Patient-Reported Symptoms and Direct Health Care Costs in Head and Neck Cancer
Notice bibliographique
Résumé
Importance: Head and neck cancer (HNC) and its associated treatments are associated with substantial functional, psychological, and financial consequences. Patient-reported outcome measures (PROMs) play a crucial role in capturing the full impact of disease. Understanding how PROMs are associated with health care costs is critical for cancer care planning; however, the association of health care expenditure and PROMs is yet to be clarified. Objective: To assess the association between Edmonton Symptom Assessment System (ESAS) scores and direct health care costs incurred in 30 days for adult patients with HNC. Design, Setting, and Participants: This cohort study used linked administrative datasets from Ontario, Canada, of adult patients who received a diagnosis of HNC between January 1, 2007, and December 31, 2022. Included patients had at least 1 ESAS assessment completed from the date of diagnosis to the date of death or January 31, 2023. Coprimary exposures were the highest individual symptom score (h-ESAS, from 0 to 10) and the sum total of the individual scores of the 9 symptoms (t-ESAS, from 0-90). Multivariable negative binomial regression models using a generalized estimating equation approach under an exchangeable correlation structure were used to assess the association between each primary exposure and 30-day costs, accounting for patient age, sex, immigration status, socioeconomic status, cancer type, and recent cancer-directed treatment modality, updated to each ESAS assessment date. Data analysis was performed from September 2024 to February 2025. Main Outcomes and Measures: A 30-day cost-capturing window was defined around each ESAS assessment date to comprise a 7-day interval before this date and a 22-day interval after this date. Direct health care costs incurred during this 30-day window were estimated using a patient-level case-costing algorithm adjusted to 2023 Canadian dollars. Results: The total sample population was 16 544 adult patients with HNC (mean [SD] age at diagnosis, 63.7 [11.5] y; 12 526 [75.7%] male individuals ) and their 90 025 ESAS assessments completed since the date of diagnosis. Each 1-point increase in h-ESAS was associated with a 22% increase in 30-day costs (rate ratio [RR], 1.22; 95% CI, 1.21-1.22). Likewise, relative costs increased progressively with higher t-ESAS scores, peaking among patients with scores of 71 to 80 (RR, 4.82; 95% CI, 4.32-5.39). Conclusions and Relevance: This cohort study found that both h-ESAS and t-ESAS were significantly associated with 30-day costs. These findings highlight the potential role of PROMs in cost-mitigation strategies for HNC care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».