Table 2.

Operationalization of IOM framework for survivorship care plans

IOM framework	Components of the framework and criteria for the evaluation of breast and colorectal survivorship care plans: when component was scored as present
Treatment summary
1. Diagnostic tests performed and results.	1. Not included in review because all diagnostic tests for breast and colorectal cancer are biopsies, and results of biopsies will fall under Tumor characteristics (below)
2. Tumor characteristics (e.g., site(s), stage and grade, hormone receptor status, marker information).	2. Any of the following: site, stage, and grade for breast and colorectal cancers; hormone receptor status only for breast cancer
3. Dates of treatment initiation and completion.	3. Assessed individually for each treatment type, as described in #4 below
4. Surgery, chemotherapy, radiotherapy, transplant, hormonal therapy, or gene or other therapies provided, including agents used, treatment regimen, total dosage, identifying number and title of clinical trials (if any), indicators of treatment response, and toxicities experienced during treatment.	4. Assessed individually for surgery: type, dates, and complications
	5. Assessed individually for chemotherapy: whether used, name of drug, dosage, dates, presence of toxicities, and indicators of response
	6. Assessed individually for radiotherapy: whether used, dosage, dates, location/field, presence of toxicities, and indicators of response
	7. Assessed individually for hormone therapy (breast cancer only): whether used, dates, presence of toxicities, and indicators of response
5. Psychosocial, nutritional, and other supportive services provided.	8. Whether psychosocial services were provided during treatment
	9. Whether nutritional services were provided during treatment
	10. Whether any other supportive services were provided during treatment
6. Full contact information on treating institutions and key individual providers.	11. Name of at least one cancer care provider at treating institution
i	12. Contact information for at least one cancer care provider at treating institution
7. Identification of a key point of contact and coordinator of continuing care.	13. Explicit mention of a person (and contact details) for cancer-related follow-up care
Follow-up care plan
1. The likely course of recovery from treatment toxicities, as well as the need for ongoing health maintenance/adjuvant therapy.	14. Description of recovery from treatment toxicities that includes any reference to the expected timing of recovery
	15. Need for ongoing health maintenance/adjuvant therapy not coded, because interpretation was too broad and appeared to overlap with another category
2. A description of recommended cancer screening and other periodic testing and examinations, and the schedule on which they should be performed (and who should provide them).	16. Statement of the need for surveillance for recurrence and second primary cancers
	17. Name or specialty of provider who provides surveillance above
	18. Timing of any surveillance tests
	19. Statement of the need for any testing for other conditions for which survivors are potentially at high risk (e.g., cholesterol, DXA, pelvic exams, cardiac monitoring for breast cancer survivors)
	20. Who provides testing for other conditions
	21. Timing of any testing for other cancers
	22. Statement of the need for screening for new cancers (colorectal or cervical cancer screening for age- and sex-appropriate breast cancer survivors; breast cancer or cervical cancer screening for age- and sex-appropriate colorectal cancer survivors)
	23. Who provides screening
	24. Timing of any screening
3. Information on possible late and long-term effects of treatment and symptoms of such effects.	25. Description of possible late and long-term effects of treatment, including symptoms of such effects.
4. Information on possible signs of recurrence and second tumors.	26. Information on possible signs of recurrence and second tumors.
5. Information on the possible effects of cancer on marital/partner relationship, sexual functioning, work, and parenting, and the potential future need for psychosocial support.	27. Information on any of the following: the possible effects of cancer on marital/partner relationship, sexual functioning, work, or parenting
	28.Information on the potential future need for psychosocial support
6. Information on the potential insurance, employment, and financial consequences of cancer and, as necessary, referral to counseling, legal aid, and financial assistance.	29. Information on any of the following: the potential insurance, employment, or financial consequences of cancer; or indication of a referral to counseling, legal aid, or financial assistance.
7. Specific recommendations for healthy behaviors (e.g., diet, exercise, healthy weight, sunscreen use, immunizations, smoking cessation, osteoporosis prevention). When appropriate, recommendations that first-degree relatives be informed about their increased risk and the need for cancer screening (e.g., breast cancer, colorectal cancer, prostate cancer).	30. Specific recommendations for any healthy behaviors and practices, such as: diet, exercise, healthy weight, smoking cessation, sunscreen use, dental exams, breast self exams, cholesterol screening (for colorectal cancer survivors), and immunizations
	31. Potential place for recommendations that first-degree relatives be informed about their increased risk and the need for cancer screening (e.g., breast cancer, colorectal cancer, prostate cancer)
8. As appropriate, information on genetic counseling and testing to identify high-risk individuals who could benefit from more comprehensive cancer surveillance, chemoprevention, or risk-reducing surgery.	32. Potential place for information on genetic counseling and testing to identify high-risk individuals who could benefit from more comprehensive cancer surveillance, chemoprevention, or risk-reducing surgery.
9. As appropriate, information on known effective chemoprevention strategies for secondary prevention (e.g., tamoxifen in women at high risk for breast cancer; aspirin for colorectal cancer prevention).	33. Potential place for information on known effective chemoprevention strategies for prevention of other cancers (e.g., tamoxifen in women at high risk for breast cancer; aspirin for colorectal cancer prevention)
10. Referrals to specific follow-up care providers (e.g., rehabilitation, fertility, psychology), support groups, and/or the patient's primary care provider.	34. Mention of referrals to any of the following: specific follow-up care providers (e.g., rehabilitation, fertility, psychology), support groups, or the patient's primary care provider
11. A listing of cancer-related resources and information (e.g., Internet-based sources and telephone listings for major cancer support organizations).	35. Mention of any of the following cancer-related resources: names of organizations, internet-based sources, and telephone listings for any cancer support organizations
Summary measures
Treatment history	1. Inclusion of tumor characteristics and whether survivor received any treatment from the following list: surgery, chemotherapy, radiation, or hormone therapy (breast cancer only)
Expectations for survivorship	2. Description of: late and long-term effects, signs of recurrence, and potential need for psychosocial support
Recommendations for ongoing care	3. Recommendations for cancer screening, cancer surveillance, and healthy behaviors
Information about who is responsible for ongoing tests	4. Explicit mention of who provides the recommended screening tests, surveillance tests, and other tests for conditions for which cancer survivors are at high risk.