Using clinical pathways to identify patient candidates for survivorship in testicular cancer.

Abstract

492 Background: Dana-Farber Cancer Institute’s (DFCI) Clinical Pathways provide evidence-based decision support for oncologists across a variety of care settings. Data generated by Pathways enable continued cancer care improvement and may also be a tool for identifying patient candidates for survivorship. Here, we explore patients diagnosed with testicular cancer treated with curative intent. Methods: Oncologists at DFCI navigate Clinical Pathways when starting or changing therapies. Each navigation provides discrete clinical data elements about disease (e.g., histology, stage), treatment setting (e.g., line of therapy), and treatment selected. Here, pathway navigation data was used to retrospectively identify patients with testicular cancer who were appropriate for survivorship resources. Eligibility criteria included patients who completed therapy, had not received treatment in 12-24 months since initial therapy navigation, and had a follow-up appointment scheduled. Eligible patients were referred to the testicular cancer survivorship program. Results: Between April 2021 to April 2022, we identified 25 testicular cancer patients treated at DFCI’s primary Longwood campus. Twelve of the 25 patients were identified as eligible for a survivorship referral. Nine of those 12 patients (75%) were successfully identified through the Pathways testicular survival algorithm described above. A Pathways navigation had not been completed by the providers of the 3-remaining survivorship-eligible patients, who were instead identified by EHR treatment plan data. One of the 12 patients screened by the testicular survivorship identification process developed metastatic disease that was not captured by the current algorithm and was then deemed inappropriate for survivorship referral. The remaining 11 patients were contacted and offered survivorship resources. As a reference, the total pathways usage rate between April 2021 to April 2022 for the DFCI genitourinary oncology group was 85% across all GU malignancies, and 74% in testicular cancer. Conclusions: Pathways Navigations can provide robust clinical information about patients, disease, and treatment. This information can be used to identify patients appropriate for survivorship and other clinical resources and trial opportunities in testicular cancer and across other malignancies. The impact of this process requires reliable provider usage of the Clinical Pathways tool.[Table: see text]