Evidence mapPaperPMID 37987207Full record

ArticleCancer2024

The association between telemedicine, advance care planning, and unplanned hospitalizations among high-risk patients with cancer.

Erin M Bange, Yimei Li, Pallavi Kumar, Abigail Doucette, Peter Gabriel, Ravi Parikh, Eric H Li, Ronac Mamtani, Kelly D Getz

Open access · bronzeAbstract read
In one paragraph

Article in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
  6. Transforming patient-centered cancer care using telehealth: the MATCHES Center.Journal of the National Cancer Institute. Monographs · 2024
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Erin M BangeMemorial Sloan Kettering Cancer Center, New York, New York, USA.ORCID 0000-0003-0000-6093
Yimei LiDepartment of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Pallavi KumarPalliative and Hospice Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Abigail DoucetteAbramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Peter GabrielAbramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ravi ParikhAbramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-2692-6306
Eric H LiDepartment of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
Ronac MamtaniDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Kelly D GetzDepartment of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Children's Hospital of Philadelphia · USUniversity of Pennsylvania · USHospital of the University of Pennsylvania · USMassachusetts General Hospital · USMemorial Sloan Kettering Cancer Center · USPhiladelphia VA Medical Center · US

Funding

The Patient-Reported Outcomes, Community-Engagement and Language (PRO-CEL) CoreP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · 1985 to 2025
$88.4M
CANCER CLINICAL EPIDEMIOLOGY TRAINING GRANTT32CA009679 · NCI · UNIVERSITY OF PENNSYLVANIA · 1992 to 2025
$3.4M
Research & Methods CoreP50CA271357 · SLOAN-KETTERING INST CAN RESEARCH · 2025 to 2025
$1.2M
NCI NIH HHS P30 CA008748NCI NIH HHS P50 CA271357NCI NIH HHS T32 CA009679NIH HHS NIHT32 CA009679
6 · The paper itself

Abstract

backgroundDespite the widespread implementation of telemedicine, there are limited data regarding its impact on key components of care for patients with incurable or high-risk cancer. For these patients, high-quality care requires detailed conversations regarding treatment priorities (advance care planning) and clinical care to minimize unnecessary acute care (unplanned hospitalizations). Whether telemedicine affects these outcomes relative to in-person clinic visits was examined among patients with cancer at high risk for 6-month mortality.

methodsThis retrospective cohort study included adult patients with cancer with any tumor type treated at the University of Pennsylvania who were newly identified between April 1 and December 31, 2020, to be at high risk for 6-month mortality via a validated machine learning algorithm. Separate modified Poisson regressions were used to assess the occurrence of advance care planning and unplanned hospitalizations for telemedicine as compared to in-person visits. Additional analyses were done comparing telemedicine type (video or phone) as compared to in-person clinic visits.

resultsThe occurrence of advance care planning was similar between telemedicine and in-person visits (6.8% vs. 6.0%; adjusted risk ratio [aRR], 1.25; 95% CI, 0.92-1.69). In regard to telemedicine subtype, patients exposed to video encounters were modestly more likely to have documented advance care planning in comparison to those seen in person (7.5% vs. 6.0%; aRR, 1.48; 95% CI, 1.03-2.11). The 3-month risk for unplanned hospitalization was comparable for telemedicine compared to in-person clinic encounters (21% vs. 18%; aRR, 1.06; 95% CI, 0.81-1.38).

conclusionsIn this study, care delivered by telemedicine, compared to in-person clinic visits, produced comparable rates of advance care planning conversations without increasing hospitalizations, which suggests that vulnerable patients can be managed safely by telemedicine.

Indexed as

Advance Care PlanningNeoplasmsTelemedicineAdultHospitalizationHumansRetrospective Studiesacute care utilizationadvance care planningend-of-life carehealth servicestelemedicine

Identifiers

PMID37987207
PMCPMC10922036
OpenAlexW4388869673

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.