Critical appraisal:Quinn GP, Block RG, Clayman ML, Kelvin J, Arvey SR, Lee J, et al 2014

Critical Appraisal

Article being appraised

Quinn GP, Block RG, Clayman ML, Kelvin J, Arvey SR, Lee J, et al. If You Did Not Document It, It Did Not Happen: Rates of Documentation of Discussion of Infertility Risk in Adolescent and Young Adult Oncology Patients' Medical Records. J Oncol Pract 2014 Dec 30 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25549654.

Applicable clinical question

What proportion of cancer patients are referred to fertility specialists? Which patients are more likely to be referred to fertility specialists?

Key Facts

Study Design

case series

Study aims:

This study sought to establish rates of documen- tation of discussion of risk of infertility, fertility preservation (FP) options, and referrals to fertility specialists in AYA patients’ med- ical records at four cancer centers.

Number of Patients:

231

Patient record eligibility criteria included new patients who: were diagnosed with breast cancer, leukemia/lymphoma, sar- coma, or testicular cancer in 2011; were between age 18 and 45 years at the time of diagnosis; did not have multiple primary cancers; and were not second-opinion patients.

Reported outcome(s):

The overall rate of documentation of discussion of FP is low, and results show disparities among specific groups. Although greater numbers of discussions may be occurring, there is a need to create interventions to improve documentation.

Results of outcome(s):

Of 231 records, 26% documented infertility risk discussion, 24% documented FP option discussion, and 13% documented referral to a fertility specialist. Records were less likely to contain evidence of infertility risk and FP option discussions for female patients (P .030 and .004, respectively) and those with breast cancer (P .021 and .001, respectively). Records for Hispanic/Latino patients were less likely to contain evidence of infertility risk discussion (P .037). Records were less likely to document infertility risk discussion, FP option discussion, and fertility specialist referral for patients age 40 years (P <.001, < .001, and <.002, respectively) and those who already had children (all P < .001).

Includes an economic evaluation

no