The Creation Of An Algorithm To Assist Survivorship Clinics Identify The Rehabilitation Needs Of Cancer Survivors: An Administrative Case Report

Background and Purpose: Approximately 40% of cancer survivors have unmet rehabilitation needs. Cancer survivors not receiving rehabilitation care may be due to survivorship clinics struggling to identify which of their survivors are appropriate for rehabilitation. The purpose of this case report was to review the literature and create an algorithm that could assist survivorship clinics with rehabilitation referrals. Case Description: A survivorship clinic in Maine was attempting to address the lack of a rehabilitation screening process. A survey done by the clinic showed that approximately 40% of their survivors used rehabilitation services. To address this lack of a screening process, a literature review was conducted in the summer of 2020 to identify common cancer impairments that may necessitate rehabilitation services. From there, an algorithm would be created that contained screening measures to identify those impairments. The initial algorithm consisted of the Pain Visual Analogue Scale, Fatigue Numerical Scale, and Short-Form 36 health questionnaire. Outcomes: The final algorithm consisted of two parts. First the oncologic clinician asks themselves whether the survivor can exercise without medical supervision. The second is based off the grading of the Short-Form 36. The answers to these two parts determine eligibility for referral to rehabilitation services. An expert in oncology rehabilitation vetted the algorithm in the fall of 2020. Expert feedback resulted in the final algorithm creation. Discussion: The stakeholders were unavailable to discuss an evaluation of the proposed algorithm or implementation into the survivorship clinic due to the 2020 pandemic. With the help of expert feedback, the final algorithm contributes to the growing body of literature regarding screening for oncology rehabilitation. Future research should be aimed at the implementation of existing algorithms into clinics