Critical appraisal:Quinn GP, Block RG, Clayman ML, Kelvin J, Arvey SR, Lee J, et al 2014 2

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 have a discussion regarding the risk of infertility with a health professional?

Key Facts

Study Design

cross sectional study

Study aims:

To establish rates of documentation of discussion of risk of infertility, fertility preservation options, and referrals to fertility specialists in AYA patients' medical records at four cancer centers.

Number of Patients:

231

Patients aged 18 to 45 years; diagnosed in 2011; no multiple primary cancers; no prior gonadotoxic therapy

Reported outcome(s):

26% documented discussion around infertility risk
24% documented discussions of fertility preservation options
13% documented referral to fertility specialist.

Results of outcome(s):

Female patients less likely to have discussions of infertility risk and fertility preservation options (p 0.030 and 0.004 respectively)
Patients with breast cancer less likely to have discussions of infertility risk and fertility preservation options (p 0.021 and <0.001 respectively).
Hispanic/Latino patient records less likely to contain evidence of infertility risk discussion (p 0.037). Records less likely to document infertility risk discussion, FP option discussion, and fertility specialist referral for patients age ≥ 40 years (P <0.001, <0.001, and 0.002, respectively) and those who already had children (all p <0.001)

Comments on results:

Article identifies that although greater numbers of discussions may be occurring, documentation does not support that and there is a need to create interventions to improve documentation.

Includes an economic evaluation

no