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Validation of an oncology-specific opioid risk calculator in cancer survivors.

Publication ,  Journal Article
Riviere, P; Vitzthum, LK; Nalawade, V; Deka, R; Furnish, T; Mell, LK; Rose, BS; Wallace, M; Murphy, JD
Published in: Cancer
May 2021

Clinical guidelines recommend that providers risk-stratify patients with cancer before prescribing opioids. Prior research has demonstrated that a simple cancer opioid risk score might help identify to patients with cancer at the time of diagnosis with a high likelihood of long-term posttreatment opioid use. This current project validates this cancer opioid risk score in a generalizable, population-based cohort of elderly cancer survivors.This study identified 44,932 Medicare beneficiaries with cancer who had received local therapy. Longitudinal opioid use was ascertained from Medicare Part D data. A risk score was calculated for each patient, and patients were categorized into low-, moderate-, and high-risk groups on the basis of the predicted probability of persistent opioid use. Model discrimination was assessed with receiver operating characteristic curves.In the study cohort, 5.2% of the patients were chronic opioid users 1 to 2 years after the initiation of cancer treatment. The majority of the patients (64%) were at low risk and had a 1.2% probability of long-term opioid use. Moderate-risk patients (33% of the cohort) had a 5.6% probability of long-term opioid use. High-risk patients (3.5% of the cohort) had a 75% probability of long-term opioid use. The opioid risk score had an area under the receiver operating characteristic curve of 0.869.This study found that a cancer opioid risk score could accurately identify individuals with a high likelihood of long-term opioid use in a large, generalizable cohort of cancer survivors. Future research should focus on the implementation of these scores into clinical practice and how this could affect prescriber behavior and patient outcomes.A novel 5-question clinical decision tool allows physicians treating patients with cancer to accurately predict which patients will persistently be using opioid medications after completing therapy.

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Published In

Cancer

DOI

EISSN

1097-0142

ISSN

0008-543X

Publication Date

May 2021

Volume

127

Issue

9

Start / End Page

1529 / 1535

Related Subject Headings

  • United States
  • Time Factors
  • SEER Program
  • Risk Assessment
  • ROC Curve
  • Probability
  • Prescription Drug Misuse
  • Oncology & Carcinogenesis
  • Medicare Part D
  • Male
 

Citation

APA
Chicago
ICMJE
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Riviere, P., Vitzthum, L. K., Nalawade, V., Deka, R., Furnish, T., Mell, L. K., … Murphy, J. D. (2021). Validation of an oncology-specific opioid risk calculator in cancer survivors. Cancer, 127(9), 1529–1535. https://doi.org/10.1002/cncr.33410
Riviere, Paul, Lucas K. Vitzthum, Vinit Nalawade, Rishi Deka, Timothy Furnish, Loren K. Mell, Brent S. Rose, Mark Wallace, and James D. Murphy. “Validation of an oncology-specific opioid risk calculator in cancer survivors.Cancer 127, no. 9 (May 2021): 1529–35. https://doi.org/10.1002/cncr.33410.
Riviere P, Vitzthum LK, Nalawade V, Deka R, Furnish T, Mell LK, et al. Validation of an oncology-specific opioid risk calculator in cancer survivors. Cancer. 2021 May;127(9):1529–35.
Riviere, Paul, et al. “Validation of an oncology-specific opioid risk calculator in cancer survivors.Cancer, vol. 127, no. 9, May 2021, pp. 1529–35. Epmc, doi:10.1002/cncr.33410.
Riviere P, Vitzthum LK, Nalawade V, Deka R, Furnish T, Mell LK, Rose BS, Wallace M, Murphy JD. Validation of an oncology-specific opioid risk calculator in cancer survivors. Cancer. 2021 May;127(9):1529–1535.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

ISSN

0008-543X

Publication Date

May 2021

Volume

127

Issue

9

Start / End Page

1529 / 1535

Related Subject Headings

  • United States
  • Time Factors
  • SEER Program
  • Risk Assessment
  • ROC Curve
  • Probability
  • Prescription Drug Misuse
  • Oncology & Carcinogenesis
  • Medicare Part D
  • Male