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Performance of a Trigger Tool for Identifying Adverse Events in Oncology
Allison Lipitz-Snyderman1, David Classen1, David Pfister1
1Memorial Sloan Kettering Cancer Center; Columbia University; AIG, New York, NY; Pascal Metrics, Washington, DC; University of Utah School of Medicine, Salt Lake City, UT; and Tufts Medical Center and Tufts University School of Medicine, Boston, MA.
Journal of Oncology Practice
|January 18, 2017
Summary
A new oncology screening tool identifies adverse events (AEs) beyond toxicities. The modified tool, with 49 triggers, improved AE detection in cancer patients, enhancing patient safety and care quality.
Area of Science:
- Oncology
- Patient Safety
- Health Informatics
Background:
- Patient safety is crucial in oncology, yet tools for measuring adverse events (AEs) beyond treatment toxicities are limited.
- Developing effective methods to identify and mitigate AEs is essential for improving cancer care quality.
Purpose of the Study:
- To assemble a set of clinical triggers within the medical record.
- To assess the performance of these triggers in identifying AEs in oncology patients.
Main Methods:
- A retrospective cohort study was conducted involving 400 patients with breast, colorectal, or lung cancer.
- A medical record screening tool was developed and evaluated for its ability to detect AEs.
Main Results:
- An initial 790 triggers were identified, with an overall positive predictive value (PPV) of 0.40 for total AEs.
- A modified tool with 49 triggers demonstrated an improved PPV of 0.48 for total AEs and 0.18 for preventable or mitigable AEs.
- High-performing triggers included postoperative return to surgery and elevated blood glucose.
Conclusions:
- A validated medical record screening tool for AEs in oncology can significantly enhance cancer care quality measurement and improvement.
- Future work should focus on optimizing tool efficiency and developing automated electronic triggers for real-time AE detection and mitigation.
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