Estimating remaining life expectancy in veterans with basal cell carcinoma using an automated electronic health record scoring system: A retrospective cohort study - 13/12/23
, Eleni Linos, MD, DrPH d, Susan M. Swetter, MD b, eAbstract |
Background |
Active surveillance may be considered for low-risk basal cell carcinomas (BCCs) in patients with limited life expectancy; however, estimates of life expectancy are not readily available. Veterans Health Administration's Care Assessment Need (CAN) score may address this problem.
Objective |
We examined the CAN score's performance in predicting 1-, 3-, and 5-year mortality in US veterans with BCC.
Methods |
This retrospective cohort study used national Veterans Health Administration's electronic medical record data. The CAN score's performance in the prediction of mortality in veterans with BCC was evaluated based on tests of goodness-of-fit, discrimination, and calibration.
Results |
For 54,744 veterans with BCC treatment encounters between 2013 and 2018, the CAN score performed well in the prediction of mortality based on multiple tests. A threshold CAN score of 90 had a positive predictive value of 55% for 3-year mortality, clinically useful in identifying patients with intermediate-term survival.
Limitations |
The study relied upon the combination of diagnosis codes and procedure codes to identify BCC cases.
Conclusion |
The CAN score has the potential to improve the quality of cancer care for veterans by providing clinicians with an estimate of life expectancy and facilitating conversations in cases where active surveillance can be considered.
Le texte complet de cet article est disponible en PDF.Key words : basal cell carcinoma, general dermatology, geriatrics, medical dermatology, outcomes, surgery
Abbreviations used : BCC, CAN, CPT, ED, ICD, LLE, MMS, PPV, VHA
Plan
| Funding sources: This material is based on support from the Veterans Affairs (VA) Office of Academic Affiliations and with resources and the use of facilities at the VA Palo Alto Health Care System, Palo Alto, California. The views expressed in this article are the authors' and not those of the VA or other institutions. The VA had no role in the design and conduct of the study; management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. |
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| Patient consent: Not applicable. |
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| IRB approval status: Reviewed and approved by Stanford University, Protocol Number: IRB-65654. |
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| Data availability statement: Due to US Department of Veterans Affairs regulations and our ethics agreements, the analytic data sets used for this study are not permitted to leave the VA firewall without a Data Use Agreement. This limitation is consistent with other studies based on VA data. However, VA data are made freely available to researchers with an approved VA study protocol. For more information, please visit www.virec.research.va.gov or contact the VA Information Resource Center at [email protected]. |
Vol 90 - N° 1
P. 98-105 - janvier 2024 Retour au numéro
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