publication date: Jun. 5, 2020
ASCO data will provide actionable insights from the COVID-19 pandemic—for every patient
Richard L. Schilsky, MD, FACP, FSCT, FASCO
Executive vice president, chief medical officer,
American Society of Clinical Oncology
This story is part of The Cancer Letter’s ongoing coverage of COVID-19’s impact on oncology. A full list of our coverage, as well as the latest meeting cancellations, is available here.
The year 2020 will no doubt be recorded as one of the most tumultuous in our nation’s, if not the world’s, history.
Even as we gathered virtually last weekend for ASCO’s annual scientific program, events unfolding across the United States shifted our attention from the impact of COVID-19 on global health and well-being to the impact of systemic racism and social inequity on the lives of people of color across America.
If we learn anything from the COVID-19 pandemic and the current crisis of civil unrest, it’s the importance of leveraging our collective experience to conquer cancer and ensuring that every person with cancer has access to high-quality care—no matter who they are, where they live, what they earn, or the color of their skin.
That vision drives ASCO’s work and is why we have dedicated significant resources to disseminating evidenced-based information to support the cancer care community and to deriving insights about the impact of the coronavirus on the people in our care.
In the early days of the pandemic, ASCO quickly assembled resources across the entire organization to help cancer care delivery teams pivot under the unparalleled demands placed on them by a rampaging and previously unknown virus. Most recently, we released the Guide to Cancer Care Delivery During the COVID-19 Pandemic, which describes immediate and short-term steps oncology practices can take to protect the safety of patients and healthcare staff as the pandemic response evolves.
As states and municipalities implement gradual easing of pandemic-related restrictions, we hope this guide will give cancer practices the information they need to restore operations, safely resume routine care and ensure uninterrupted patient access to necessary treatments and diagnostic services.
We also set out to collect data and, currently, have three lines of sight into the COVID-19 impact.
The first I’ve written about previously on these pages: the ASCO Survey on COVID-19 in Oncology Registry, is collecting both baseline and longitudinal data on how the virus is impacting patients with cancer, their cancer treatment, and outcomes to inform current cancer care and decision-making for future disease outbreaks. Still in its early stages, the ASCO Registry continues to recruit oncology practices across the United States, all eager to contribute knowledge about their patients’ experience during this challenging period. More than 100 practices have expressed interest in contributing to the Registry and more than 20 have already begun to enter data.
On another front, CancerLinQ, ASCO’s big-data initiative, is monitoring COVID-19 diagnoses among active cancer patients in its database of 1.5 million cancer patients from participating organizations. COVID-19 disease is being detected by searching for positive tests for the SARS-CoV-2 virus and/or a diagnosis code for COVID-19 disease and/or a diagnosis code for viral pneumonia not attributed to known agents.
These cases have been characterized by age, gender, race, ethnicity, and cancer diagnosis. In addition, we have provided similar distributions for all active cancer patients from the sites that are reporting COVID disease (“Baseline Cases”) for purposes of comparing the COVID-19 infected cancer population with the non-infected patient population at the same sites. We are sharing this data with the cancer community in a series of regularly updated reports.
Third, to complement the clinical data gathered by CancerLinQ, ASCO’s PracticeNET program has compiled data on practice activity from its benchmarking collaborative. Starting in March 2020, a group of 16 practices have shared weekly data in order to analyze the impact of COVID-19 on practice operations.
These observations have shown, among other findings, a decrease in total visit activity, including new patient visits, established patient visits, and hospital visits; a growth in telehealth, including telephone-only visits, e-visits, and virtual check-ins; a decrease in overall physician work relative value units, a measure which reflects the volume, nature and complexity of physician services; a sustained decrease in non-chemotherapy drug infusions; and a fall in new patient and consult activity, primarily for patients with blood cancers and benign hematology disorders.
Collecting data from multiple sources will allow ASCO, and the larger cancer community, to confirm, deepen, and extend our insight into the pandemic’s impact on individuals with cancer and the cancer care delivery system. This investment will provide actionable, accurate, and reliable insights that can be used to improve cancer care today, shape the future of care delivery and leverage our collective experiences even during times of grief and uncertainty.