bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community oncology treatment patterns and clinical effectiveness in metastatic castration-resistant prostate cancer (mCRPC) patients who progressed after docetaxel.
Authors: Houts Arthur C. , Hennessy Daniel , Walker Mark S. , Nicacio Leonardo , Thompson Stephen F. , Miller Paul J. E. , Somer Bradley G. 
Published: February 2017

118 Background: Cabazitaxel (C) and abiraterone (A) improve survival in mCRPC after progression on docetaxel (D). We examined whether mCRPC patients progressing on D received C and/or A, in which sequence, and how they compared with patients not receiving C or A. Methods: This retrospective study used medical records from the ACORN Data Warehouse. Eligible patients were: diagnosed with mCRPC, progressed after 1st-line D, treated 2nd-line with C (DC) or A (DA). Some went to 3rd-line C or A (DCA, DAC). A random sample of comparable patients without A or C (DO) was included. Demographic and clinical characteristics were extracted. Cox regression analyses assessed PFS and OS by 2nd-line group after D. Results: Screened out patients were: 60 with no progression on D; 41 absent records; 18 with another cancer. Table below shows patients by treatment sequence group. Age, PS, and PSA did not differ significantly. More patients appear to have received A after C (56.7%) than C after A (25.7%). In the 3-drug sequence groups, more patients received DCA in the 6-month period from April-October 2011 (n = 17/19) than in the 6-month period from June-December 2012 (n = 2/10), suggesting a drop-off in use of C immediately after D. Cox PFS treatment effect was not significant. Cox OS treatment effect was significant (DA vs DC, HR = 1.693 [95% CI: 1.066, 2.691], p = 0.0258). Conclusions: Patterns suggest comparable outcomes in PFS. Controlling for patient characteristics, OS may be longer in DC vs DA. Patients appear undertreated in third line with fewer receiving C after A than the opposite sequence. We hypothesize that DAC may not be as feasible as DCA. Reasons for underutilization of C are being examined. [Table: see text]
Use of clinical care registries to facilitate research study recruitment.
Authors: Messer Karen , Layton Tracy M. , Chen Tony , Nandigam Viswanath , Abihider Katherine , Chase Peter W. , Pierce John P. , Madlensky Lisa , Cadmus Lisa , Patterson Ruth E. , Faerber Susan , Schwab Richard B. , Blair Sarah , Wallace Anne M. , Ojeda-Fournier Haydee , Parker Barbara A. 
Published: February 2017

129 Background: We developed IRB-approved secure research registries for our Breast Imaging and Breast Care Clinics at Moores UC San Diego Cancer Center, as part of the UC statewide Athena Breast Health Network. Our clinical care registries securely store patient-reported intake data, which are summarized and uploaded into the medical record for patient care. Following consent, data are securely maintained in a separate research registry. In addition to facilitating quality assurance data collection, these registries aim to 1) maintain a data-rich research registry, 2) offer patients research opportunities, and 3) facilitate participant screening and recruitment into research studies. Methods: Breast Imaging or Breast Care clinic patients complete an online clinical intake form prior to their appointment, either at home or using an iPad in clinic, and are given the opportunity to be involved in research. Patients are asked for site-specific consent to keep personally identifiable intake data in a research registry, for consent to be approached about providing a biospecimen sample, and for consent to be contacted for future research opportunities. Data from consented participants are pulled into secure databases available to study personnel. Results: Participants to date include 4,480 patients, of whom 3,246 consented to use of data for research (72%), and 2,627 have agreed to be contacted for future research opportunities (59%). In a pilot biospecimen collection protocol, 46% of patients agreed to be approached and we have collected over 360 blood or saliva and 51 tissue samples. Additionally, with the use of future contact consent, we have facilitated recruitment of more than 370 participants to multiple lifestyle and survey-based clinical studies. Conclusions: Patients are willing to participate in research, especially in a research registry that requires little additional time on their part. The use of research registries allows collection of a variety of data elements useful for prescreening participants for research studies, including body mass index, age, menopausal status and breast cancer diagnosis. Data- and participant-rich research registries facilitate efficient screening and recruitment for other research studies.
Impact of a clinical care online intake form in a breast care clinic.
Authors: Layton Tracy M. , Messer Karen , Pierce John P. , Madlensky Lisa , Cadmus Lisa , Patterson Ruth E. , Chase Peter W. , Faerber Susan , Schwab Richard B. , Blair Sarah , Wallace Anne M. , Parker Barbara A. 
Published: February 2017

137 Background: An online self-reported clinical care intake form was provided to new surgery patients of the Moores UCSD Breast Care Clinic, as part of a pilot project in collaboration with the University of California Athena Breast Health Network. Clinical care goals were 1) to reduce clinic time by pre-visit collection of patient histories, co-morbidities, and medications and 2) provide patient reported data to clinicians and the electronic medical record (EMR). Clinical research goals were to 1) identify individuals diagnosed with breast cancer, 2) collect baseline measures related to co-morbidities, psychosocial parameters, and lifestyle factors and 3) increase research opportunities and enrollment. Methods: We developed an online intake form for patients to complete at home prior to their appointment. Patients were informed to complete the intake form before their appointment and were sent instructions via email. Patients without an email address had the opportunity to complete their intake form on an iPad in clinic. A summary of intake form answers was uploaded into the EMR for all patients. Patients could consent to future contact, to have their intake data kept in a research registry and/or to provide a blood or tissue sample. Results: From March 2010 to May 2013, 1,224 sequential new breast surgery clinic patients were contacted to complete the online intake form as part of their clinical care. 890 patients completed the intake form prior to their visit (73%). 802 of the 890 patients consented to contact for future research opportunities (90%) and 624 of the 802 consented to share data and EMR access for research (78%). We have coordinated enrollment with our ongoing UCSD biorepository study and have collected 210 blood and 51 tissue samples. Additionally, using future contact consent, we recruited more than 100 participants to multiple lifestyle and survey-based clinical studies. Conclusions: The use of an online intake form is well accepted by patients and provides patient reported data to all clinicians involved in patient care. In conjunction with consented EMR access, these data can be evaluated routinely for quality and efficiency purposes. Initial consent for future contact greatly facilitates participant recruitment to research studies.
Patients’ perceptions of early palliative oncology care: A qualitative analysis.
Authors: Hannon Breffni , Swami Nadia , Krzyzanowska Monika K. , Leighl Natasha B. , Oza Amit M. , Moore Malcolm J. , Rodin Gary , Tannock Ian , Zimmermann Camilla 
Published: February 2017

138 Background: Early palliative care referral is encouraged for patients with advanced cancer. However, little is known about patients’ perceptions of the impact and relevance of early referral. We conducted a qualitative study in which patients with advanced cancer were interviewed following completion of a randomized controlled trial comparing early palliative care with standard oncology care. Our aim was to delineate what, in the opinion of patients, were the respective roles of the oncology and palliative care teams in an outpatient setting. Methods: We conducted qualitative interviews with patients following completion of a cluster randomised controlled trial of early versus routine palliative care referral. Participants were recruited from 24 medical oncology clinics at a comprehensive cancer center. Selective sampling was employed to ensure equivalent numbers of participants from intervention vs. control arms, male vs. female, age ≥60 vs. <60 years, with high vs. low self-reported quality of life, and with high vs. low satisfaction with care. Forty-eight patients (26 intervention and 22 control) with advanced lung, breast, gynecological, gastrointestinal and genitourinary cancers completed interviews lasting 25 to 90 minutes. Control patients were asked about the role of oncology; intervention patients were asked about both teams. Interviews were recorded, transcribed and analysed using NVivo. A grounded theory approach was used to explore emerging themes. Results: Several themes emerged in relation to the contrast between oncology (OC) and palliative care (PC) including (1) the focus of the consultation, with OC tending to focus on cancer or treatment options while PC was regarded as being more holistic, including physical, psychological and family domains; (2) the model of care delivery, with OC described as being clinician-led and time-limited, in contrast with PC where time was more flexible and the patient set the agenda; and (3) the complementary nature of early palliative care alongside standard oncology care in terms of overall well-being. Conclusions: From a patient perspective, palliative care and medical oncology have distinct and complementary roles, supporting the relevance of early referral.
Influenza vaccine immunization in a pediatric oncology ambulatory practice.
Authors: Tishler David , Escobedo Erika , Alhushki Waseem , Margol Ashley S. , Mehta Bhakti , Rushing Teresa 
Published: February 2017

139 Backround: Complications from Influenza infection remain an important cause of morbidity and mortality among immunosuppressed children and adolescents. Seasonal Influenza vaccine has been shown to be both safe and effective in pediatric and adolescent patients on chemotherapy treatment although at the Childrens Center for Cancer and Blood Diseases (CCCBD), immunization rates remain suboptimal. We initiated a comprehensive campaign for the 2012-13 flu season with these objectives: 1) evaluate provider attitudes regarding Influenza vaccine, 2) provide a data capture form in the patient medical record to improve vaccine compliance and 3) retrieve electronic medical record (EMR) data on immunization incidence. Methods: The study period was October 1, 2012 through January 31, 2013; a hybrid hard copy/EMR was in use. A Survey Monkey questionnaire was given to CCCBD oncology providers to assess individual influenza vaccine practices. Information was provided how to document vaccination in the EMR. A reminder/data capture form was attached to the hard copy medical record and collected following each patient visit. Forms were tracked to ensure completion for each active oncology patient seen during the campaign period. Patient medical record numbers were cross-referenced with EMR data to determine immunization incidence and the success of the campaign. Results: 100% of providers (46/46) responded to the survey. All respondents believed that the flu vaccine was both safe and efficacious; many reported that the priority of oncology care pre-empted ordering vaccine (27%). Total vaccine doses dispensed increased by 28 % over the previous season (502 doses in 2012-13 vs. 361 doses in 2011-12). 61% of eligible patients with Acute Lymphoblastic Leukemia (ALL) were immunized in 2012-13 compared to 40% of ALL patients in 2011-12. EMR documentation of vaccination also improved during the campaign. Conclusions: A comprehensive campaign to promote Influenza immunization during the most recent flu season was overwhelmingly successful. In-progress improvement in the institutional EMR will further advance our ability to document and retrieve influenza vaccine data for this at-risk population of children and adolescents.
Community-based dental evaluation program for hematopoietic cell transplantation.
Authors: Frustino Jennifer L. , Treister Nathaniel S. , Sonis Stephen T. , Woo Sook-Bin 
Published: February 2017

143 Background: Conditioning regimens for hematopoietic cell transplantation (HCT) may result in profound neutropenia placing patients at risk for infection. Since the mouth is a common site of origin for infection and bacteremia, elimination of pre-existing oral and dental disease prior to HCT favorably impacts infection risk and attendant morbidities. While pre-HCT dental screening is highly desirable, the logistics of assuring that all HCT patients are comprehensively evaluated and appropriately managed is challenging. Dana-Farber/Brigham and Women’s Cancer Center (DFBWCC) implemented a community-based dental evaluation program (CBDEP) for all patients scheduled to undergo HCT which has proved to be effective, cost-efficient and patient-friendly. The objective of this presentation is to describe that program. Methods: We describe the CBDEP and evaluate volume trends and clinical and cost outcomes. As part of the HCT work-up, the patient is provided with education materials, evaluation guidelines and forms to be completed by the community dentist (CD). The patient is responsible for making a timely appointment with the CD who obtains a full series of radiographs and completes a comprehensive examination and treatment plan. The completed documents and radiographs are returned to DFBWCC and reviewed by the oral medicine specialist. The CD is contacted immediately with any discordance in the plan. A letter confirming the final treatment plan is sent to the CD and entered into the electronic medical record. Upon admission for HCT, the patient is evaluated bedside to ensure all work is completed and there are no new symptoms. Results: From 2009-2012 an average of 523 patients per year participated in the CBDEP, with an increasing trend due to growing HCT volume with 440 patients evaluated in 2009 and 563 in 2012. Once returned, evaluations were reviewed within 1-10 days. The average cost for examination, radiographs, scaling and prophylaxis was $255. The average cost rose to $453 if additional treatment was required. Conclusions: The CBDEP provides an efficient and effective model for clearance prior to HCT. This directly involves the patient and the CD, is inexpensive and easy to implement, and may reduce complications during HCT.
Developing a culturally and linguistically responsive survivorship care plan for breast cancer.
Authors: Ashing Kimlin Tan , Rosales Monica , Fulcher Gingi , Serrano Mayra , Weitzel Jeffrey N. , Paz Isaac Benjamin , Lai Lily L. 
Published: February 2017

146 Background: African and Latina-American breast cancers patients (BCA) experience the greatest morbidity and mortality, suggesting a critical need for improved surveillance and quality care. The Institute of Medicine (IOM) and the Commission on Cancer (CoC) recommend that survivors receive personalized Treatment Summaries and Survivorship Care Plans (TSSCP) in order to facilitate best practice in clinical surveillance and follow-up care. This TSSCP template development study joined advocacy, scientific and medical communities to comprise a diverse advisory council (AC, N=38) to inform the development of the TSSCP-AA (African American) and TSSCP-S (Latino) templates targeting BCA. This abstract reports on the development, and presents the TSSCP-AA and TSSCP-S. Methods: The overall study was guided by the Shared Care and Psychooncology Models, and Contextual Model of Health Related Quality of Life. The AC provided input into the culturally relevant modifications of the American Society of Clinical Oncology (ASCO) TSSCP template to create the TSSCP-AA and TSSCP-S. Health care professionals enlisted from cancer centers and community hospitals (n=51) evaluated the TSSCP-AA and TSSCP-S templates on the following domains: content, clarity, utility, and cultural and socioecological responsiveness. Results: AC input revealed that the clinical (i.e., comorbidities) and cultural contexts (i.e., language, spirituality) must inform TS and SCP, respectively. Preliminary evaluation analyses documented that health professionals rated our TSSCP-AA and TSSCP-S templates as excellent to outstanding on content, clarity, utility, cultural responsiveness, and socioecological responsiveness (p<0.01). Conclusions: The evaluation results imply that the TSSCP-AA and TSSCP-S templates achieved cultural responsiveness with high acceptability and utility among professionals and survivors. We created both paper and electronic versions of theTSSCP-AA andTSSCP-S (English and bilingual English-Spanish formats) for providers to create individualized TSSCPs. Further, our TSSCP development approach can be adopted for TSSCP template development targeting ethnic/linguistic minority cancer survivors.
Patient-reported symptoms obtained through telephonic nursing services in an oncology disease management program.
Authors: Harrison Deb , Jameson Melissa , Espirito Janet L. , Harrell Robyn K. , Clayton Matthew , Abdullahpour Mitra , McQueen Jessica , Hoverman J. Russell 
Published: February 2017

147 Background: Telephonic nursing (RN) outreach was provided as part of an oncology disease management program to provide symptom (sx) management education, assess patient-reported sxs during treatment (tx), and reduce acute care utilization. The Edmonton Symptom Assessment Scale (ESAS) was used to assess sx severity in patients (pts) receiving active chemotherapy. Methods: ESAS scores were obtained at scheduled intervals and documented in the electronic health record for eligible pts receiving chemotherapy between 6/2010-12/2012. Participation was voluntary. Pts were categorized according to cancer diagnosis (dx) and tx setting (early vs. advanced). Repeated measures logistic regression analysis was used to test for differences in ESAS scores between dx and tx settings. Results: 365 pts had 2,198 calls with ESAS scores. Mean age was 53 yrs, 67% female, 33% male. Pts were managed an average of 97 days and received on avg 6 calls/pt. The majority of pts had breast, colon, and non-small cell lung (NSCL) cancer (74%). Of these pts, the most frequent reported sx of any severity other than zero during post-tx calls were for mild/moderate tiredness, appetite, and pain. There was no evidence of a significant difference in the severity of sxs by tx setting in these cohorts; p=NS. One hundred and nine breast, colon, and NSCL pts (40%) received additional unscheduled calls based on sx scores or RN assessment. Outcomes related to acute care utilization are being evaluated. Conclusions: Pt reported sxs obtained through telephonic RN support demonstrated mild/moderate ESAS scores for mainly tiredness, appetite, and pain. This is lower than previously reported in different contexts. Regular RN contact as a supplement to clinic visits may help reduce sx severity. While the ESAS tool is traditionally used for palliative care, in this active tx setting it supported identification of sxs for referrals back to the practice with the goal to reinforce education and avoid acute care utilization. [Table: see text]
A population-based study examining the impact of a multidisciplinary rapid access clinic on utilization of initial treatment options for patients with localized prostate cancer.
Authors: Ho Clement K. , Ruether Joseph D. , Donnelly Bryan J , Kerba Marc 
Published: February 2017

15 Background: Treatment decisions in localized prostate cancer (LPCa) are complicated by the variety of available options. A rapid access cancer clinic (RAC) has been unique to Calgary, Alberta (AB) since 2007. RAC offers multidisciplinary prostate cancer care by a urologist, medical oncologist, and radiation oncologist. It is hypothesized that treatment utilization data from decisions taken at RAC may serve to benchmark the appropriateness of treatment decisions on a population level. Objectives: To compare utilization rates for initial treatment of LPCa between AB and RAC. Methods: Records of patients with clinically LPCa in AB between 2007-9 were reviewed with ethics approval. Records were linked to the AB cancer registry database. Clinical, treatment and health services characteristics pertaining to patients attending RAC were compared to those managed elsewhere in AB. The primary endpoints were utilization rates by initial treatment; prostatectomy (P), radiotherapy (RT), hormone therapy (H), active surveillance (A). A logistics regression model was constructed to examine the influence of RAC on initial treatment decisions, while controlling for interactions and factors of interest. Results: 2,660 patients were diagnosed with LPCa. 375 presented to RAC. Utilization rates among RAC patients: P-60.3% (95%CI: 55.3-65.2), A-16%(12.3-19.7), RT-11.7%(8.5-15.0) and H-8.0%(CI:5.2-10.8). This compares to AB rates of P-47.2%(45.9-48.3), A-6.1%(15.2-17.0), RT-18.8%(17.9-19.7), and H-14.5%(13.6-15.4). On multivariate analysis, RAC was associated with a trend towards receiving RT (OR 1.6, p=0.097). Conclusions: A specialized clinic for LPCa may be associated with a higher likelihood of receiving radiotherapy as initial treatment compared to the prostate cancer population in Alberta.
Engaging new media to drive advance care planning.
Authors: Mulcahy Mary Frances , Gaitan Daniel M. , Belisomo Randi 
Published: February 2017

153 Background: Though Congress enacted the Patient Self-Determination Act in 1991, only 18-36% of Americans have completed an advance directive. Less than half of severely ill patients had an advance directive in their medical record, only one in three with a chronic illness completed an advance directive, and studies suggest that two-thirds of physicians whose patients had advance directives were unaware of the existence of the documents. The Act required healthcare facilities to provide written information on rights to make treatment decisions and to make information available to patients who did not have an advance directive. There was a mandate directing HHS to conduct an awareness campaign about advance directives. The low acceptance of the directives demonstrates a failure to educate patients about their rights. Hypothesis: A patient-centered approach to end of life issues will generate better communication and result in greater acceptance of advance directives- achieving the goals of the Patient Self-Determination Act. Methods: A survey of 196 people showed that 67.7% felt that end of life issues were not covered enough in the media. We created a Newswire using WordPress and posted an average of three news stories weekly on topics pertaining to end of life. Posts were generated from existing media coverage and original reporting. The topics included culture, society, politics, healthcare, caregiving, law, advance care planning, hospice, and palliative care services. We tracked the number of views, the most viewed reports, monthly traffic and referral sources. We established Facebook, Twitter, and Pinterest accounts. We tracked followers, likes, re-tweets, pins, and shares. Results: From 8/2012 through 2/2013, the number of views increased from 566 to 2,452 with a peak of 3,809 in 11/2012. The most viewed day was 11/7/2012, the day following Election Day. The most viewed reports to date have been “Caregiver Discrimination Against LGBT Seniors,” “Psychedelic Drugs at the End of Life,” and “POLST Moving Forward in Illinois.” The referral sources in descending order are Facebook, Twitter, and Yahoo. Conclusions: We demonstrated that there is an interest in patient-centered topics pertaining to the end of life and that social media drives interest, education and conversation.