development is that it is very important to establish what will be done with the summary information. The pediatric oncology community has honed the summary down to key elements that are needed to generate patient-specific guidelines. It is through the COG guidelines and not through the treatment summary that psychosocial issues are addressed. Appropriate guidelines are generated on the basis of the treatment summary that documents the patient’s treatment-related risk factors.

Dr. Loria Pollack of the Centers for Disease Control and Prevention concluded the discussion by pointing out that one of the potential uses of a treatment plan is to assist patients in treatment following a disaster. She described how there were an estimated 24,000 people diagnosed with cancer in the past year in the areas affected by Hurricane Katrina. Many of these individuals were displaced during their treatment, and when they sought care in another setting, some could not tell the oncology providers what type of cancer they had. In discussions of whether to start with plans or summaries, it would be helpful to keep these experiences in mind.

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