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256 Triage decision tools for cancer related symptoms
  1. Dawn Stacey1,2,
  2. C Laire Ludwig3,
  3. Gail Macartney4,
  4. Joy Tarasuk5,
  5. Craig Kuziemsky6,
  6. Meg Carley2,
  7. or the COSTaRS Research Groupf
  1. 1School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
  2. 2Ottawa Hospital Research Institute, Ottawa, Canada
  3. 3The Ottawa Hospital, Ottawa, Canada
  4. 4Faculty of Nursing, University of Prince Edward Island, Charlottestown, Canada
  5. 5Nova Scotia Health Cancer Care Program, Halifax, Canada
  6. 6MacEwen University, Edmonton, Canada


Introduction Symptoms can quickly become life-threatening for people receiving cancer treatments; thus, high quality symptom assessment and decision triage tools are critical for keeping patients safe. We co- produced the pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) practice guides, a set of evidence-informed symptom triage decision tools used in outpatient cancer programs across Canada. Our current research aimed to: a) update the evidence in 17 COSTaRS practice guides; and b) evaluate the model of co-production.

Methods We are co-producing a 2-year study with an expanded team of researchers, patient, caregiver, nurses, managers, policy makers and collaborators (e.g., CANO/ACIO, Cancer Care Ontario, de Souza Institute) who interact with and influence all levels of the Canadian healthcare system. We co- conducted 17 systematic reviews guided by Cochrane methods and reported using PRISMA. Eligible citations were clinical practice guidelines and systematic reviews with meta-analysis. We evaluated our co-production approach using the Patient Engagement in Research (PEIRS-22) instrument.

Results We identified 124 guidelines and 65 systematic reviews. Preliminary findings showed that each of the 17 symptom guides had a mean of 19 new citations to be included (range 9 to 38). The 17 symptom guides were updated. There were few changes based on new evidence. Drafts of the 17 updated symptom guides will be validated by oncology nurses from across Canada. To facilitate co-production, monthly updates were sent to the team with invitations to participate on research activities in process.

Discussion Although synthesized evidence on symptom management is continuing to emerge, decision triage tools required few changes. Co-production of decision triage tools is possible.

Conclusion(s) Nurses and other clinicians can use these updated triage decision tools for supporting patients reporting cancer symptoms. They are publicly available (English, French) free of charge at T elephone Guidelines CANO/ACIO ( and

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