The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index; none of the 14 sources its claims cite is checked for support yet.
Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery
Open accessAbstract
Purpose: Numerous organizations recommend that patients with cancer receive a survivorship care plan (SCP) comprising a treatment summary and follow-up care plans. Among current barriers to implementation are providers’ concerns about the strength of evidence that SCPs improve outcomes. This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors. Methods: Randomized and nonrandomized studies evaluating patient-reported outcomes, health care use, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Data extracted by independent raters were summarized on the basis of qualitative synthesis. Results: Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer types, SCP delivery timing and method, SCP recipients and content, SCP-related counseling, and outcomes assessed. Nonrandomized study findings yielded descriptive information on satisfaction with care and reactions to SCPs. Randomized study findings were generally negative for the most commonly assessed outcomes (ie, physical, functional, and psychological well-being); findings were positive in single studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care. Conclusion: Existing research provides little evidence that SCPs improve health outcomes and health care delivery. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal outcomes. Findings are limited but more positive for proximal outcomes (eg, information received) and for care delivery, particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This systematic review of 24 studies found limited evidence that survivorship care plans (SCPs) improve health outcomes or health care delivery for cancer survivors. Findings were generally null for commonly assessed patient-reported outcomes, with isolated positive findings for proximal outcomes and care delivery, especially when SCPs were accompanied by counseling.
Key findings
- The review included 24 articles: 11 nonrandomized studies and 13 randomized studies. Nonrandomized studies were mostly descriptive and focused on feasibility, acceptability, and satisfaction; one analysis of changes in psychological distress found no statistically significant differences.
- Among randomized studies, findings were generally negative for the most commonly assessed outcomes (physical, functional, and psychological well-being). Seven studies reported no statistically significant differences across intervention conditions; four reported beneficial effects limited to single studies (fewer depressive symptoms, less health worry and less negative outlook, greater satisfaction with care, greater amount of information received), and one reported adverse effects (more symptoms, illness concerns, and emotional impact of illness).
- Six randomized studies assessed health care delivery and use; five reported beneficial effects (greater preference for shared care, greater likelihood of correctly identifying the PCP as responsible for follow-up, greater adherence to cardiomyopathy screening, better physician implementation of survivorship care recommendations, and more cancer-related contact with the PCP), while one reported no statistically significant differences.
- Two studies assessed disease-related end points and found no statistically significant differences in time to diagnosis of recurrence or recurrence-related serious clinical events. Economic findings were mixed: one study reported lower health care costs in the SCP condition, while another reported higher societal and health care costs but negligible differences in quality-adjusted life years.
Methods
- Systematic literature searches were conducted in PubMed/MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Cochrane Library, with coverage ending July 16, 2017. Studies were eligible if published in English, involved delivery of an SCP to survivors and/or their health care providers, and evaluated patient-reported outcomes, health care use, or disease outcomes.
- A total of 1,399 studies were identified through database searches and 54 additional articles from reference lists and previous reviews; after duplicates were removed, 1,091 articles were screened, 41 full texts were assessed, and 24 articles met inclusion criteria.
- Two paired reviewers independently screened, extracted data, and rated quality using the Quality Assessment Tool for Quantitative Studies for nonrandomized studies and items adapted from the Cochrane Risk of Bias Tool for randomized studies. Because of limited size and marked heterogeneity, analysis focused on qualitative synthesis rather than meta-analysis.
Limitations
- The paper states that the limited number of studies and heterogeneous methodology precluded quantitative synthesis, so the review examined whether randomized study findings reached statistical significance rather than aggregating effect sizes. It was also limited to published studies in English, excluding relevant unpublished studies and research in other languages, and examined only health outcomes and health care delivery, not other aspects such as survivor and provider preferences for SCP content and delivery methods.
- Evident from the text: the nonrandomized studies were uncontrolled and focused mostly on feasibility and acceptability, limiting conclusions about impact. Many randomized studies had unclear risk-of-bias ratings because of insufficient information, and significant findings for any specific outcome were often limited to single studies, which the authors note seriously limits definitive conclusions.
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Claims the paper makes
26 Own result · 15 Not checked yet · 8 Own method · 8 Own interpretation · 7 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Variability was evident across studies in cancer types, SCP delivery timing and method, SCP recipients and content, SCP-related counseling, and outcomes assessed.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Among the 13 randomized studies, most focused on examining the impact of SCPs on patient-reported health states and perceptions of care.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“No statistically significant differences across intervention conditions were reported in seven studies.23,24,26-28,33,35”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only six studies reported results for the impact of SCPs on health care delivery and use; however, five of these studies reported significant findings.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The one exception was an analysis of changes over time in psychological distress scores, which yielded no statistically significant differences.19”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was also little consistency in what outcomes were assessed and even in what measures were used to assess the same outcome (eg, psychological distress).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All the significant findings suggested beneficial effects of SCPs, but, once again, the findings for any specific outcome (eg, physician implementation of survivorship care recommendations) were limited to single studies.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The studies reviewed evaluated SCPs that differed markedly in terms of the follow-up information and care recommendations provided, when they were delivered in relation to treatment completion, and how and to whom they were delivered.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Consistent with this view are results described in the current article showing delivery of SCPs resulted in survivors reporting a greater amount of information received34 and greater likelihood of survivors correctly identifying their PCP as responsible for follow-up care.23”
What the sources say
- Not checked yetcites [34] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All the significant findings suggested beneficial effects of SCPs, but, once again, the findings for any specific outcome (eg, physician implementation of survivorship care recommendations) were limited to single studies.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In one study, health care costs were reported to be lower in the SCP condition relative to the no-SCP condition.26”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“High risk of bias ratings was uncommon except for incomplete outcome data being adequately assessed.”
plainn = 13- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Consistent with this view are results described in the current article showing delivery of SCPs resulted in survivors reporting a greater amount of information received34 and greater likelihood of survivors correctly identifying their PCP as responsible for follow-up care.23”
What the sources say
- Not checked yetcites [23] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“most nonrandomized studies were rated weak for selection bias, study design, and data collection methods.”
plainn = 11- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“This strategy was used in one of the studies reviewed and resulted in greater physician implementation of SCP recommendations.33”
What the sources say
- Not checked yetcites [33] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“findings were positive in single studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among the few significant findings, results suggesting beneficial effects on depressive symptoms, health worry, outlook on life, amount of information received, and satisfaction with care were limited to single studies.”
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Similarly, results suggesting adverse effects on symptom reporting, illness concerns, and emotional impact of illness were limited to a single study.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only six studies reported results for the impact of SCPs on health care delivery and use; however, five of these studies reported significant findings.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Five studies reported findings suggesting beneficial effects of providing SCPs”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Studies examining disease end points and economic outcomes are too few to draw even tentative conclusions.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three studies were notable for a relatively high number of items rated as having a low risk of bias (ie, indicative of more rigorous methodology).27,30,31”
plaincorrelationaln = 13- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nonrandomized study findings yielded descriptive information on satisfaction with care and reactions to SCPs.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Four studies reported findings suggesting beneficial effects of providing SCPs”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“One study reported findings suggesting adverse effects of providing SCPs”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These studies generally yielded statistically nonsignificant findings.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unclear ratings due to insufficient information were common for three aspects of risk: adequate concealment of allocation, adequate prevention of knowledge of allocated intervention by outcome assessors, and adequate protection against contamination.”
plainn = 13- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Randomized study findings were generally negative for the most commonly assessed outcomes (ie, physical, functional, and psychological well-being)”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In conclusion, this systematic review found limited evidence that SCPs improve health outcomes or health care delivery.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the limited size and marked heterogeneity of the evidence base, analysis focused on qualitative synthesis rather than quantitative synthesis (ie, meta-analysis) of identified literature.”
plaindirectn = 24- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Few conclusions can be drawn about impact of SCPs from the 11 nonrandomized studies that were reviewed, because they were uncontrolled and focused mostly on issues of the feasibility and acceptability of delivering SCPs.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The general lack of convergent significant findings across studies seriously limits the extent to which definitive conclusions can be drawn about the impact of SCPs for patient-reported health status, perceptions of care, health care delivery, and health care use.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With regard to distal outcomes, results of this review suggest that delivery of SCPs alone is not likely to influence long-term health outcomes.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Existing research provides little evidence that SCPs improve health outcomes and health care delivery.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The outcomes assessed in the included studies adequately capture the benefits SCPs are intended to produce, so that null findings reflect a true absence of effect rather than unmeasured or unassessed benefits.
In the paper
“More broadly, there is a compelling need to address the identified lack of research addressing the adoption of survivorship care models within community-based primary care practices.47”
What the sources say
- Not checked yetcites [47] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Although there is a growing consensus that survivorship care should be shared between oncology specialists and PCPs for many survivors,43 evidence bearing on the optimal timing for transitioning some or all aspects of follow-up care to PCPs is lacking.”
What the sources say
- Not checked yetcites [43] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“These include characteristics of the evidence base (eg, limited number of studies and heterogeneous methodology) that precluded conducting a quantitative synthesis of existing research.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Consequently, we were limited to examining whether findings from randomized studies reached statistical significance rather than being able to calculate and aggregate effect sizes irrespective of prespecified significance levels.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Numerous survivorship care models exist44; however, there has been little research to date evaluating their relative strengths and weaknesses.42,43,45”
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“An SCP is unlikely to be effective if there are no mechanisms in place to implement the plan’s recommendations.41”
What the sources say
- Not checked yetcites [41] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 19
- Probably not a substantial claim. 13
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eleven nonrandomized and 13 randomized studies met inclusion criteria.”
- Also stated in: § RESULTS · plain
“A total of 24 articles, comprising 11 nonrandomized studies12-22 and 13 randomized studies23-35, were eligible for inclusion in the synthesis.”
plainn = 24- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found 17 studies focused on a specific cancer type”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The global rating of study quality was weak for nine studies and moderate for two studies.”
plainn = 11- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Studies in this area have tended to focus on more distal outcomes such as survivors’ reports of their health status in the months after delivery of an SCP.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Including the last two studies, SCPs were provided to PCPs in 10 studies.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“In the other study, societal costs and health care costs were higher in the SCP condition relative to the no-SCP condition; however, differences in quality-adjusted life years were negligible.25”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No statistically significant differences in either outcome was reported when specialist follow-up care was compared with transfer of follow-up care to a PCP.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Few conclusions can be drawn about impact of SCPs from the 11 nonrandomized studies that were reviewed, because they were uncontrolled and focused mostly on issues of the feasibility and acceptability of delivering SCPs.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Across studies, four aspects of risk were frequently rated low: allocation adequately concealed, baseline outcome assessments similar, baseline characteristics similar, and free of selective outcome reporting.”
plainn = 13- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Among the 13 randomized studies, the unit of randomization was the participant in 11 studies,23,25-33,35 hospital in one study,34 and oncology practice in one study.24”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sample sizes ranged from 41 to 968 (median, n = 224).”
plainn = 224- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“sample sizes ranged from 10 to 4,021 (median, n = 142).”
plainn = 142- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Five studies focused on survivors of childhood-onset cancers13,19,21,22,31 and 19 focused on survivors of adult-onset cancers.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“SCPs were likely all delivered within 1 year of treatment completion in nine studies14,18,20,24,26,30,32,34,35 and otherwise in 14 studies.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Agreement on inclusion or exclusion between the two reviewers for the 41 articles was substantial (90%; ĸ = 0.790; 95% CI, 0.594 to 0.985).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two paired reviewers independently entered this information into a spreadsheet and subsequently discussed and resolved discrepancies.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Reviewers also independently rated the quality of evidence using the Quality Assessment Tool for Quantitative Studies (QATQS)10 for nonrandomized studies and items adapted from the Cochrane Risk of Bias Tool for Randomized Controlled Trials11 for randomized studies.”
What the sources say
- Not checked yetcites [10]
- Not checked yetcites [11]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Findings are limited but more positive for proximal outcomes (eg, information received) and for care delivery, particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“It has a broader scope than previous reviews,36 encompassing several forms of cancer, and includes many more studies of the impact of SCPs on health outcomes and health care delivery than included in previous reviews.37,38”
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal outcomes.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, it is premature to conclude that SCPs are not beneficial, given weaknesses in the evidence base that include a limited number of studies, heterogeneity in the content and delivery of SCPs, and unrealistic expectations that one-time delivery of an SCP would improve patient outcomes weeks or months later.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“two paired reviewers independently screened study titles and abstracts and reviewed full-text articles as needed to determine study eligibility. Discussion of discordant eligibility ratings or involvement of a third rater was used to address disagreements.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, the review examined the impact of SCPs only on health outcomes and health care delivery, and did not examine other aspects of SCPs (eg, survivor and provider preferences for SCP content and delivery methods).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, the review was limited to published studies in English and, thus, did not include relevant unpublished studies as well as research in other languages.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
The outcomes assessed in the included studies adequately capture the benefits SCPs are intended to produce, so that null findings reflect a true absence of effect rather than unmeasured or unassessed benefits.
“Existing research provides little evidence that SCPs improve health outcomes and health care delivery.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“a previous systematic review of 24 articles comprising 11 nonrandomized and 13 randomized studies concluded that the delivery of a SCP alone is unlikely to achieve the desired benefits, and a more comprehensive approach to survivorship care delivery is needed.43,44”
From Implementing a PROACTive Care Pathway to Empower and Support Survivors of Breast Cancer (2023) · cites this paper as [44]
In the citing paper
“a previous systematic review of 24 articles comprising 11 nonrandomized and 13 randomized studies concluded that the delivery of a SCP alone is unlikely to achieve the desired benefits, and a more comprehensive approach to survivorship care delivery is needed.43,44”
From Implementing a PROACTive Care Pathway to Empower and Support Survivors of Breast Cancer (2023) · cites this paper as [44]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ RESULTS
“greater likelihood of correctly identifying their PCP as responsible for follow-up care,27”
§ DISCUSSION
“greater likelihood of survivors correctly identifying their PCP as responsible for follow-up care.23”
Citations
Cites
Curran, G. M., Bauer, M., Mittman, B., Pyne, J. M., & Stetler, C. (2012) · Medical Care · doi:10.1097/mlr.0b013e3182408812 · Cited by 4,058
An introduction to implementation science for the non-specialist
Bauer, M. S., Damschroder, L. J., Hagedorn, H., Smith, J. L., & Kilbourne, A. M. (2015) · BMC Psychology · doi:10.1186/s40359-015-0089-9 · Cited by 2,168
From Cancer Patient to Cancer Survivor - Lost in Transition
Institute of Medicine and National Research Council (2006) · National Academies Press eBooks · doi:10.17226/11613 · Cited by 747
Runowicz, C. D., Leach, C. R., Henry, N. L., Henry, K. S., Mackey, H. T., Cowens‐Alvarado, R. L., Cannady, R. S., Pratt‐Chapman, M. L., Edge, S. B., Jacobs, L. A., et al. (2016) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21319 · Cited by 728
Grunfeld, E., Levine, M. N., Julian, J. A., Coyle, D., Szechtman, B., Mirsky, D., Verma, S., Dent, S. F., Sawka, C. A., Pritchard, K. I., et al. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.03.2235 · Cited by 545
Routine follow up of breast cancer in primary care: randomised trial
Grunfeld, E., Mant, D., Yudkin, P. L., Adewuyi-Dalton, R., Cole, D., Stewart, J., Fitzpatrick, R. M., & Vessey, M. P. (1996) · BMJ · doi:10.1136/bmj.313.7058.665 · Cited by 403
Grunfeld, E., Julian, J. A., Pond, G. R., Maunsell, E., Coyle, D., Folkes, A., Joy, A. A., Provencher, L., Rayson, D., Rheaume, D., et al. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2011.36.8373 · Cited by 322
Nekhlyudov, L., O'malley, D. M., & Hudson, S. V. (2017) · The Lancet Oncology · doi:10.1016/s1470-2045(16)30570-8 · Cited by 249
Survivorship care plans in research and practice
Salz, T., Oeffinger, K. C., McCabe, M. S., Layne, T. M., & Bach, P. B. (2012) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.20142 · Cited by 241
Survivorship care plans in cancer: a systematic review of care plan outcomes
Brennan, M. E., Gormally, J. F., Butow, P., Boyle, F. M., & Spillane, A. J. (2014) · British Journal of Cancer · doi:10.1038/bjc.2014.505 · Cited by 221
Research works printed but not linked: 2
- American College of Surgeons Commision on Cancer, 2012, Cancer Program Standards 2012: Ensuring Patient-Centered Care
- Martin TA, 2013, JBI Database of Systematic Reviews and Implementation Reports, 11, 258
Cited by
Sorted by citations
Improved models of care for cancer survivors
Jefford, M., Howell, D., Li, Q., Lisy, K., Maher, J., Alfano, C. M., Rynderman, M., & Emery, J. (2022) · The Lancet · doi:10.1016/s0140-6736(22)00306-3 · Cited by 281
Adolescent and Young Adult (AYA) Cancer Survivorship Practices: An Overview
Janssen, S. H. M., van der Graaf, W. T. A., van der Meer, D. J., Manten‐Horst, E., & Husson, O. (2021) · Cancers · doi:10.3390/cancers13194847 · Cited by 216
“Despite widespread effort, the use of SCPs in practice remains suboptimal, and evidence regarding their impact on survivors’ outcomes is limited [150–153].”
Vaz-Luis, I., Masiero, M., Cavaletti, G., Cervantes, A., Chlebowski, R. T., Curigliano, G., Felip, E., Ferreira, A. R., Ganz, P. A., Hegarty, J., et al. (2022) · Annals of Oncology · doi:10.1016/j.annonc.2022.07.1941 · Cited by 208
Survivorship Care Plans in Cancer: A Meta-Analysis and Systematic Review of Care Plan Outcomes
Hill, R., Wakefield, C. E., Cohn, R. J., Fardell, J. E., Brierley, M., Kothe, E. J., Jacobsen, P. B., Hetherington, K., & Mercieca‐Bebber, R. (2019) · The Oncologist · doi:10.1634/theoncologist.2019-0184 · Cited by 186
“However, these reviews were descriptive (rather than quantitative), and it was difficult to draw conclusions because of design differences noted in included studies [14, 15].”
BackgroundResultInfluentialSelf-citationMichel, G., Mulder, R. L., van der Pal, H. J. H., Skinner, R., Bárdi, E., Brown, M. C., Vetsch, J., Frey, E., Windsor, R. E., Kremer, L. C. M., et al. (2019) · Journal of Cancer Survivorship · doi:10.1007/s11764-019-00795-5 · Cited by 117
“However, clear evidence for the effectiveness of an SCP to improve LTFU and survivor’s health in the long term is still lacking [102].”
Background
Metadata
- Authors
- Jacobsen, P. B., DeRosa, A. P., Henderson, T. O., Mayer, D. K., Moskowitz, C. S., Paskett, E. D., & Rowland, J. H.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Jacobsen, Paul B.
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2018-07-10
- Volume
- 36
- Issue
- 20
- Pages
- 2088-2100
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC6036622
- OpenAlex
- W2803946275
- Cited by
- 274
- References
- 44
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 25 · 2023: 25 · 2022: 27 · 2021: 30 · 2020: 87 · 2019: 40 · 2018: 5
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- National Cancer Institute (P30CA008748, P30CA016058)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- cancer survivorship care plans, cancer survivors, follow-up care, patient-reported outcomes, health care utilization, satisfaction with care, psychophysical well-being, functional well-being
- MeSH terms
- Cancer Survivors, Delivery of Health Care, Humans, Neoplasms, Patient Care Planning, Randomized Controlled Trials as Topic, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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