The Internal Prospective validatiON of a prediCtiOn Model for the Change of admIssion for Patient With caNcer Admitted to the emerGency Department (ONCOMING Study)
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Erasmus Medical Center
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- Cancer Admission Score
Study Overview
Brief Summary
The goal of this single center prospective observational study is to determine the agreement between the cancer admission score (CAS) predicted disposition and the actual disposition in patients with an active cancer diagnosis visiting the emergency department (ED). The main question it aims to answer are: Is the performance of the CAS good enough to play a potential role in the ED care process. For each participant the CAS will be calculated and compared to the actual outcome.
Detailed Description
The goal of this single center prospective observational study is to determine the agreement between the cancer admission score (CAS) predicted disposition and the actual disposition in patients with an active cancer diagnosis visiting the emergency department (ED). The main question it aims to answer are: Is the performance of the CAS good enough to play a potential role in the ED care process.
The first part of this study is an observational part. For patients with cancer that are presented to the emergency department (ED) the cancer admission score (CAS) will be calculated by the model both after triage and after the first blood results are in. Furthermore, the expected disposition will be asked to the attending nurse after triage and after the first blood results. Finally, the actual disposition will be written down after the patient has left the ED, in combination with ED length of stay (LOS) and the time for the attending physician to reach a decision about the disposition (time-to-disposition) and the time for a patient to leave the ED (time-to-leave).
The second part is the interventional part. In this part we introduce an early bed reservation intervention. The CAS is still calculated for the patient. If the CAS is 80% or higher based on the triage, the attending physician will be alerted and a call to the bed coordinator will be placed to reserve a bed in advance. After the first blood results are known the second CAS will be calculated, if this drops below 70% the reserved bed can be canceled by the attending physician. Similar to the first part, the expected disposition from the attending nurse after triage and after first blood results will be collected. Finally, the actual disposition, ED LOS, time-to-disposition and time-to-leave will be noted.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients with solid or hematological malignancies and receiving systemic therapy or having received systemic therapy within the last 3 months.
- •Presented at or admitted from the emergency department for the oncology, hematology neuro- or lung-oncology clinical unit.
Exclusion Criteria
- •<18 years old
- •Only received a surgical intervention as cancer treatment
- •Admitted to the ED for the surgical department
Outcomes
Primary Outcomes
Cancer Admission Score
Time Frame: Through study completion, an average of 6 months
Cancer Admission Score (CAS) calculated after triage and after first blood results, ranging from 0 to 100%. The higher the score the greater the change of admission
Agreement between the CAS and the actual disposition
Time Frame: Through study completion, an average of 6 months
Agreement between the CAS predicted outcome and the actual outcome
Disposition
Time Frame: Through study completion, an average of 6 months
The outcome of a visit to the ED, being either admission or home
Secondary Outcomes
- ED Length of Stay(Through study completion, an average of 6 months)
- Agreement between expected disposition by nurse and actual disposition(Through study completion, an average of 6 months)
- time-to-disposition(Through study completion, an average of 6 months)
- time-to-leave(Through study completion, an average of 6 months)
Investigators
Jason den Duijn
Principal Investigator
Erasmus Medical Center