Evidence map›Paper›PMID 40533095›Full record

ArticleApplied clinical informatics2025

Using Electronic Health Records to Classify Cancer Site and Metastasis.

Kurt Kroenke, Kathryn J Ruddy, Deirdre R Pachman, Veronica Grzegorczyk, Jeph Herrin, Parvez A Rahman, Kyle A Tobin, Joan M Griffin, Linda L Chlan, Jessica D Austin and 4 more

Abstract read
In one paragraph

Article in Applied clinical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Trial
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

14 authors.

Kurt KroenkeDepartment of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States.
Kathryn J RuddyDivision of Medical Oncology, Mayo Clinic, Rochester, Minnesota, United States.
Deirdre R PachmanDivision of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota, United States.
Veronica GrzegorczykDepartment of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, United States.
Jeph HerrinDepartment of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States.
Parvez A RahmanRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, United States.
Kyle A TobinRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, United States.
Joan M GriffinRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, United States.
Linda L ChlanDivision of Nursing Research, Department of Nursing, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, United States.
Jessica D AustinDepartment of Epidemiology, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona, United States.
Jennifer L RidgewayRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, United States.
Sandra A MitchellOutcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, United States.
Keith A MarsoloDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States.
Andrea L ChevilleDepartment of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, United States.

Funding

Enhanced, EHR-facilitated Cancer Symptom Control (E2C2) Pragmatic Clinical TrialUM1CA233033 · NCI · MAYO CLINIC ROCHESTER · PI CHEVILLE, ANDREA LYNNE · 2018 to 2018
$8.7M
National Cancer Institute of the NIH UM1CA233033NCI NIH HHS UM1 CA233033
6 · The paper itself

Abstract

The Enhanced EHR-facilitated Cancer Symptom Control (E2C2) Trial is a pragmatic trial testing a collaborative care approach for managing common cancer symptoms. There were challenges in identifying cancer site and metastatic status.This study compares three different approaches to determine cancer site and six strategies for identifying the presence of metastasis using EHR and cancer registry data.The E2C2 cohort included 50,559 patients seen in the medical oncology clinics of a large health system. SPPADE symptoms were assessed with 0 to 10 numeric rating scales (NRS). A multistep process was used to develop three approaches for representing cancer site: the single most prevalent International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) code, the two most prevalent codes, and any diagnostic code. Six approaches for identifying metastatic disease were compared: ICD-10 codes, natural language processing (NLP), cancer registry, medications typically prescribed for incurable disease, treatment plan, and evaluation for phase 1 trials.The approach counting the two most prevalent ICD-10 cancer site diagnoses per patient detected a median of 92% of the cases identified by counting all cancer site diagnoses, whereas the approach counting only the single most prevalent cancer site diagnosis identified a median of 65%. However, agreement among the three approaches was very good (kappa > 0.80) for most cancer sites. ICD and NLP methods could be applied to the entire cohort and had the highest agreement (kappa = 0.53) for identifying metastasis. Cancer registry data was available for less than half of the patients.Identification of cancer site and metastatic disease using EHR data was feasible in this large and diverse cohort of patients with common cancer symptoms. The methods were pragmatic and may be acceptable for covariates, but likely require refinement for key dependent and independent variables.

Indexed as

Electronic Health RecordsNeoplasm MetastasisNeoplasmsHumansInternational Classification of DiseasesNatural Language ProcessingRegistries

Identifiers

PMID40533095
PMCPMC12176508

What Socratic holds

Textmetadata
LicenceCC BY
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.