{"id":22036,"date":"2025-04-15T16:15:23","date_gmt":"2025-04-15T20:15:23","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=22036"},"modified":"2025-06-27T16:16:02","modified_gmt":"2025-06-27T20:16:02","slug":"health-care-contact-days-and-outcomes-in-clinical-trials-vs-routine-care-among-patients-with-non-small-cell-lung-cancer","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/health-care-contact-days-and-outcomes-in-clinical-trials-vs-routine-care-among-patients-with-non-small-cell-lung-cancer\/","title":{"rendered":"Health care contact days and outcomes in clinical trials vs routine care among patients with non-small cell lung cancer"},"content":{"rendered":"

Importance<\/strong> \u2014 Although patients enrolled in trials have superior survival outcomes compared with those in routine practice, it is unknown whether such differences extend to contact days, a measure of time toxicity.<\/p>\n

Objective<\/strong> \u2014 To evaluate differences in contact days for patients with advanced stage non-small cell lung cancer (NSCLC) receiving care in trials or routine practice.<\/p>\n

Design, setting, and participants<\/strong> \u2014 This population-based, retrospective, matched cohort study assessed adults from Ontario, Canada, who were diagnosed with advanced-stage NSCLC between January 1, 2010, and December 31, 2017, and who died between January 1, 2010, and December 31, 2019. The maximum follow-up time from diagnosis was 2 years. Data analysis was performed from May 5, 2024, to October 22, 2024.<\/p>\n

Exposure<\/strong> \u2014 Patients receiving specific, systemic, palliative-intent, cancer-directed drug(s) as part of a trial were matched 1:1 with patients who received the same drug(s) after approval in routine practice in the same line of treatment.<\/p>\n

Main outcomes and measures<\/strong> \u2014 Contact days (days with in-person health care contact) were identified through administrative claims data. Models were fitted with cubic splines to describe trajectories of weekly percentage of contact days.<\/p>\n

Results<\/strong> \u2014 Of the 250 patients (mean [SD] age, 63.6 [9.2] years; 140 [56.0%] male), 125 were trial participants and 125 were receiving care in routine practice. Trial participants were younger (median [IQR] age, 63 [56-69] years vs 64 [58-70] years in routine care patients; standardized difference, 0.21) and had fewer comorbidities (eg, hypertension [45 (36.0%) vs 59 (47.2%); standardized difference, 0.23]). Median (IQR) contact days from diagnosis to death were higher for trial participants compared with those in routine practice (79 [62-104] vs 68 [46-98] days; standardized difference, 0.26). However, trial participants had a longer median (IQR) overall survival (eg, 12.8 [8.7-18.0] vs 10.5 [5.2-14.7] months; standardized difference, 0.46) and a slightly lower median percentage of contact days after adjusting for survival (20.3% [95% CI, 18.1%-21.7%] vs 21.2% [95% CI, 19.3%-25.7%]). During treatment, trial participants experienced a lower median percentage of contact days (18.4% [95% CI, 16.3%-20.8%] vs 25.5% [95% CI, 20.7%-30.3%]); inpatient care accounted for 18.5% (95% CI, 11.1%-29.6%) of on-treatment contact days for trial participants vs 40.0% (95% CI, 30.0%-47.6%) in routine practice. Normalized contact-day trajectories were U-shaped for all groups, with lower peaks and troughs among trial participants.<\/p>\n

Conclusions and relevance<\/strong> \u2014 In this population-based cohort study, patients receiving systemic therapy as part of trials experienced a lower percentage of contact days, accounted for by greater hospitalization rates in routine practice. Addressing the predominantly outpatient, protocol-mandated visits may represent opportunities to decrease trial-related time toxicity.<\/p>\n","protected":false},"excerpt":{"rendered":"

Importance \u2014 Although patients enrolled in trials have superior survival outcomes compared with those in routine practice, it is unknown whether such differences extend to contact days, a measure of time toxicity. Objective \u2014 To evaluate differences in contact days for patients with advanced stage non-small cell lung cancer (NSCLC) receiving care in trials or […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[38,59,52],"migration-helper-qa-sample-set":[],"class_list":["post-22036","journal_article","type-journal_article","status-publish","hentry","topic-cancer-and-cancer-screening","topic-data-science","topic-lung-health"],"acf":{"citation":"Gupta A, Nguyen P, Wilson BE, Booth CM, Hanna TP.\u00a0 JAMA Netw Open<\/em>. 2025; 8(4):e255033.","source_url":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.5033","ices_scientist":[1263],"site":[6736],"research_program":[6741],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | Health care contact days 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