Development and Validation of a Score to Predict Acute Care Use After Initiation of Systemic Therapy for Cancer

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Abstract
Use of acute care is common during systemic therapy for cancer. A systematic review estimated that almost half of patients in observational studies are hospitalized while receiving chemotherapy.1 Use of acute care is undesirable because it may reflect suboptimal control of disease-related symptoms or toxic effects of treatment and constitutes the largest component of cancer care costs.2 The risk of acute care use with cancer treatment should be included as part of the informed consent process because this information can influence treatment decisions.3 Some acute care use is preventable4 and interventions can reduce acute care use, morbidity, and costs.5,6 Reducing acute care use is a strategic priority of health care policy makers including Cancer Care Ontario7 (CCO) and the Center for Medicare and Medicaid Innovation.8 In Ontario specifically, CCO plans to develop a “standardized and comprehensive approach to managing treatment-related toxicity,”7 including “a standardized process/tool for stratifying patients by toxicity risk.”9

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