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Author Spotlight: Advancing Cancer Associated Thrombosis Research in Rodent Models
Published on: January 5, 2024
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External Validation of a Venous Thromboembolic Risk Score for Cancer Outpatients with Solid Tumors: The COMPASS-CAT
Alex C Spyropoulos1,2,3, Joanna B Eldredge4, Lalitha N Anand2
1Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Huntington, New York, USA.
The Oncologist
|February 5, 2020
Summary
The COMPASS-CAT risk model shows moderate accuracy for predicting venous thromboembolism (VTE) in cancer patients, with good negative predictive value. Further prospective studies are needed before clinical implementation for primary thromboprophylaxis.
Area of Science:
- Oncology
- Hematology
- Clinical Risk Assessment
Background:
- Current risk assessment models (RAMs) for venous thromboembolism (VTE) in outpatient cancer patients have limited predictive value.
- The Comparison of Methods for Thromboembolic Risk Assessment with Clinical Perceptions and AwareneSS in Real Life Patients-Cancer Associated Thrombosis (COMPASS-CAT) RAM was developed for this population.
- External validation of the COMPASS-CAT RAM is necessary to assess its utility in real-world clinical settings.
Purpose of the Study:
- To externally validate the COMPASS-CAT RAM in a diverse cohort of cancer patients.
- To evaluate the predictive performance of the COMPASS-CAT RAM for VTE in patients with breast, ovarian, lung, or colorectal cancer.
- To determine the model's accuracy, sensitivity, specificity, and predictive values for VTE risk stratification.
Main Methods:
- Retrospective validation study including 3,814 patients with invasive breast, ovarian, lung, or colorectal cancer.
- Application of the COMPASS-CAT RAM using tumor registry data and International Statistical Classification of Diseases and Related Health Problems (ICD-9/10) codes.
- Primary endpoint: documented VTE at 6-month follow-up.
Main Results:
- A total of 3,814 patients were analyzed, with a 6-month VTE incidence of 5.85%.
- Patients in the high-risk group had a VTE rate of 6.31%, compared to 2.27% in the low/intermediate-risk group.
- The model demonstrated a sensitivity of 95%, specificity of 12%, and negative predictive value of 97.73%, with an area under the receiver operating characteristic curve of 0.62.
Conclusions:
- The COMPASS-CAT RAM exhibited moderate discrimination and poor calibration in this external validation cohort.
- The model's strong negative predictive value suggests its potential utility in ruling out VTE risk.
- Further prospective validation, particularly within 6 months of cancer diagnosis, is recommended before routine clinical use for primary thromboprophylaxis.
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