= 12 g/dL.
CONCLUSIONS: RESPOND, a validated computerized clinical guidance system with an incremental effect beyond the pharmacotherapeutic effect of erythropoietic proteins, offers clinicians accurate and safe guidance in managing anemia in cancer patients.

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Year:  2009        PMID: 19904563     DOI: 10.1007/s00520-009-0718-z

Source DB:  PubMed          Journal:  Support Care Cancer        ISSN: 0941-4355            Impact factor:   3.603


  28 in total

1.  Anemia: not just an innocent bystander?

Authors:  Allen R Nissenson; Lawrence T Goodnough; Robert W Dubois
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Review 4.  EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update.

Authors:  C Bokemeyer; M S Aapro; A Courdi; J Foubert; H Link; A Osterborg; L Repetto; P Soubeyran
Journal:  Eur J Cancer       Date:  2006-12-19       Impact factor: 9.162

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7.  September 2007 update on EORTC guidelines and anemia management with erythropoiesis-stimulating agents.

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Review 8.  Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis.

Authors:  Marcello Tonelli; Brenda Hemmelgarn; Tony Reiman; Braden Manns; M Neil Reaume; Anita Lloyd; Natasha Wiebe; Scott Klarenbach
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Authors:  Nicole Hébert-Croteau; Jacques Brisson; Jean Latreille; Michèle Rivard; Nadia Abdelaziz; Ginette Martin
Journal:  J Clin Oncol       Date:  2004-08-02       Impact factor: 44.544

10.  Quality and methods of developing practice guidelines.

Authors:  Hugh Cruse; Magdalena Winiarek; Jan Marshburn; Otavio Clark; Benjamin Djulbegovic
Journal:  BMC Health Serv Res       Date:  2002-01-11       Impact factor: 2.655

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