bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of online patient education materials for acute myeloid leukemia.
Authors: Weiss Jessica M. , Mahayni Yasmeen , Steinberg Amir S. 
Published: June 2024

e23135 Background: Acute myeloid leukemia (AML) is the most common adult leukemia, accounting for approximately 80% of all cases. In the modern healthcare landscape, a substantial number of patients turn to online platforms such as Google for information pertaining to their diagnoses and treatment options. This study sought to assess 14 online AML websites for their understandability and actionability using the Patient Education Materials Assessment Tool (PEMAT). Methods: Fourteen patient-facing U.S. online AML websites were searched in Google, selected and analyzed using the PEMAT criteria. The PEMAT rating tool is a freely accessible online resource evaluating print and audiovisual information. The ‘understandability’ section is scored out of 17 possible points and the ‘actionability’ section is scored out of 6 possible points. The websites were rated by two independent reviewers and any discrepancies were discussed. The websites were categorized by Government, Public/Private companies, Patient Advocacy Groups, Professional Societies, and Cancer Centers. Results: The study analyzed 14 websites on AML education material. The mean ‘understandability’ score was 85% ( Range: 79%–92%); Government scored the highest, followed by Professional Societies, Patient Advocacy Groups, Cancer Centers, and Private/Public Companies. PEMAT metric 11 ‘the material provides a summary’ scored poorest across all ‘understandability’ criteria. The mean ‘actionability’ score was 66% ( Range: 56%–90%); Patient Advocacy Groups scored the highest, followed by Professional Societies, Government, Private/Public Companies, and Cancer Centers. PEMAT metric 26 ‘the material uses visual aids whenever they could make it easier to act on the instructions’ scored poorest across all ‘actionability’ criteria. Conclusions: Most of the AML websites analyzed were easy to understand but lacked material that prompts patients to take action. As patients turn to online website sources for information, it is crucial that these education materials provide clear information that patients can appropriately act on. This study highlights an opportunity to enhance online patient education material by adding action-oriented features, such as content summaries, tangible tools, and visual aids. [Table: see text]
Disparities in cancer care utilization in patients with brain tumors: A nationwide analysis.
Authors: Ahmad Shahzaib , Javaid Saad , Aziz Nouman , Khan Hadin Darain , Yousaf Mirza Rehan , Rehman Haseeb Ur , Chaudhary Muhammad Ahsan Hanif , Ganiyani Mohammad Arfat , Khokhar Muhammad Abbas , Ahluwalia Manmeet Singh 
Published: June 2024

e23142 Background: Brain tumors are highly aggressive and are associated with poor prognosis. Minority populations still experience inequities in the delivery of cancer care, despite concerted efforts to reduce such disparities. We studied disparities in receipt of cancer care for patients with primary brain tumor. Methods: National Inpatient Sample 2017-2020 was queried to identify the patients admitted with brain tumor. Results of the study were reported in accordance with the STROBE guidelines. We divided the cases into two groups i.e., the patients undergoing curative cancer care (CC) and palliative care (PC). We performed descriptive analysis and analyzed predictors of getting PC or CC using logistic regression analysis. Results: Among 144,355 patients hospitalized for primary brain tumor, 33,645 (23.3%) received PC. Mean age of PC group was 60±20.1 years, while the CC group had mean age of 52.9±21.3 years ( P < 0.01). Compared to patients < 45 years, the patients with age 46-64 years and ≥65 years were more likely to receive PC (OR = 1.9, 95% CI 1.6-2.4 and OR = 2.23, 95% CI 1.8-2.8, P < 0.01, respectively). The proportion of Black patients in the PC group was more compared to the CC group (10.4% vs 7.6%). However, the proportion of White patients in the PC group was lower than the CC group (74.8% vs 77.9%), P < 0.001. Black patients were more likely to receive PC (OR = 1.5, 95% CI 1.3-1.7, p < 0.01), while no difference was observed in other ethnic or racial groups. Compared to CC group, PC group had a higher percentage of patients with Medicare (50.9% vs 35.9%), Medicaid (14.4% vs 13.8%) and a lower percentage of patients with private insurance (31.9% vs 47.0%) p < 0.01. Patients with private insurance were less likely to receive PC (OR = 0.7, 95% CI 0.6-0.8, p < 0.01). PC group had a higher percentage of low-income group patients compared to the CC group ($1-$49,999: 22.5% vs 20.6% and $50,000-$64,999: 25.3% vs 24.2%, P < 0.01). Patients in teaching hospitals had decreased odds of PC (OR 0.8, 95% CI 0.7-0.9, P = 0.01) compared to non-teaching hospitals. Patients with major depressive disorder (OR 1.3, 95% CI 1.1-1.4, P < 0.01), electrolyte disorders (OR 1.6, 95% CI 1.5-1.8, P < 0.01), and atrial fibrillation (OR 1.3, 95% CI 1.1-1.5, P = 0.01) had increased odds of receiving PC. Conclusions: The patients who underwent PC were older, more likely to be Black, and of low-income groups. Patients in teaching hospital had a decreased likelihood of undergoing PC. The health care disparities should be addressed to achieve a better quality of care across all groups. [Table: see text]
A real-world assessment of the treatment-related symptoms and associated burden among patients with lung cancer receiving chemotherapy.
Authors: Galaznik Aaron , Rusli Emelly , Holt Tracy , Kramer Mordecai , Trask Peter 
Published: June 2024

e23159 Background: For patients (pts) with metastatic non-small cell lung cancer (NSCLC), treatment with chemotherapy has shown improved survival, symptom control, and increased quality of life. In clinical trials, the adverse event profile associated with these treatments has been identified. Less explored is the real-world experience of treatment-related symptoms and treatment burden. The objective of this study is to evaluate treatment-related symptoms and treatment burden among chemotherapy-treated NSCLC pts through an electronic remote symptom monitoring system. Methods: Pts diagnosed with NSCLC who received chemotherapy at U.S. academic cancer centers were enrolled in the Carevive’s Patient Reported Outcomes Mobile Platform (Carevive PROmpt®) from September 2020 - June 2023. 174 pts were enrolled. Weekly PRO-CTCAE-derived surveys assessed severity, frequency, and interference for 16 symptoms: anxiety, constipation, cough, decreased appetite, diarrhea, fatigue, general pain, insomnia, mouth/throat sores, muscle pain, nausea, numbness and tingling, rash, sadness, shortness of breath, and vomiting. The GP5 assessed weekly overall side effect treatment bother. Results: The mean age of NSCLC pts was 67.3 (SD = 9.2) years, with 51% female, and 12% African American. The majority of pts, 126 (72%), were enrolled at or within 1 month of the start of treatment. Ninety-one (52%) received chemotherapy and 83 (48%) received chemotherapy in combination. At enrollment, cough, fatigue, and shortness of breath was reported by > 40% of pts receiving chemotherapy, with constipation, decreased appetite, general pain, and numbness/tingling occurring in > 20% of pts. Over 40% of pts reported being at least “somewhat” bothered by the side effects of treatment. Pts with decreased appetite, nausea, and numbness/tingling were more likely to rate symptoms as “somewhat” or “very much” bothersome. No differences were noted for those with combination regimens. Conclusions: For real-world chemotherapy pts, the most frequent symptoms at enrollment were cough, fatigue, shortness of breath, decreased appetite, general pain, and numbness/tingling. Patients with decreased appetite and numbness/tingling were more likely to note higher treatment bother. Results show the feasibility of assessing symptom burden and corresponding patient bother in a real-world NSCLC population, which will have increasing importance increasing use of new treatment modalities with and without cytotoxic chemotherapy. [Table: see text]
An application (ePRO) -based patient reported outcomes of quality of life from an innovative cancer care delivery model.
Authors: Pendharkar Dinesh , Tripathi Chandramauli , Parmar Ajay , Ather Mohammad Imam , Nagar Ashok Kumar , Raj Abhishek , Hari Vishnu 
Published: June 2024

e23176 Background: With the accessibility of smartphones, it has become possible to develop applications for patient-reported outcomes. Quality of life (QoL) is an important measure in oncology research. We developed a phone application that could use any standardized form to be filled in by the patient. Here, we report using the EORTC questionnaire, QLQ-C30, built into the application as a form for data collection from our ongoing district cancer care program, which offers support at government district hospitals in India using an alternate oncology work force. Methods: An application (ePRO) was created, which allows one doctor administrator to follow the patients. Once the application is downloaded, the patient opens the QoL questionnaire (QLQ-C30), built into the application, and completes it using a smartphone. The researcher downloaded the data in Excel format and analyzed it. The application was attempted at a tertiary cancer center and a public hospital district cancer unit. A cross-sectional study was conducted over six months in 2023.The data were analyzed using SPSS version 24. Results: The application was downloaded and activated on the smartphones of 441 patients. Patients completed the form available through the application. Of all the respondents, 229 (51.9%) were male and 212 (48.1%) were female. The mean QoL of the tertiary hospital was 69.29, with a standard deviation (SD) of 18.98.The QoL scores were 50.94 (SD 23.50) in district hospital 1 and 77.01 (SD 17.35) in district hospital 2. The difference between one district and the other was significant (p < 0.001). The symptom scale scores varied between district hospitals and other hospitals. Conclusions: This presentation serves two purposes: to validate a new patient-reported outcome application and to provide data on QoL from peripheral centers compared with tertiary centers. The use of technology is feasible and can help gather patient-reported outcomes easily. There appears to be a difference in the quality of life of patients from different geographical locations. [Table: see text]
Cross-cultural differences in diet and quality of life between Taiwanese and American women during breast cancer treatment.
Authors: Yung Kristin , Thomas Maya , Liu Yu-Chen , Sander Grace , Pawlow Caroline , Chen Jacqueline , Wang Judy Huei-yu , Jeong Suin , Hsiao Fei-Hsiu , Chang King Jen , Lo Chiao , Kuo Wen-Hung , Huang Chiun-Sheng 
Published: June 2024

e23187 Background: Limited research has examined the role of different food types (vegetables, fruits, meat, fat, and whole grains) on quality of life (QoL) among cancer patients undergoing active treatment. This study aimed to examine what different food intakes are associated with QoL among American and Taiwanese women who are newly diagnosed with breast cancer (BC). Methods: This ongoing observational study enrolled 77 American (Black, Latina, and non-Hispanic White) adult women from MedStar Georgetown University Hospital and 79 Taiwanese women from National Taiwan University Hospital. They were diagnosed with stage 0-III primary BC within six months prior to enrollment, were undergoing surgery, chemotherapy, and radiation, with no other cancers. Patient-reported overall health and QoL were assessed using the two global health items from the EORTC-QLQ30. Three random 24-hour diet recalls (two weekdays and one weekend) were administered using the NIH-developed ASA24 program. Linear regression was conducted to examine the associations between food categories and QoL outcome, adjusting for nationality, age, cancer stage, treatment type, body mass index, physical activities, financial problems, and appetite loss. Results: American and Taiwanese patients displayed differing food intake during BC treatment. Taiwanese patients consumed less starchy vegetables and total fat (both p < .01) than American patients, on average. Multivariate results indicated that QoL was positively associated with higher total vegetable intake (excluding starchy vegetables and legumes; β = 5.38, 95% CI: 0.22, 1.20), controlling for other food types and covariates. Starchy vegetables and legumes showed non-significant negative effects on QoL. QoL was positively associated with total fat intake (β = 0.11, 95% CI: 0.02, 0.21). Total meat, fruit, and whole grain intakes were not significantly associated with QoL. Conclusions: The associations between food intakes and QoL were not affected by nationality, regardless of food type. Non-starchy vegetables and adequate total fat intakes may support BC patients undergoing treatments. More research is needed to verify the identified associations and explore how cancer treatment affects the digestion of certain food types and their potential impact on QoL. This study provides cross-cultural insights into potential nutritional influence on QoL among patients undergoing cancer treatment.
Patient-reported and clinical outcomes among patients with pancreatic cancer.
Authors: Pichardo Rayli , Jacob Brigid , Jamil Maria , Jamil Dawood , Raslan Shahm , Rose Courtney M. , Adjei Boakye Eric , Poisson Laila , Tam Samantha , Philip Philip A. 
Published: June 2024

e23200 Background: Pancreatic cancer is associated with poor survival, high symptom burden, and psychological distress. Conventional assessments such as performance status (PS) have relied on provider-generated data to evaluate the selection of treatment and prognosis. Patient-reported outcome measures (PROMs) represent a patient-centric representation of the patient experience and are increasingly applied as tools to help improve outcomes and quality of life. However, little is known about the correlation of PROMs with ECOG PS and clinical outcomes in pancreatic cancer. Methods: We performed a retrospective analysis of patients with pancreatic cancer seen at the Henry Ford Health System between 09/2020 and7/2023, using ICD codes. The NIH’s validated and standardized Patient-Reported Outcomes Measurement Information System was used to capture 4 core domains: fatigue, pain interference, physical function, and depression. Patient-level variables and disease-specific variables were obtained by chart review from EHR. Kruskal-Wallis tests for continuous variables and or Fisher’s exact tests for categorial variables were used to compare the different ECOG scores and PROM scores and patient-level and disease-specific variables. Results: 176 patients were analyzed, with a median age of 65, 58% were male. Most patients had Stage 1 32.9% followed by Stage 4 25.9%, stage 3 22.9%, 1 32.9%. The majority had an ECOG score of 1, followed by, 0, 2, and only 10 had an ECOG PS of 3. There was no statistically significant difference in PS scores according to smoking status, race, or AJCC Stage but differed by age (P = 0.0007). PS score was not significantly associated with PROMscores on depression, fatigue, or pain interference. However, increasing PS scores were associated with a significant increase in low physical function PROM scores (P < 0.0001). Conclusions: Clinician-assessed PS is a single assessment of the patient’s tolerance to therapies subject to physician bias; our study provides encouraging data on the association between PS and patients’ reported physical function. The other PROM domains did not provide additional meaningful information on the patient’s function although are part of clinical decision-making. [Table: see text]
Implementation of patient navigation services to improve colorectal cancer health literacy in a vulnerable community health center population.
Authors: Brown Kari , Hartley Maria , Doreswamy Shriya , Mishra Sakshi , Ratnani Akshay , Behme Matthew 
Published: June 2024

e23208 Background: Under-served community populations face social and health inequities which contribute to sub-optimal colorectal cancer (CRC) screening rates and excess mortality risk. Furthermore, these populations may not have the health literacy or food security necessary to mitigate the well-established nutrition-related risk of CRC. This quality improvement study aimed to improve CRC-related health literacy and dietary habits, with the additional goal of improving screening rates in our disadvantaged community health center population. Methods: This single-institutional study utilized the Plan-Do-Study-Act (PDSA) model to implement patient navigation services and administer a cross-sectional survey evaluating nutrition-related CRC risk. Patients eligible for screening were contacted by patient outreach coordinators prior to scheduled primary care appointments, and the survey was administered. During patient visits, outreach coordinators met with them to provide 1:1 education addressing CRC prevention, screening and nutrition. Information on free or low-cost fresh food options was provided to help address barriers such as food insecurity. The outreach coordinators also liaised with physicians to assist with coordination to services. Results: Prior to the intervention 58% of survey respondents (25/43) were not aware of any foods or dietary habits that decreased the risk of colorectal cancer; 51% (22/43) were not aware of foods that increased the risk of colorectal cancer. Most respondents (54%) were in fact not at all worried about possibly developing CRC in their lifetimes (22/41), while 34% (14/41) were a little worried, and the remainder (12%) very or extremely worried. 97% of respondents (33/34) felt more knowledgeable about CRC screening and felt more confident about improving their nutrition to reduce CRC risk after receiving the educational intervention, while 94% of respondents (31/33) stated they would subsequently make dietary changes. Conclusions: Health literacy regarding colorectal cancer was low in this underserved community population. Implementation of a patient navigation intervention led to increased knowledge and confidence in modifying dietary risk factors. However, preliminary data review did not reveal significant change in CRC screening rates during the initial phase of the intervention. One of the initially identified barriers included system-level delays in colonoscopy access. During the Act phase of the PDSA model, patient navigation services will be further optimized by workflow adaptation based on the response of outreach coordinators and patient-reported barriers regarding stool-based testing. [Table: see text]
Educating and empowering health care teams who present to the hospital to recognize and intervene on cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) in patients on bispecific t-cell engager therapy (BiTEs): A quality improvement study.
Authors: Petrillo Alessandra , Seog Woo Jin , Halterman Justin , Winter Alex , Lee Christina Y. 
Published: June 2024

e23212 Background: Treatment of oncologic disease with Bispecific T-Cell Engager antibodies (BiTEs) are an emerging novel immunotherapy with demonstrated efficacy in multiple hematologic malignancies. Notable side effects of BiTE therapy include cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which can be life-threatening and must be rapidly identified. We aim to fill knowledge gaps surrounding CRS and ICANS for medical providers, particularly considering increased use of BiTE therapy. We hope that educating providers will allow faster recognition and treatment and will improve patient outcomes. Methods: Our study focused on the impact of educational presentations on awareness and identification of CRS/ICANS. Our intervention targeted the residents and attendings in the emergency department and the nurses, advanced practice providers, and hospitalists in the bone marrow transplant (BMT) unit at Stony Brook University Hospital. Anonymous surveys consisting of 9 multiple choice questions were conducted to assess baseline foundational knowledge of CRS/ICANS. QI consisted of a 15-minute educational presentation for both groups. The same surveys were repeated following the presentations to assess improvement in overall knowledge of CRS/ICANS. A two tailed independent T test was used to calculate significance. Results: The average pre-survey score for the emergency department (N = 37) was 39%. The average presurvey score for the BMT department (N = 13) was 45%. Significant improvements in scores after intervention were shown in both the emergency department (39% vs 66%, p = 0.0001) and the BMT department (45% vs 68%, p = 0.0006). Conclusions: Education among emergency department and hospitalist providers is essential in improving management of CRS and ICANS in patients treated with BiTEs. This quality improvement initiative confirmed a knowledge gap in CRS and ICANS amongst our healthcare teams. By providing educational resources to both departments, there was a significant improvement in this gap. Future directions for continued improvement in the detection and management of CRS/ICANS include patient medication identification cards, a central repository of treatment protocols, algorithms, and toxicities associated with BiTEs, and expanding our educational curriculum which are all currently under development at Stony Brook University Hospital.
Unveiling a low-hanging fruit: Single-center study on secondary immunodeficiency in newly diagnosed chronic lymphocytic leukemia and multiple myeloma.
Authors: Kharel Zeni , Kharel Himal , Mustafa S. Shahzad , Jamshed Saad 
Published: June 2024

e23215 Background: Infectious complications are the leading cause of morbidity and mortality in patients with chronic lymphocytic leukemia(CLL) and multiple myeloma(MM). Despite recognized risks, evaluation of immune function occurs inconsistently. Our retrospective study evaluated practice patterns for assessing secondary immunodeficiency (SID) in newly diagnosed CLL and MM patients. Our aim is to identify areas for improvement to guide future prospective studies. Methods: We analyzed various immune parameters in newly diagnosed CLL and MM patients at Rochester Regional Health, Rochester, NY, focusing on the first six months of their clinical course, with descriptive data analysis. Results: Conclusions: Current infection prevention guidelines for newly diagnosed CLL and MM patients lack robust evidence. Despite our study’s inherent limitations (small, retrospective, single-center), based on our clinical experience, we propose the following recommendations: Complete SID assessment in all new diagnoses of CLL and MM, and this should include not only Ig levels but also vaccine response. If found to have abnormal SID evaluation, consider prophylactic antibiotics and Ig replacement, and consider reevaluation when appropriate to better define the duration of immunoparesis. Consider short-term Ig replacement (irrespective of IgG levels) and antibacterial prophylaxis for all newly diagnosed MM patients due to high infection risk during the initial six months. A thorough immune evaluation is non-invasive and low-cost, yet it can reveal clinically significant immune dysfunction, potentially influencing management in CLL and MM. Consequently, we hope our study will prompt the development of prospective, randomized studies to systematically evaluate these recommendations. [Table: see text]