Evidence mapPaperPMID 40710198Full record

Observational studyCurrent oncology (Toronto, Ont.)2025

Associations Between Symptom Complexity and Acute Care Utilization Among Adult Advanced Cancer Patients Followed by a Palliative Care Service.

Philip Pranajaya, Vincent Ho, Mengzhu Jiang, Vance Tran, Aynharan Sinnarajah

Abstract readObservational Study
In one paragraph

Observational study in Current oncology (Toronto, Ont.), 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. 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

5 authors.

Philip PranajayaFaculty of Health Sciences, Queen's University, Kingston, ON K7L 3N6, Canada.
Vincent HoDivision of Palliative Medicine, Department of Medicine, Lakeridge Health, Oshawa, ON L1G 2B9, Canada.
Mengzhu JiangDivision of Palliative Medicine, Department of Medicine, Lakeridge Health, Oshawa, ON L1G 2B9, Canada.
Vance TranDivision of Palliative Medicine, Department of Medicine, Lakeridge Health, Oshawa, ON L1G 2B9, Canada.ORCID 0000-0001-7948-7349
Aynharan SinnarajahDivision of Palliative Medicine, Department of Medicine, Lakeridge Health, Oshawa, ON L1G 2B9, Canada.ORCID 0000-0002-7967-159X

Funding

Canadian Cancer Society 707151
6 · The paper itself

Abstract

Among adult advanced cancer patients already accessing palliative care, symptoms can contribute to unplanned acute care utilizations, which can disrupt care and worsen patient outcomes. We examined how a novel symptom complexity algorithm, using patients' ratings of the nine Edmonton Symptom Assessment System-Revised (ESAS-r) symptoms to assign "low", "medium", or "high" complexity, predicts acute care utilizations. This retrospective observational cohort study used electronic medical record data from the Durham Regional Cancer Centre in Ontario, Canada, comprising adult advanced cancer patients who completed at least one ESAS-r report between 1 January 2022 and 31 December 2023. We applied chi-squared tests, Kruskal-Wallis H tests, and multivariable binary logistic regressions to evaluate factors associated with higher odds of acute care utilization within seven and fourteen days of patients' first ESAS-r reports after their first palliative care interaction. Of 559 included patients, 125 (22.4%) exhibited low complexity, 180 (32.2%) exhibited medium complexity, and 254 (45.4%) exhibited high complexity on their first ESAS-r report. In total, 61 (10.9%) patients accessed acute care within seven days and 108 (19.3%) patients accessed acute care within fourteen days of their first ESAS-r report. Controlling for sociodemographic and clinical covariates, compared to low-complexity patients, high-complexity patients had higher odds of acute care utilization within seven days (aOR = 2.83, 95% CI: 1.18-6.77), but not within fourteen days (aOR = 1.78, 95% CI: 0.97-3.28). Accordingly, as a clinical decision-making tool, ESAS-r symptom complexity may help identify patients who would benefit from more intensive follow-up and potentially reduce unnecessary acute care utilizations.

Indexed as

NeoplasmsPalliative CareAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedOntarioRetrospective StudiesSymptom Assessmentacute careadvanced cancerpalliative carepatient-reported outcomessymptom complexity

Identifiers

PMID40710198
PMCPMC12293374

What Socratic holds

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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.