bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the impact of translational research enrollment on the patient care experience of Veterans with prostate cancer who receive care through the Veterans Affairs (VA) healthcare system.
Authors: Carlson Alexander , Hamilton Ian , Pollen Joel , Lesnik Dyan M. , Kosoff David 
Published: June 2024

e23210 Background: Veterans with cancer represent a unique subset of patients with distinct exposure histories and cancer epidemiology. Translational research studies that incorporate Veteran-derived biospecimens are therefore critical to advance our understanding of Veteran cancer biology and improve treatment options for Veterans with cancer. Biospecimen-based translational studies also offer an opportunity to enhance the Veteran care experience by enabling Veterans to directly contribute to cancer research efforts. While the biologic benefits of biospecimen research have been well established, the benefit of translational research on the Veteran care experience has yet to be defined. In this study, we evaluated: 1. Whether Veteran enrollment in a biospecimen-based prostate cancer research study improved their VA patient care experience and satisfaction and 2. Whether a VA-based data analyst tool could be used to optimize patient enrollment in translational research studies. Methods: Beginning in January, 2022, Veterans with a diagnosis of prostate cancer receiving care at the William S. Middleton VA were enrolled in a translational research study that collected blood and tissue biospecimens for subsequent investigation and analysis. After at least 30 days of enrollment, subjects were sent an anonymous survey inquiring about how participation in the translational research study impacted their VA care experience and healthcare satisfaction. To optimize enrollment in the study, an ICD-9 code search function was employed within the medical record database to readily identify eligible VA clinic patients based on an active prostate cancer diagnosis. Descriptive analyses were performed using Prism statistical software. Results: Nearly all Veterans who responded to the questionnaire agreed that participation in translational research was a meaningful experience that increased their satisfaction with their VA medical care. In addition, a vast majority of Veterans surveyed felt that their research participation could help improve care for other Veterans, and most expressed willingness to participate in future VA research opportunities. In a secondary analysis, our ICD-9 search function accurately identified eligible VA clinic patients with a prostate cancer diagnosis, and implementation of this tool has saved approximately 30 minutes of weekly physician and research coordinator work compared to manual chart review. Conclusions: Veteran enrollment in translational research studies provides a meaningful experience for Veterans that can lead to increased satisfaction with the VA healthcare system. Future VA initiatives to improve the Veteran care experience should focus on expanding translational research opportunities for Veterans as well as addressing potential barriers to enrollment.
Targeted interventions to address local challenges in HR+/HER2- and HER2+ breast cancer treatment in community-based settings.
Authors: Mahtani Reshma L. , Hamilton Erika P. , Storey Janet , Dewald Ilona , Dooyema Samuel , Carter Jeffrey D. , Heggen Cherilyn , McKinnon Kelly E. 
Published: June 2024

e23213 Background: Advancements in novel targeted agents and antibody-drug conjugates (ADCs) have dramatically improved patient outcomes and survival for breast cancer patients, yet the successful utilization of these agents remains a key challenge for clinicians, particularly in the community. To improve the care of HR+/HER2- and HER2+ patients, a quality improvement (QI) initiative was conducted across 6 community-based oncology practices. Methods: Between 7/2023 and 10/2023, multidisciplinary oncology team members (N = 98) across 6 US-based community oncology practices were surveyed to identify gaps in the treatment and management of patients with HR+/HER2- and HER2+ breast cancer. Providers then participated in audit/feedback (AF) sessions where they (a) assessed site-specific practice gaps identified via the provider surveys; (b) received targeted education based on their specific gaps; and (c) developed action plans for improvement. Follow-up surveys administered 90 days after AF sessions will evaluate the impact of practice changes driven by the QI initiative. Results: Top challenges reported by providers in caring for patients with HR+/HER2- and HER2+ breast cancer were providing patient-centered supportive care measures (37%), individualizing treatment plans (18%), and managing treatment-related adverse events (14%). Reported challenges in treatment sequencing included rapidly evolving guideline recommendations (44%) and knowing which treatment to select when patients are eligible for multiple lines of therapy (34%). Additionally, oncology team members reported having the most difficulty managing treatment-related neurological effects (32%), neutropenia (16%), and GI toxicities (14%). Providers believed improved collaboration across interprofessional teams (28%) and increased patient education/referrals for supportive care (26%) would most improve care for breast cancer patients. To address the identified gaps at each location, teams participated in targeted AF sessions focused on addressing their specific gaps and developed action plans, such as developing new workflows for improving care coordination, implementing institutional protocols for identifying and managing adverse events, and improving patient supportive care, quality-of-life assessments, and distress screenings. Full findings from baseline surveys will be presented, along with follow-up surveys measuring real-world impact of the system-level practice changes. Conclusions: Through this QI initiative, teams identified gaps/barriers in their own practices, and developed and implemented action plans for improvement. These data and actionable insights support safe, effective, and evidence-based integration of novel therapies into HR+/HER2- and HER2+ breast cancer care to optimize patient outcomes.
Insight into quality of life: Understanding the experience of patients with cancer in southern Brazil's public healthcare system.
Authors: Aleixo Sabina B. , Pulido Jose Zago , Parmanhane Narelle , Sartoli Ana Arlete , Siller Ana Paula 
Published: June 2024

e23223 Background: This study explores the quality of life of individuals undergoing cancer treatment in the southern region of Brazil within the public healthcare system. Recognizing the potential negative impacts of both the disease and its treatment on patients' well-being, there is a pressing need to comprehensively assess their quality of life. The study aims to understand the challenges faced by these individuals in various well-being dimensions. Methods: Data collection occurred from August 1, 2023, to December 31, 2023, approved by the Ethics and Research Committee (Opinion Number: 6,136,833). Quality of life was assessed using the Brazilian version of the Medical Outcome Survey Short-Form 36 (SF-36), a validated instrument comprising 11 questions. Inclusion criteria included individuals over 18, of any gender, residing in the southern region if the state of Espirito Santo, diagnosed with cancer, and receiving treatment at the public healthcare reference oncology center. Exclusion criteria encompassed those under 18, non-residents of southern region, lacking a cancer diagnosis and undergoing oncohematological treatments. Among 263 eligible participants, 21 were excluded for not meeting inclusion criteria and 16 invited individuals chose not to participate, resulting in a final sample of 226 individuals. Results: The composition of the participant pool comprised 71.6% women and 28.4% men. The evaluation of quality of life utilized the SF-36 instrument, which explores various domains: Functional Capacity, Limitation due to Physical Aspects, Pain, General Health Status, Vitality, Social Aspects, Emotional Aspects, and Mental Health.Functional Capacity saw 44.20% facing significant difficulties, 32.80% experiencing mild difficulties, and 23% reporting no hindrance in daily activities. Physical limitations due to cancer treatment were reported by 61%, while 39% did not face such limitations. Most patients experienced some level of pain; only 24.20% were pain-free. General Health Status varied from excellent (9.10%) to very bad (2%). Vitality fluctuated, with 31% reporting vitality all the time. Regarding the social dimension, most individuals experience interference, while only 37% report no impact.Emotional aspects interfered with daily life for 59% of participants. Conclusions: This research indicates that both physical and emotional aspects are significantly affected in cancer patients from southern Espírito Santo. While physical limitations and pain are prevalent, emotional aspects, including manifestations of anxiety and depression, also play a substantial role in influencing daily life. Understanding these dimensions is vital for developing targeted interventions, especially for vulnerable individuals relying on Brazil's public healthcare system, to enhance the quality of life during cancer treatment.
Improving adequacy rates of bone marrow aspirate and core biopsies through training and a bedside X-ray device.
Authors: Vegunta Rathnamitreyee , Karakus Gulen Kuaybe , Ghanta Snigdha , Seiter Karen , Dewar Rajan 
Published: June 2024

e23228 Background: Bone marrow (BM) evaluation is crucial to the diagnosis of hematolymphoid disorders. WHO requires an adequate number of well-spread-out spicules in aspirates and defines an adequate BM core biopsy as ≥1.5 cm with at least 10 inter-trabecular areas (ITA). Gross examination of the core biopsy at the bedside can be misleading due to attached clot, thick periosteum, and cortical bone, or tangential biopsies, which histologically results in biopsy without adequate ITAs. Suboptimal BM biopsies hinder appropriate diagnosis, delay patient care, and may require the patient to undergo additional BM biopsies. Bedside image analysis via a cabinet x-ray system can be utilized as a point-of-care tool to assess the amount of evaluable marrow permitting re-biopsy at the time of the procedure. Methods: The study was conducted over 5 months at Westchester Medical Center. We retrospectively estimated BM adequacy rates by analyzing the aspirate quality and measuring the BM core biopsy length. Subsequently, a training demonstration to the proceduralist (fellows in training) by an experienced attending was performed and the adequacy rates were reassessed. BM biopsies were analyzed with a cabinet x-ray system, Faxitron, soon after biopsy, then subjected to routine histology and processing. High-resolution images of the core biopsy were obtained. The length of the core biopsy and the number of ITAs were calculated from the x-ray images. Measurement of the gross biopsy length and microscopic assessment of evaluable marrow were compared to the measurements obtained by x-ray imaging. Results: Our adequacy rates which met aspirate quality were 5% (1/20) pre-intervention and 65% (13/20) post-intervention. The aspirate smear quality improved after the demonstration technique to 65%. Only 13/53 core biopsies exceeded the WHO standard of 1.5 cm by microscopy, while 34/53 were grossly estimated to be > 1.5 cm. There was general concordance between the number of ITAs and the length of core biopsies by microscopy. In approximately 20% of cases, the x-ray images highlighted suboptimal core biopsy ( < 10 ITA/cortical bone/cartilage), which weren’t apparent by gross examination alone at the bedside. Utilizing x-ray image measurements, core biopsy fragment length was shown to be in concordance with microscopic estimation of length and number of ITAs. X-ray imaging readily identified clot sections (non-radiopaque), sclerotic cortical bone (absence of trabeculae), and periosteum (soft tissue shadow) in all 10 sub-1 cm biopsies. Conclusions: We conclude that a standard instruction technique of slide preparation can improve the quality of bone marrow aspirate. Core biopsy length and number of ITAs can easily be estimated using bedside point-of-care x-ray analysis to ensure adequate BM evaluations. We propose training and the routine use of bedside x-ray machine to improve the adequacy rates of BM biopsies.
An international expert consensus on improving the quality of care in patients with cancer by optimal central vascular access device selection.
Authors: Jahanzeb Mohammad , Wu Ching Yang , Lim Howard J , Muro Kei , Xu Lichao , Somashekhar Manjiri , Somashekhar S.P. , Zhang Xiaotao , Qiu Xiaoxia , Fu Ying , Pittiruti Mauro 
Published: June 2024

e23233 Background: In cancer patients (CPs), selection of an appropriate venous access is critical not only for delivering effective treatment, but also for enhancing patient comfort and quality of life to ensure treatment continuity. This consensus provides recommendations on the selection of the most appropriate central venous access device (CVAD) and its management in CPs. Methods: Eleven experts from three continents, including oncologists and healthcare professionals (HCPs) skilled in CVAD placement & maintenance, convened electronically and face-to-face at a 2-day meeting. A comprehensive review of clinical trials & guidelines on CVADs published between January 2013 and December 2023 from PubMed & Cochrane Library was conducted. Preliminarily drafted statements were discussed by the panel and voted on. Evidence and panelists' expertise was employed in an anonymous polling for consensus. The final recommendations were approved by all panelists. Results: A summary of the panel’s consensus (ten statements) is shown in Table 1. Conclusions: The present consensus provides a robust clinical framework for HCPs to select the most suitable CVAD to facilitate therapy for CPs. [Table: see text]
Aesthetics treatment with injectable fillers in patients with cancer: Safety and quality of life during active antineoplastic therapy.
Authors: Shachar Eliya , Hasson Eden , Arzi Ofir , Levy Bar , Pantanowitz Mabjeesh Lee , Adar Lyri , Shani Omer , Safra Tamar 
Published: June 2024

e23245 Background: Patients treated with antineoplastic treatment,commonly experience physical changes,secondary to the disease,weight loss,stress,and cancer therapy side-effects.Injectable fillers,offer effective and safe soft-tissue manipulations improving patients’ positive body image.While FDA-approved fillers are used in various medical settings,data on the safety and implications on quality of life(QOL)in oncology patients during active cancer therapy are limited.The study aimed to assess oncology patients' safety,QOL and both physician and patients’ perceived skin changes when fillers are used during active cancer therapies. Methods: The study was conducted at the Women's Cancer Center and Dermatology Department between 2021-2023.Female oncology patients treated with antineoplastic therapies completed a validated QOL questionnaire,dermatologist and patient self-evaluation,prior and following aesthetic intervention.Patients were randomly assigned to receive aesthetic treatments. Results: 127 female patients diagnosed with cancer,and treated at a single cancer center were included in the study.Patient mean age was 57 years.Patient diagnoses included breast,ovarian,uterine,cervical,and other cancers(58%, 22%,7%,5%,8%,respectively).31 (24%) patients were randomized to receive filler treatment.106(83%)patients were not treated with fillers,patients were either not randomized to filler treatments,or attributing their abstention to their cancer diagnosis,potential risks shared by other patients,or their treating oncologist.Patients receiving fillers were treated with chemotherapy,chemotherapy and biological agents,biological agents,hormonal therapies,immunotherapy,biological and hormonal therapy(39%,23%,10%,19%,6%,3%,respectively).3 independent dermatologists assessed improved aesthetic parameters following filler treatment,patients appeared less ill,sad,distracted.6-8 weeks post filler injections,there was a markedly improved QOL score,and noticeable positive skin changes by dermatologists and patients evaluation.Patients appeared less tired,angry,worried(45%,38%,35%,respectively).Most patients were satisfied following injections(81%) and planned future aesthetic treatments.More than half of the patients(55%)had no adverse events.Thirteen patients experienced minor dermal side effects (grade 1,42%).While 1 patient developed delayed inflammatory reaction 6-months post injection(grade 2,3%). Conclusions: Aesthetic treatment with filler injections while on anti-cancer treatment,with minimal side effects,statistically improved patient QOL and dermatological measures,enhanced dermatologist and patient sense of positive body image,demonstrating that injectable fillers can be safely recommended to patients receiving anti-neoplastic therapies.
Addressing misinformation about cancer care in the clinical setting: A pilot study of a conversation guide and training for cancer care providers.
Authors: Palmer Amitabha , Lopez Gabriel , Taylor Jolyn Sharpe , Gallagher Colleen M. 
Published: June 2024

e23250 Background: Medical misinformation about cancer care is understudied despite its pervasiveness and harmful effects on patients. This misinformation causes a) delays in care or forgoing of treatment for curable conditions; b) economic harm such as spending and travel on ineffective or harmful treatments; c) potentially toxic effects of the suggested test/treatment; and d) harmful medical interactions with standard curative treatments. Recently, in an IRB study we surveyed MD Anderson clinicians about their ability to successfully address patients who endorse medical misinformation. We found that ~40% of physicians report success rates below 60% for correcting misinformation. ~50% of respondents answered that they have insufficient resources to address patients who endorse misinformation; ~65% answered that they have insufficient training, and ~50% answered that there is insufficient institutional support. In response to these findings, we developed (as far as we know) the first pilot conversation guide and training to improve provider skills and confidence in addressing misinformation about cancer in clinical encounters. Methods: For our quality improvement project, we partnered with clinicians in integrative oncology and gynecologic oncology to develop the conversation guide. The techniques, strategies, and model dialogue in the guide are adapted from best practices developed for addressing vaccine hesitancy. Before the training, we asked 11 physicians to provide a self-assessment of their comfort, confidence, and competence in addressing patients who endorse misinformation about cancer. Then we provided a 25min training in which participants role-played to learn strategies and model dialogue for four common scenarios. After, we resurveyed participants’ self-assessment measures and assessment of the training’s utility. Results: All participants believed the conversation guide and training will be significantly (82%) or moderately (18%) helpful for correcting patients/families who endorse medical misinformation about cancer. 91% said the conversation guide and training significantly (9% moderately) improved their ability to correct patients/patients’ families who endorse medical misinformation. All participants reported improved comfort, confidence, and competence in their ability to address patients/families who endorse misinformation about cancer care. 100% would recommend the guide and training to their peers. Conclusions: Given the prevalence of medical misinformation generally, the training and resources we have developed will be valuable to clinicians effectively address the growing number of patients who endorse misinformation about their care. Our long-term goal is to conduct a larger study and turn our conversation guide and training into a replicable model available for widespread use.
Real-world clinical effectiveness and treatment patterns in the early-stage esophageal/gastroesophageal junction cancer (EC/GEJC) population treated in the community oncology setting in the United States.
Authors: Ramakrishnan Karthik , Beeks April , Valderrama Adriana , Shi Junxin , Patton Gregory , Wilson Thomas W. , Herms Lisa , Bordia Sonal , Nallapareddy Sujatha 
Published: June 2024

e23273 Background: Definitive chemoradiotherapy (dCRT) is the recommended treatment for patients with early-stage EC/GEJC not eligible for surgery. There have been improvements with treatment for esophageal cancer, but the overall 5-year survival rates remain low at approximately 20%. This study examined patient characteristics, current treatment patterns and outcomes with dCRT regimens in the US community oncology setting. Methods: This was a retrospective observational cohort study using structured and unstructured electronic health records data of 300 adult patients with locally advanced/unresectable EC/GEJC who initiated dCRT (index date) within The US Oncology Network between 1 January 2015 and 30 June 2021. Patients were followed through 31 December 2022, last patient record or death, whichever occurred first. Descriptive analyses were conducted to evaluate patient and treatment characteristics. Kaplan-Meier methods were used to assess overall survival (OS) and real-world event-free survival (EFS) from index date. Results: Median age at index was 73 years; three-fourths of patients were male (74.3%), and three-fourths were Caucasian (73.7%). Stage III was the most common stage at initial diagnosis, followed by stage II and stage IVA (55.7%, 34.7%, and 5.3% respectively). The majority of the initial tumor location at diagnosis was esophageal (70.7%) whereas 29.3% were GEJ. Most patients had a baseline ECOG score of 0-1 (63.3%). Median (IQR) follow-up time to death or censor was 10.5 (4.0, 21.0) months from index. The most common initial regimen received was carboplatin+paclitaxel (87%), followed by cisplatin+fluorouracil (9%). Almost all patients received chemoradiotherapy concurrently (99.7%). Median radiation dose was 5040 cGy. Median duration of index treatment was 1.4 months. One-fifth of patients went on to receive a second treatment (21.7%). One-half of patients died before the end of the study observation period (53.7%), and 66% of patients experienced a clinical event (progression, locoregional recurrence, metastatic recurrence or death). Median (95% CI) OS and EFS were 18.1 (13.3, 21.8) and 8.9 (7.7, 10.6) months, respectively. Conclusions: Our study showed that patients mostly received carboplatin+paclitaxel as chemotherapy and did not receive further lines of treatments. Over 60% of patients experienced disease progression with a median survival of a year and a half. These clinical outcomes are poor for early esophageal cancer and support the development of more effective therapies to improve outcomes.