Severe chemotherapy induced diarrhea (CID) in patients with colorectal cancer: A cost of illness analysis
Bibliographic record
Abstract
6087 Background: Considerable cancer supportive care research has been devoted to febrile neutropenia, emesis and anemia. In contrast, diarrhea as a side effect of chemotherapy has received less attention. However, CID is common with many types of chemotherapy and can have a major impact on maintaining dose intensity, treatment effectiveness and on overall health care resources. In this study, a cost of illness analysis was conducted to estimate the overall economic impact of grade III/IV diarrhea in patients with colorectal cancer receiving chemotherapy. Methods: This was a retrospective cohort study consisting of patients with colorectal cancer that had received chemotherapy and had developed grade III or IV diarrhea. Data collection included patient demographics, disease related information and healthcare resource utilization to manage the grade III/IV CID event. Multivariable logistic regression analysis was then used to identify factors associated with hospitalization for uncontrolled CID. Results: Patients (n=96) had a mean age of 60.3 years and 49% of the sample was receiving adjuvant chemotherapy with a curative intent. The severe CID developed after the first cycle of chemotherapy in 54.2% of patients and was responsible for a median dose reduction and delay of 20% and 7 days respectively. Overall, 30 of 96 patients (31%) with severe CID required a hospital admission for supportive care with an 8-day median length of stay (range = 2 to 28 days). There were 2 deaths with 1 possibly being related to the diarrhea. When the economic impact of the grade III/IV CID was quantified, the mean cost was $2,559 per patient (95%CI: $1,665 to $3,453). The logistic regression analysis identified grade IV diarrhea (OR=9.9; P < 0.001) and severe CID developing after the first chemotherapy cycle (OR=3.6; P = 0.026) as significant predictors of patient hospitalization. Conclusions: Grade III/IV diarrhea is a debilitating and costly complication of chemotherapy in colorectal cancer. Effective interventions that prevent the development of severe CID need to be identified to save health care costs and reduce patient morbidity. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Novartis Novartis Canada
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".