Karen B. Lewing, MD
Program Director, Pediatric Hematology/Oncology Fellowship; Associate Professor of Pediatrics, University of Missouri-Kansas City School of Medicine
Full BiographyKaren Lewing, MD, Hematology/Oncology/BMT, was awarded a 1-year, $35,000 KU Cancer Center Community Outreach and Engagement program pilot award from The University of Kansas Cancer Center.
Dr. Lewing’s project, “KUCC COE Spring 2022 Pilot: Predictive Analytics for Fever in the Setting of Neutropenia in Pediatric Leukemia” will use Cerner Health Facts data to predict pediatric leukemia patients with febrile neutropenia (FN) that are low risk. The information will be used to develop a single low-risk febrile neutropenia (LRFN) predictive model.
As Dr. Lewing explains fever in the setting of neutropenia is the most common complication in pediatric oncology. It is an oncologic emergency and requires prompt evaluation and treatment. LRFN admissions are financially and emotionally burdensome on families and they put the patients at risk for antimicrobial resistance, catheter dysfunction, and nosocomial infection.
Many academic institutions have implemented practice guidelines for identification of patients with LRFN that may safely be treated as an outpatient and/or with oral antibiotic therapy. At Children’s Mercy Kansas City, we have recently implemented a LRFN guideline in a strict cohort of patients, but there is currently no nationally accepted and externally validated single prediction model for pediatric cancer patients with FN.
Dr. Lewing and her team of data science experts, statisticians, and oncology physicians have developed the initial methods for isolating a robust, diverse cohort from electronic health record data to be used in the development and validation of a risk-prediction model for FN in pediatric leukemia. The model will be used to predict pediatric leukemia patients with FN that are low risk, where early discharge or outpatient management is acceptable.
“This innovative strategy will serve as a precursor for future development of a clinical decision support system (CDSS) that can be incorporated into the EHR and added to the CM PedsGuide mobile application for use by community providers,” Dr. Lewing said. “The development of these data resources and methods will significantly advance cancer research and patient care.”
Team members include Nikki Wood, DO, co-investigator and Mark Hoffman, PhD, co-investigator, Janelle Noel-MacDonnell, PhD, Statistician, and Natalie Kane, PhD, Data Scientist.