Morbidity, mortality and healthcare use among siblings of children with cancer: A population-based study.
Bibliographic record
Abstract
7040 Background: Siblings of children with cancer are at increased risk of adverse mental health outcomes; impact of the childhood cancer experience on these siblings’ physical health is unclear. We characterized the long-term risk of adverse physical health outcomes and healthcare use among siblings of children with cancer. Methods: Pediatric cancer patients in Ontario diagnosed between 1988 and 2016 were linked to their biological siblings to form the siblings/case cohort. Cases were matched to population controls based on sex, age, and residence area. Index date for cases was the date of their brother’s or sister’s cancer diagnosis (controls had the same index date as cases). After individual linkage to health services data, we compared several outcomes between these two groups: 1) physical health conditions (e.g. cancer, hypertension, injuries, death); 2) acute healthcare use (hospitalization, emergency department [ED] visits), and; 3) preventative healthcare use (periodic health checkups, influenza vaccinations). Predictors of outcomes, including demographics and characteristics of the cancer-affected child, were examined in cases. Cox proportional hazards, recurrent event, or logistic regression models were used as appropriate. Results: We identified 8,529 cases and 30,364 matched controls [median age at index: 6 years, interquartile range (IQR) 0-10; median follow-up time: 9 years, IQR 5-15]. Compared to controls, cases had increased risk of hypertension [hazard ratio (HR) 1.8; 95% confidence interval (95CI) 1.1-2.9; p = 0.01]. They also had higher rates of ED visits [rate ratio 1.1; 95CI 1.1-1.2; p < 0.001] and increased risk of hospitalization [HR 1.1; 95CI 1.1-1.2; p < 0.001]. Cases were more likely to undergo periodic health checkups [odds ratio (OR) 1.1; 95CI 1.0-1.1; p = 0.01] and influenza vaccinations [OR 1.5; 95CI 1.4-1.6; p < 0.001]. In multivariable analysis restricted to cases, rurality and bereavement, among other predictors, were associated with increased use of acute healthcare. Conclusions: Increased risk of hypertension and hospitalization in cases suggests that these siblings are experiencing poorer physical health compared to their peers. Increased rates of ED visits and preventive healthcare suggests parental anxiety surrounding these siblings’ health. Siblings at highest risk of adverse outcomes could be identified through demographic characteristics, among others. Siblings would benefit from targeted surveillance and further investigation to elucidate underlying mechanisms influencing their health.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".