Csik et al reported the REDUCE (Reducing ED Utilization in the Cancer Experience) score. This is an acute care risk prediction model for oncology patients. The authors are from Sidney Kimmel Cancer Center and Thomas Jefferson University.
Patient selection: oncology patient
Parameters:
(1) number of ED visits in the past 90 days
(2) COPD (active diagnosis)
(3) congestive heart failure (CHF, active diagnosis)
(4) renal failure (active diagnosis)
(5) serum albumin in g/dL
(6) hemoglobin in g/dL
(7) absolute neutrophil count per µL
|
Parameter
|
Finding
|
Points
|
|
number of ED visits
|
|
MIN(3,)
|
|
COPD
|
no
|
0
|
|
|
yes
|
1
|
|
CHF
|
no
|
0
|
|
|
yes
|
1
|
|
renal failure
|
no
|
0
|
|
|
yes
|
1
|
|
serum albumin
|
>= 2.5 g/dL
|
0
|
|
|
< 2.5 g/dL
|
1
|
|
hemoglobin
|
>= 10 g/dL
|
0
|
|
|
< 10 g/dL
|
1
|
|
absolute neutrophil count
|
>= 1,000 per µL
|
0
|
|
|
< 1,000 per µL
|
1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the more likely the patient will have a chemotherapy-related ED visit.
• A score >= 2 is associated with high risk for an ED visit.
Performance:
• The area under the ROC curve is 0.73.
