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Demoor-Goldschmidt C, Veillon P, Esvan M, Leonard M, Chauvet S, Bertrand A, Carausu L, Delehaye F, Lejeune J, Rouger J, Schneider P, Thomas C, Millot F, Claude L, Leseur J, Missohou F, Supiot S, Bihannic N, Debroise I, Jeanneaud C, Lebreton E, Roumy M, Aguerris L, Chrétien JM, Gandemer V, Pellier I. A software tool to support follow-up care in a French childhood cancer cohort: construction and feasibility. BMC Cancer 2024; 24:130. [PMID: 38267891 PMCID: PMC10809785 DOI: 10.1186/s12885-024-11857-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Treatment summaries and a personalized survivorship care plans based on internationally approved, organ-specific follow-up care recommendations are essential in preserving the health and quality of life for cancer survivors. Cohorts made up of survivors of childhood cancer have made significant contributions to the understanding of early mortality, somatic late complications, and psychosocial outcomes among former patients. New treatment protocols are needed to enhance survival and reduce the potential risk and severity of late effects, and working with treatment databases is crucial in doing so. CONSTRUCTION AND CONTENT In the GOCE (Grand Ouest Cancer de l'Enfant [Western Region Childhood Cancer]) network, in a participative approach, we developed the LOG-after medical tool, on which health data are registered and can be extracted for analysis. Its name emphasizes the tool's goal, referring to 'logiciel' (the French word for software) that focuses on the period "after" the acute phase. This tool is hosted on a certified health data server. Several interfaces have been developed that can be used depending on the user's profile. Here we present this innovative co-constructed tool that takes national aspects into account, including the results of the feasibility/satisfaction study and its perspective. UTILITY AND DISCUSSION The database contains data relating to 2558 patients, with samples from 1702 of these (66.54%) being held in a tumor bank. The average year in which treatment started was 2015 (ranging from December 1967 to November 2022: 118 patients were treated before 2012 and registered retrospectively when seen in long-term follow-up consultations or for another cancer since November 2021). A short questionnaire was distributed to healthcare professionals using the tool (physicians and research associates or technicians, n = 14), of whom 11 answered and were all satisfied. Access to the patient interface is currently open to 124 former patients. This was initially offered to 30 former patients who were over 15 years old, affected by the disease within the last 5 years, and had agreed to test it. Their opinions were collected by their doctor by e-mail, telephone, or during a consultation in an open-ended question and a non-directive interview. All patients were satisfied with the tool, with interest in testing it in the long term. Some former patients found that the tool provided them with some ease of mind; one, for instance, commented: "I feel lighter. I allow myself to forget. I know I will get a notification when the time comes." CONCLUSIONS Freely available to all users, LOG-after: (1) provides help with determining personalized survivorship care plans for follow-up; (2) builds links with general practitioners; (3) empowers the patient; and (4) enables health data to be exported for analysis. Database URL for presentation: https://youtu.be/2Ga64iausJE.
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Affiliation(s)
- Charlotte Demoor-Goldschmidt
- Department of Oncohematopediatrics, University Hospital of Angers, University of Angers, Angers, France.
- Department of Radiotherapy, Centre François Baclesse, University of Caen, Caen, France.
- Department of Supportive Care, Centre François Baclesse, University of Caen, Caen, France.
- Inserm U 1018, Epidemiology of Radiation, Gustave Roussy, Villejuif, France.
| | - Pascal Veillon
- Department of Oncohematopediatrics, University Hospital of Angers, University of Angers, Angers, France
| | - Maxime Esvan
- Department of Biostatitics, University Hospital of Rennes, Rennes, France
| | - Mathilde Leonard
- Department of Biostatitics, University Hospital of Rennes, Rennes, France
| | - Sophie Chauvet
- Department of Oncohematopediatrics, University Hospital of Nantes, Nantes, France
| | | | - Liana Carausu
- Department of Oncohematopediatrics, University Hospital of Brest, Brest, France
| | - Fanny Delehaye
- Department of Oncohematopediatrics, University Hospital of Caen, Caen, France
| | - Julien Lejeune
- Department of Oncohematopediatrics, University Hospital of Tours, Tours, France
| | - Jérémie Rouger
- Department of Oncohematopediatrics, University Hospital of Caen, Caen, France
| | - Pascale Schneider
- Department of Oncohematopediatrics, University Hospital of Rouen, Rouen, France
| | - Caroline Thomas
- Department of Oncohematopediatrics, University Hospital of Nantes, Nantes, France
| | - Frédéric Millot
- Department of Oncohematopediatrics, University Hospital of Poitiers, Poitiers, France
| | - Line Claude
- Department of Radiotherapy, Centre Leon Berard, Lyon, France
| | - Julie Leseur
- Department of Radiotherapy, Centre Eugène Marquis, Rennes, France
| | - Fernand Missohou
- Department of Radiotherapy, Centre François Baclesse, University of Caen, Caen, France
| | - Stéphane Supiot
- Department of Radiotherapy, Institut de Cancérologie de L'Ouest, Nantes, France
| | - Nathalie Bihannic
- Department of Oncohematopediatrics, University Hospital of Brest, Brest, France
| | | | - Carole Jeanneaud
- Department of Oncohematopediatrics, University Hospital of Tours, Tours, France
| | - Esther Lebreton
- Department of Oncohematopediatrics, University Hospital of Caen, Caen, France
| | - Marianne Roumy
- Department of Oncohematopediatrics, University Hospital of Angers, University of Angers, Angers, France
| | | | - Jean-Marie Chrétien
- Data Science Department, Clinical and Innovation Direction, CHU Angers, Angers, France
| | - Virginie Gandemer
- Department of Oncohematopediatrics, University Hospital of Rennes, Rennes, France
| | - Isabelle Pellier
- Department of Oncohematopediatrics, University Hospital of Angers, University of Angers, Angers, France
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Noyd DH, Chen S, Bailey A, Janitz A, Baker A, Beasley W, Etzold N, Kendrick D, Kibbe W, Oeffinger K. Informatics tools to implement late cardiovascular risk prediction modeling for population management of high-risk childhood cancer survivors. Pediatr Blood Cancer 2023; 70:e30474. [PMID: 37283294 PMCID: PMC11110462 DOI: 10.1002/pbc.30474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/04/2023] [Accepted: 05/17/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Clinical informatics tools to integrate data from multiple sources have the potential to catalyze population health management of childhood cancer survivors at high risk for late heart failure through the implementation of previously validated risk calculators. METHODS The Oklahoma cohort (n = 365) harnessed data elements from Passport for Care (PFC), and the Duke cohort (n = 274) employed informatics methods to automatically extract chemotherapy exposures from electronic health record (EHR) data for survivors 18 years old and younger at diagnosis. The Childhood Cancer Survivor Study (CCSS) late cardiovascular risk calculator was implemented, and risk groups for heart failure were compared to the Children's Oncology Group (COG) and the International Guidelines Harmonization Group (IGHG) recommendations. Analysis within the Oklahoma cohort assessed disparities in guideline-adherent care. RESULTS The Oklahoma and Duke cohorts both observed good overall concordance between the CCSS and COG risk groups for late heart failure, with weighted kappa statistics of .70 and .75, respectively. Low-risk groups showed excellent concordance (kappa > .9). Moderate and high-risk groups showed moderate concordance (kappa .44-.60). In the Oklahoma cohort, adolescents at diagnosis were significantly less likely to receive guideline-adherent echocardiogram surveillance compared with survivors younger than 13 years old at diagnosis (odds ratio [OD] 0.22; 95% confidence interval [CI]: 0.10-0.49). CONCLUSIONS Clinical informatics tools represent a feasible approach to leverage discrete treatment-related data elements from PFC or the EHR to successfully implement previously validated late cardiovascular risk prediction models on a population health level. Concordance of CCSS, COG, and IGHG risk groups using real-world data informs current guidelines and identifies inequities in guideline-adherent care.
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Affiliation(s)
- David H. Noyd
- Department of Pediatrics, The University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma, USA
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Hudson College of Public Health, Oklahoma City, Oklahoma, USA
| | - Anna Bailey
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Hudson College of Public Health, Oklahoma City, Oklahoma, USA
| | - Amanda Janitz
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Hudson College of Public Health, Oklahoma City, Oklahoma, USA
| | - Ashley Baker
- Department of Pediatrics, The University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma, USA
| | - William Beasley
- Department of Pediatrics, The University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma, USA
| | - Nancy Etzold
- Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - David Kendrick
- Department of Medical Informatics, The University of Oklahoma Health Sciences Center, Tulsa, Oklahoma, USA
| | - Warren Kibbe
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kevin Oeffinger
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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