Data Stream
Blood Money The Match Game
It’s no secret that a diagnosis of a hematologic malignancy is a financial
burden on patients and their families, but a study commissioned by the
Leukemia & Lymphoma Society reveals just how costly blood cancers are. For patients who need a bone marrow transplant, the likelihood of finding a matched donor
varies based on ancestry.
Per-patient health-care spending (including both out-of-pocket patient
spending and expenses covered by insurance) in the first year after
diagnosis of a blood cancer was $156,845. The average costs varied widely
depending on specific diagnosis,
In Blood Advances, researchers found that, of 1,312 patients with hematologic
malignancies undergoing a transplant, people of non-European or southern-European
descent were less likely to find a fully matched donor.
from nearly $89,000
for chronic leukemias
to more than
$460,000
for acute
leukemias.
Europeans
Spending never returned to prediagnosis levels: Monthly health-care costs
averaged $1,600 before diagnosis and, even 3 years after diagnosis, average
monthly spending was between $3,500 and $4,500.
Source: The Leukemia & Lymphoma Society, “The Cost Burden of Cancer Care.”
Southern
Europeans
Non-
Europeans
Keep the Comments Coming!
Researchers at Brigham and Women’s Hospital in Boston have found that
cranky comments on clinical decision support tools may have a purpose
aside from allowing doctors to vent their frustrations.
Africans
In an analysis of
comments left by
clinicians who
were requesting
overrides on
150 electronic
health record–
based clinical decision
support tools, they found
that comments like “This is
an inappropriate rec,” “NOT ON
CYCLOSPORINE!!!!!!!!!!!!!!!!!!!!!!!!!!,”
and even “you are stupid,” helped staff
uncover malfunctions in
26 % of the rules.
Sentiment was important, as the authors found
that the frequency of comments did not predict
if a rule was broken. So, if you think a rule is
broken, say something (but try to be reasonably
polite about it)!
Source: Aaron S, McEvoy DS, Ray S, et al. Cranky comments:
detecting clinical decision support malfunctions through
free-text override reasons. J Am Med Inform Assoc.
2019;26:37-43.
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ASH Clinical News
67 %
likelihood
33 % 41 % 18 %
likelihood
likelihood
likelihood
“We have identified tremendous racial and ethnic disparity in transplant access,” lead
author Juliet Barker, MBBS, said in a press release. “What’s more, it has been thought by
some that if you just increase the number of registered adult donors that it would resolve
this problem, but it hasn’t.”
Sources: American Society of Hematology press release, March 27, 2019; Barker JN, Boughan K, Dahi PB, et al. Racial dispari-
ties in access to HLA-matched unrelated donor transplants: a prospective 1312-patient analysis. Blood Adv. 2019;3:939-44.
June 2019