Real-world data that reflects how oncology patients experience toxicity, complications, and follow-up is essential to sustaining safety, adherence, and market confidence.
Real-world data helps close the gap between treatment and care for post-market success.
Cancer care has advanced rapidly in recent years, from broad cytotoxic chemotherapy to targeted and immune-based therapies that promise durable responses and, in some cases, cures. Yet, these new mechanisms of action may bring new patterns of toxicity, many of which surface first in the emergency department (ED).
Despite being one of the most frequent points of contact for cancer patients, the ED remains largely invisible to traditional post-market datasets. Adverse event reporting systems like the Food and Drug Administration’s FAERS help, but are known to underreport incidents, with some studies estimating that fewer than one in 10 events are captured. When you consider that cancer patients have a higher rate of emergency care use than individuals without cancer, it’s clear that countless real-world safety signals are never seen.
As large pharma companies shift resources from R&D to ensuring post-approval success, this missing view into acute care represents both a blind spot and an opportunity. Real-world data that accurately reflects how patients experience toxicity, complications, and follow-up is essential to sustaining safety, adherence, and market confidence. In fact, a recent Northwestern University study found that moderate side effects increased the likelihood of a patient discontinuing treatment by 59%, underscoring how even manageable toxicities can have major real-world consequences when they’re not identified and addressed early.
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Where Traditional Data Falls Short
Claims data may show that an ED visit happened, but not why. It flags the “where and when,” without the clinical “why.” Electronic health records (EHRs) contain those details but may be delayed, inconsistent, and fragmented across institutions.
The result is decontextualized information that makes it difficult to distinguish toxicities from preventable complications. When an ED visit occurs outside a cancer center’s network, the event can vanish from the record entirely, creating a gap in the record of how a drug performs in trials and how it performs in the real world.
This is why observational, clinical-grade data from emergency settings is so valuable. It doesn’t replace other sources, but rather it completes them.
What ED Data Reveals
A national study of more than 35 million cancer-related ED visits found that more than half (51.6%) were potentially preventable. Each encounter offers insight into opportunities to refine treatment pathways, improve supportive care, and reduce unnecessary admissions.
d2i’s curated emergency dataset captures the full clinical picture: triage level, vital signs, orders, medications, and outcomes that are standardized and research-ready. With that foundation, life sciences and health system teams can:
- Identify and quantify acute adverse events as they occur
- See patterns of preventable ED utilization
- Expose gaps in coordination between oncology clinics and acute care
The value isn’t abstract. These insights flow directly into stronger patient-support programs, tighter risk-management plans, and more persuasive HEOR evidence.
Turning Insight Into Post-Market Advantage
Rare but serious events often show up in emergency settings before they show up anywhere else. Structured, continuously refreshed ED data allows teams to see clusters early and intervene quickly.
That visibility supports the kind of field education and label refinement that prevents issues from escalating. It also strengthens adherence programs. In oncology, time to treatment failure (TTF) is frequently a tolerability problem, not an efficacy problem. If the ED shows a recurrent pattern — say, dehydration three to five days post-infusion — teams can preempt with hydration protocols, antiemetics, or dose adjustments during the risk window. That is the kind of practical, precision‑timed support that keeps patients on therapy and preserves the value of a brand. As such, the ED is where the reality of side‑effect management is seen, and that reality is inseparable from therapy persistence.
Utilization is the language of value. When supportive-care and education programs reduce potentially preventable ED visits by a measurable margin in defined subpopulations, that’s a concrete, utilization-based outcome that can be taken into discussions of coverage and contracting.
Finally, ED data helps refine care models. When you can trace how often specific ED presentations lead to admission, ICU transfer, or safe discharge, the clinic–ED handoff can be optimized. That may mean setting up rapid oncology follow-ups for high-risk discharges, embedding palliative expertise earlier for appropriate patients, or clarifying return-to-ED thresholds in discharge instructions.
Closing the Gap Between Research and Care
Roughly 20% of cancer patients receive their initial diagnosis in the emergency department. For this group, the ED is where the real-world effects of modern oncology therapies first become visible.
d2i’s approach is to curate and harmonize encounter-level ED data and align those encounters to oncology-relevant contexts, including regimen and line of therapy, cycle timing, comorbidity burden, and downstream inpatient outcomes. That alignment is what converts a late-night visit for fever into a decision-grade signal about febrile neutropenia risk on a particular regimen, in a particular window, for specific patients.
Because d2i’s dataset is updated continuously, the signal is early enough to matter. The data informs safety monitoring, adherence programs, and payer negotiations while helping life-sciences teams connect what happens at 2 a.m. in the ED to what happens next in the clinic. Book a meeting to explore how d2i’s emergency and inpatient data can accelerate oncology insights and strengthen post-market evidence.