Abstract: In this study the risk scoring algorithm is evaluated to see the ability of the scoring systems to accurately identify patients deemed to be high risk for CINV.
Patients who were receiving chemotherapy are included in the study after taking informed consent from them. Then the patients are followed up for 5-day telephone call backs after chemotherapy in every cycle. All patients received anti-emetic prophylaxis as prescribed by the treating physician. Before each cycle of chemotherapy, the delayed CINV scoring systems were used to stratify patients into low- and high-risk groups. Logistic regression modelling was then applied to compare the risk for grade 2 or greater CINV between patients considered to be at high and at low risk. The external validity of each system was also assessed using an area under the receiver operating characteristic curve (AUROC) analysis.
CINV outcomes data was collected from 128 patients during 356 cycles of chemotherapy. The incidence of delayed CINV was 76.4%. Major predictors for CINV included earlier cycles of chemotherapy, previous history of morning sickness, and prior emetic episodes after chemotherapy. The delayed scoring system had good predictive accuracy when applied to the external validation sample (delayed—AUROC: 0.75; 95% confidence interval: 0.70 to 0.80). Patients identified by the scoring systems to be at high risk were 3.8 (p = 0.001) times more likely to develop grade 2 or greater delayed CINV.
The present study demonstrates that our scoring systems are able to accurately identify patients at high risk for delayed CINV.
