Protocol for a scoping review for risk prediction models for identifying late-onset cardiotoxic effects in cancer survivors for use in a primary care setting

Rationale After completing treatment for cancer, survivors may experience late cardiotoxic effects: consequences of treatment that persist or arise after a latent period. Primary care providers are well situated to manage these effects. Risk prediction models may assist with this. Purpose To identify and describe all models that predict the risk of late effects and could be used in an ambulatory care setting. Data sources Searches will be conducted across MEDLINE and EMBASE supplemented by manual reference list reviews and targeted grey literature searches using Google. Study Selection Studies to be included are those describing models that 1) predicted the absolute risk of a late cardiotoxic effect present at least one year post-treatment, across all cancer treatment modalities, and 2) could be used in an ambulatory care clinical setting, Data Extraction & Synthesis Data will be extracted as per the CHARMS checklist, an assessment of bias will be conducted as per the McGinn Checklist. Discussion This scoping review will comprehensively map existing tools for risk prediction of the late cardiotoxic effects of cancer therapy in cancer survivors, applicable to an ambulatory care setting. Registration This protocol was registered on 21.6.25 to Zenodo : 10.5281/zenodo.15708760 Key Messages Cancer survivors face a significant long-term risk of late-onset cardiotoxicity, often undetected until advanced stages. This review will identify and map validated multivariable risk prediction models that could support the early identification of cardiotoxicity in ambulatory and primary care settings. Integrating prediction tools into primary care may help address growing oncology workforce gaps while enabling timely, risk-adapted cardiovascular follow-up.