The Internal Prospective Validation of the Cancer Admission Score (CAS) Prediction Model (ONCOMING)

The Internal Prospective validatiON of a prediCtiOn Model for the Change of admIssion for Patient With caNcer Admitted to the emerGency Department (ONCOMING Study)

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.

Study Overview

• Status: Recruiting
• Conditions: Oncology
• Intervention / Treatment: Other: Cancer Admission Score Prediction Model

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 Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

• Study Contact: Name: Jason den Duijn; Phone Number: 0107040704; Email: j.denduijn@erasmusmc.nl

Study Locations

• Netherlands
  • Zuid-Holland
    • Rotterdam, Zuid-Holland, Netherlands, 3015GD
      • Recruiting
      • Erasmus University Medical Center
      • Contact: Jason den Duijn, MSc.; Phone Number: +31107040704; Email: j.denduijn@erasmusmc.nl

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All adult patients with an active cancer diagnosis who visit the ED of the Erasmus University Medical Center (Erasmus MC).

Description

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

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Cancer patients; All adult patients with an active cancer diagnosis who visit the emergency department (ED) of the Erasmus University Medical Centre (Erasmus MC).	Other: Cancer Admission Score Prediction Model; A prediction model that calculates the chance for a patient to be admitted after triage and after first blood results

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Disposition	The outcome of a visit to the ED, being either admission or home	Through study completion, an average of 6 months
Agreement between the CAS and the actual disposition	Agreement between the CAS predicted outcome and the actual outcome	Through study completion, an average of 6 months
Cancer Admission Score	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	Through study completion, an average of 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Agreement between expected disposition by nurse and actual disposition	Agreement between the nurse predicted outcome and the actual outcome	Through study completion, an average of 6 months
time-to-disposition	The average time between patient's arrival at the emergency department (ED) and the decision to disposition	Through study completion, an average of 6 months
time-to-leave	The average time between the decision to disposition and departure from the ED (either home or ward)	Through study completion, an average of 6 months
ED Length of Stay	The total time spent in the ED by a patient during their visit	Through study completion, an average of 6 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sex	The sex of a patient	Through study completion, an average of 6 months
Age	The age of a patient	Through study completion, an average of 6 months
Type of Cancer	The type of cancer a patient has	Through study completion, an average of 6 months
Type of Treatment	Type of cancer treatment a patient receives	Through study completion, an average of 6 months
Main Complaint	Main complaint of ED visit	Through study completion, an average of 6 months
Physical parameters recorded during triage	Physical parameters that are recorded during triage and are used in the prediction model	Through study completion, an average of 6 months
First Blood results	The blood results that are recorded during triage and are used in the prediction model	Through study completion, an average of 6 months

Collaborators and Investigators

• Sponsor: Erasmus Medical Center
• Investigators: Principal Investigator: Jason den Duijn, Erasmus Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): December 2, 2024
• Primary Completion (Estimated): December 1, 2025
• Study Completion (Estimated): December 31, 2025

Study Registration Dates

• First Submitted: August 14, 2024
• First Submitted That Met QC Criteria: August 14, 2024
• First Posted (Actual): August 16, 2024

Study Record Updates

• Last Update Posted (Estimated): August 15, 2025
• Last Update Submitted That Met QC Criteria: August 12, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: prediction model; emergency care; admission; cancer care
• Additional Relevant MeSH Terms: Neoplasms
• Other Study ID Numbers: 12821

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No