Hess Lisa M, Smith David, Cui Zhanglin L, Montejano Leslie, Liepa Astra M, Schelman William, Bowman Lee
Eli Lilly and Company, Indianapolis, IN, USA.
IBM Watson Health, Cambridge, MA, USA.
J Drug Assess. 2020 Dec 16;10(1):10-17. doi: 10.1080/21556660.2020.1851504.
The ability of a patient to receive anti-cancer treatment depends on a variety of factors, including performance status (PS), which is typically measured using the Eastern Cooperative Oncology Group (ECOG) scale. This study hypothesized that there would be a strong and positive correlation between ECOG PS values and healthcare resource utilization (HCRU) and a strong and negative correlation with the use of anti-cancer therapy.
Patients with colorectal, lung or gastric cancer were included in this retrospective analysis of administrative claims data linked to electronic medical records (EMR). All-cause HCRU (hospitalization/inpatient care, emergency room visits, systemic anti-cancer therapy, radiation therapy, outpatient physician visits, hospice, home health care and key supportive care treatments such as anti-emetics, hematopoietic treatments, transfusions, and durable medical equipment) was evaluated by baseline ECOG PS value and PS over time. Adjusted multivariable regression analysis was used to assess the relationship between baseline ECOG PS and HCRU. Regression analyses were conducted to explore the relationship between other baseline variables and HCRU.
There were 1311 patients included in this study. There was low correlation between PS and any HCRU variable or receipt of anti-cancer therapy (correlation coefficients all <0.10). In regression analyses, the proportion of patients with poor PS (PS = 2+) who were hospitalized was not significantly different from those with good PS (PS = 0/1) (28.9% versus 19.3%, = .07).
The low rate of reporting of PS and the small sample size of patient groups in this study.
There is very little evidence of a relationship between ECOG PS and HCRU, ECOG PS, or anti-cancer therapy in this study, in part due to low rates of and lack of variability in reported PS. There is some evidence that baseline comorbidities were significantly associated with HCRU and should be accounted for in future research evaluating HCRU.
患者接受抗癌治疗的能力取决于多种因素，包括体能状态（PS），其通常使用东部肿瘤协作组（ECOG）量表进行测量。本研究假设ECOG PS值与医疗资源利用（HCRU）之间存在强正相关，与抗癌治疗的使用存在强负相关。
对与电子病历（EMR）相关的行政索赔数据进行回顾性分析，纳入患有结直肠癌、肺癌或胃癌的患者。通过基线ECOG PS值和随时间变化的PS评估全因HCRU（住院/住院护理、急诊就诊、全身抗癌治疗、放射治疗、门诊医生就诊、临终关怀、家庭医疗保健以及关键支持性治疗，如止吐药、造血治疗、输血和耐用医疗设备）。采用调整后的多变量回归分析评估基线ECOG PS与HCRU之间的关系。进行回归分析以探讨其他基线变量与HCRU之间的关系。
本研究共纳入1311例患者。PS与任何HCRU变量或抗癌治疗的接受情况之间的相关性较低（相关系数均<0.10）。在回归分析中，PS较差（PS = 2+）的患者住院比例与PS较好（PS = 0/1）的患者无显著差异（28.9%对19.3%，P = 0.07）。
本研究中PS的报告率较低且患者组样本量较小。
本研究中几乎没有证据表明ECOG PS与HCRU、ECOG PS或抗癌治疗之间存在关联，部分原因是报告的PS率低且缺乏变异性。有证据表明基线合并症与HCRU显著相关，在未来评估HCRU的研究中应予以考虑。
