Need Help?
If you have any questions or need help with this site, please send an email to Help@ChemoOrders.com. We will reply to you shortly.
Frequently Asked Questions
Question:
Can I modify orders? The drugs, the dose, the schedule?
Answer:
This is by far the most commonly asked question and addresses the core philosophy of ChemoOrders.com. The answer is both NO and YES.
NO, because the protocols are printed out as they are reviewed online.
YES, because the printed work-products are designed to allow the user to scratch through the drug, dose, or schedule and write in the desired alternative.
We believe the only validated therapies are those that are published and subjected to peer review. When those treatments necessitate modification for co-morbid disease or toxicity, we believe the published prescribed therapy should be still be visible, though scratched through, with the modification clearly printed and a comment explaining the reason behind the modification. This way, we preserve the physicians’ integrity while minimizing the patients’ risk and the delivery team’s liability.
Question:
What I am really looking for is generic orders that I can print out and keep in the exam room and the MD's can use to order off of. Do you have that option?
Answer:
I'm sorry but the generic order option is what we're trying to discourage. We believe order entry should be real time, reflect the most up to date literature, be patient centered, accurately calculated and administered via published peer reviewed literature. As the average time to generate orders is < 3 min., it's hard to believe hand writing a generic order will be more efficient.
Question:
This program is great except, that not all facilities use aloxi. Ours in particular is Using Zofran at this point in time. Is there a way to change to anti emetic or have a choice?
Answer:
The complexity of building a dynamic database that permits dose and schedule modifications as well as drug substitutions is beyond the scope of what can be provided in a FREE web based tool. Such user ability truly requires the purchase of a proprietary EMR. The ChemoOrders advisory board struggled with the problem of loading in a specific anti-emetic but then designed the order- and flow-sheet to allow enough space to hand write in alternative rx or dosing. Thanks for using ChemoOrders.com and continue sending us your comments.
Question:
First, I really like your site and appreciate what you are trying to accomplish—validating chemotherapy orders in the community hospital setting can be challenging. In experimenting with your Calvert Carboplatin calculations, I noticed that you uniformly use actual body wt in calculating the GFR. In practice, we normally use ideal body wt or an adjusted body wt (if obese) in calculating the GFR. In the interest of not underdosing our obese patients, can you provide me with some evidence to support your calculations? We have struggled with Carboplatin dosing in obese patients for some time and would appreciate any supportive information that you can provide.
Answer:
The original Calvert formula used isotopic evaluation of creatinine clearance. Since the latter is impractical, different equations have been used to estimate creatinine clearance. GOG uses the Jeliffe formula. Most medical oncologists use the Cockroft-Gaul formula, which uses ideal body weight. However, since most physicians never bother to calculate IBW, the usual practice in the US is to use the modified Calvert formula, using actual BW. There is controversy as to whether the modified formula is accurate enough. NCCN does not specify one or the other. I enclose a reference for each point of view, the Paraplatin package insert, and an available calculator that allows use of multiple formulas and explains the differences between formulas.