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Executive Summary

A leadership view of where systemic mastocytosis care gaps occur, why they happen, and which tab to open to act on each finding.

Patients impacted
1,981
2,000 in current cohort
Active gap rules
22
Critical findings
6
Estimated patients freed
1,863
Sum of top 5 recommended actions

Top care gaps

Ranked by patient impact (volume × severity). Each row links to the tab where you can act.

  • No KIT D816V test on record
    Critical
    1,056 pts · 52.8% of cohort · stage: Diagnosis · PCP
    Why this happens
    • Repeat ED visits without outpatient handoff652
    • Biomarker testing never ordered575
    • Tolerability or access barrier on therapy451
  • Multiple ED visits before SM diagnosis
    High
    1,239 pts · 62% of cohort · stage: Diagnosis · PCP
    Why this happens
    • Repeat ED visits without outpatient handoff1239
    • Tolerability or access barrier on therapy582
    • Biomarker testing never ordered350
  • Recurrent anaphylaxis without epinephrine prescription
    Critical
    755 pts · 37.8% of cohort · stage: Treatment · PCP
    Why this happens
    • Tolerability or access barrier on therapy505
    • Repeat ED visits without outpatient handoff476
    • Biomarker testing never ordered184
  • Therapy discontinuation without replacement
    High
    942 pts · 47.1% of cohort · stage: Treatment · PCP
    Why this happens
    • Tolerability or access barrier on therapy942
    • Repeat ED visits without outpatient handoff582
    • Biomarker testing never ordered264
  • Elevated tryptase without hematology referral
    Critical
    666 pts · 33.3% of cohort · stage: Diagnosis · PCP
    Why this happens
    • Repeat ED visits without outpatient handoff410
    • Tolerability or access barrier on therapy357
    • Pathway delay, no single dominant cause81
  • No serum tryptase test on record
    Critical
    575 pts · 28.8% of cohort · stage: Diagnosis · PCP
    Why this happens
    • Biomarker testing never ordered575
    • Repeat ED visits without outpatient handoff350
    • Tolerability or access barrier on therapy264

Pathway stage load

RAG by % of cohort with at least one gap at each stage.

  • Pre-diagnosis207 · 10%
  • Diagnosis1,939 · 97%
  • Treatment1,333 · 67%
  • Outcome0 · 0%

By gap category

  • Testing gap1,551 pts · 5 rules
  • Diagnostic miss1,729 pts · 7 rules
  • Treatment gap1,333 pts · 5 rules
  • Referral leakage207 pts · 5 rules

What should we do next?

Auto-generated from the highest-impact gaps. Click through to the tab that owns the action.

  1. 1
    Close testing gap: No KIT D816V test on record
    Why: Repeat ED visits without outpatient handoff
    Pts freed
    422
  2. 2
    Trigger biomarker workup for "Multiple ED visits before SM diagnosis"
    Why: Repeat ED visits without outpatient handoff
    Pts freed
    496
  3. 3
    Initiate or restore therapy: Recurrent anaphylaxis without epinephrine prescription
    Why: Tolerability or access barrier on therapy
    Pts freed
    302
  4. 4
    Initiate or restore therapy: Therapy discontinuation without replacement
    Why: Tolerability or access barrier on therapy
    Pts freed
    377
  5. 5
    Trigger biomarker workup for "Elevated tryptase without hematology referral"
    Why: Repeat ED visits without outpatient handoff
    Pts freed
    266

Off-label opportunity

Where labelled therapy may not fit and an alternative could be considered.

See the Off-Label Lens for ISM-high symptom burden, smouldering patients with rising signals, and AdvSM patients not on a TKI.

Open Off-Label Lens