Why the study?
Survivors of adolescent and young adult cancer face increased cardiovascular disease risk, but it remains unclear whether cardiovascular risk prediction models developed for pediatric or older adult cancer populations apply to them.
This protocol outlines a systematic review to identify and evaluate cardiovascular risk prediction models applicable to adolescent and young adult cancer survivors.
Protocol for systematic review of CV risk models in AYA cancer survivors; will inform clinical application and highlight research needs.
<ns3:p>Background Survivors of adolescent and young adult (AYA) cancer are at increased risk of cardiovascular disease (CVD) including ischemic heart disease, stroke, and heart failure. While numerous risk prediction models (RPM) have been developed or validated for CVD in pediatric or older adult cancer populations, it is unclear whether they can be applied to survivors of AYA cancer. Methods We plan to undertake a systematic review of cardiovascular RPM development/ validation studies in survivors of cancer diagnosed at any age. We will search MEDLINE, EMBASE, and Web of Science with additional hand searching. Two reviewers will screen abstracts and full texts; we will include full-text English studies that used real-life patient data to predict outcomes ≥1 year from diagnosis and after completing therapy. We will use the CHARMS checklist to guide data extraction and further extract data on participant demographics, outcomes, and predictors used in the models grouped by cardiovascular outcome; these data will be described with frequencies, means/medians, and other relevant descriptive statistics dictated by the data. We will apply the PROBAST tool to assess risk of bias (RoB) and applicability to AYA cancer survivors. Results and Use We will report all steps of the screening process, and identify number of models developed or validated for each of the following outcomes: heart failure, ischemic heart disease, stroke, death, arrhythmia, or composite CVD outcome. We will report RoB and applicability to AYA cancer survivors. With our results, we will identify those models most clinically applicable to AYA cancer survivors which will help guide whether additional models need to be developed or validated in this population. Results will be disseminated in conference presentations, manuscript form, and PhD dissertation (L.Guolla); ethical approval is not required given public availability of data. Registration PROSPERO - CRD42023458516 (Updated August, 2025)</ns3:p>
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Guolla et al. (2025) studied this question.
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