bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health information and technology engagement for clinical research and healthcare purposes (HITECH) survey of patients with a history of cancer.
Authors: Hamparsumian Anahid , Naeim Arash 
Published: May 2024

e13672 Background: Digital technology offers oncology clinicians and researchers the ability to more closely monitor patients on therapy, including with electronic patient-reported outcomes (ePROs) and real-time passively collected data (for example: heart rate, oxygen saturation, etc.), via smartphone and wearable devices. In order to realize the potential for these technologies to improve patient experience and outcomes, it is critical that we consider the perspectives of patients to design usable and useful digital monitoring programs. Methods: We conducted a cross-sectional survey of cancer patients from a large academic medical institution to study willingness to use digital devices to collect data and to share discrete types of data for the purposes of medical care or research. A survey including baseline characteristics and questions pertaining to digital technology use was sent to participants enrolled in the UCLA Mental Health and Health Technology Research Registry, from November 2023 to January 2024. Participants were included if they were patients at UCLA, age 18 years and older, owned a smartphone and/or wearable device, and self-reported a history of cancer. The primary outcomes of interest were willingness to collect and share digital device data. We report summary statistics for our population. Results: A total of 690 patients participated in our survey. The majority were female (58.5%), 76.7% non-Hispanic white, 8.8% Hispanic, 5.8% Asian, and 2.0% black. Median age was 69 years old. Nearly all participants reported experience using a patient portal (98.9%). Willingness to collect data using a digital device, for the purposes of clinical care was reported by 93.3% of patients. Similarly, 92.0% were willing to use a device to collect health data for research purposes. Sharing patterns were similar regardless of whether data was intended to be for clinical care or research purposes (Table). Conclusions: The overwhelming majority of patients who own a smartphone and/or wearable are willing to collect health data on their digital device for either clinical care or research. There is a preference for sharing more objective clinical information (vitals and physical activity measurements), and less inclination to share subjective information (daily activity, symptoms, and mood). This could be attributable to the greater effort required to input information as well as skepticism of the usefulness of the subjective data. Notably, we must recognize that some patients are not well-represented in this study population. Their perspectives should also be explored to prevent widening of the digital divide. [Table: see text]
Unraveling the impact of social determinants of health on HER2+ early breast cancer screening and treatment in a county oncology setting in China.
Authors: Ji Yinghua , Zhou Feidu , Qu Honglan , Wu Qianfu , Liang Wei , Liu Mengyou , Wang Juan , Luo Jun , Tan Xiang , Dai Guohua , Hu Guinv , Meng Qiuli , He Wenbo , Wang Hongjian , Qin Zien , Luo Guoxiang , Tang Huali , Ren Yun , Liu Hui , Tian Yinguo 
Published: May 2024

e13677 Background: HER2 positive breast cancer (BC) accounts for 15-20% of all BC cases. Various barriers, including social, demographic, and economic factors, may hinder BC screening and treatment. We examined the barriers to screening and treatment for patients (pts) with HER2 positive early BC (eBC) in a county setting in China. Methods: This analysis investigated patient profiles, treatment patterns, and social determinants of health (SDOH) indicators among newly diagnosed pts with HER2+ eBC from in 26 hospitals in a real-world county setting. Univariate (UVA) and multivariate logistic regression analysis (MVA) were performed to explore the association between SDOH and treatment. Results: 878 pts with HER+ eBC were identified, with a median age of 53 years. 12.8% received BC screening, 18.5% received neo-adjuvant targeted therapy (NATT), 9.9% received breast-conserving surgery (BCS), 23.5% received radiotherapy (RT); 87.8% received adjuvant targeted therapy (ATT), and 52.5% received dual-targeted therapy. The UVA and MVA found differences in treatment patterns associated with age, employment, education level, insurance type, and regions. Pts in the central China regions had a higher likelihood of receiving BC screening. Pts who received NATT were more likely to be located in the western. Younger pts and those in the north-eastern areas were primarily likely to receive BCS. RT was relatively common among pts with a higher-level education, employee medical insurance, and residents in the north-eastern. Pts from eastern regions were more likely to receive ATT, while younger pts were more likely to receive dual-targeted therapy. Conclusions: In the county oncology setting, we observed inequities in screening and treatment based on social determinants analyzed. Promoting standardization of BC screening and treatment should take the sociodemographic disparities into consideration. To address these disparities, it is necessary to raise public awareness, promote high-quality, balanced development and integrate urban-rural areas in compulsory education, allocate more quality medical resources to the county level and ensure their even distribution among regions. [Table: see text]
Effects of socioeconomic status (SES) and healthcare resource (HCR) availability on survival in Black patients (pts) versus (vs) White pts with multiple myeloma (MM): A SEER Medicare analysis.
Authors: Li Sophia S. , Schuldt Robert , Zafar Faiza , To Tu My , Yellow-Duke Archibong , Levine Alina , Girvan Allicia , Mikhael Joseph 
Published: May 2024

e13678 Background: In MM, disparities exist for overall survival (OS) by race, and many factors may contribute to these differences. This study evaluates whether SES and HCR availability impacts OS in older pts with newly diagnosed MM (NDMM) based on race. Methods: This retrospective study used linked SEER-Medicare claims (diagnosis [Dx] 6/1/2013–12/31/2017) and Area Health Resource Files (AHRFs; from 2018) to identify non-Hispanic White and non-Hispanic Black pts aged ≥66 years with NDMM. AHRFs included county-level HCR availability data (e.g. number of long-term hospital beds, medical doctors [MDs]). Continuous Medicare A and B enrollment until 12/31/2019 or preceding death was required. Pts with other cancers, Dx from death data, missing county information and enrollment in health maintenance organizations or clinical trials were excluded. Kaplan-Meier was used for unadjusted median OS and Cox proportional hazards for OS risk by race. Age, sex, race, Charlson Comorbidity Index (CCI), poverty, education, and HCR availability were included in the adjusted mixed effects Cox model. Results: We identified 6,609 pts with NDMM; 15.6% were Black. For Black pts vs White pts, median age at Dx was 76 vs 77 years, 57.1% vs 46.0% were female, and mean CCI was 2.1 vs 1.4 (p<.001 for all). Within census tracts, mean percentage of pts living under the poverty line and received <12 years of education was 21.2% vs 11.3% (p<.001) and 19.0% vs 11.3% (p<.001) for Black pts vs White pts, respectively. Unadjusted median OS for Black pts vs White pts was 2.76 vs 3.01 years (hazard ratio [HR]: 1.08; p=.063). In the adjusted model, several SES and HCR availability factors were significant. OS HR by race reversed directionality when adjusted for demographics, SES and HCR availability, but this was not significant (HR: 0.92; p=.12; Table). Conclusions: We found that Black pts with NDMM in SEER-Medicare claims were younger, had higher CCI, completed less education, and were more likely to live in census tracts with higher poverty percentages vs White pts. Several factors relating to SES and HCR availability significantly influenced OS and may drive disparities in care. Further research on larger datasets is needed to better understand these disparities. [Table: see text]
Racial and ethnic disparities in hospital outcomes following hospitalizations for mastectomy for breast cancer.
Authors: Sandoval-Leon Ana Cristina , Chamorro Yolcar , Rubens Muni , Roy Mukesh , Carcas Lauren , Dempsey Naomi , Ahluwalia Manmeet Singh , Mahtani Reshma L. 
Published: May 2024

e13691 Background: Racial and ethnic disparities in breast cancer (BC) treatment and survival have been well documented. White (W) and Asian (A) women are more likely to have localized BC (BC) than Black (B) or Hispanic (H) women. Furthermore, the incidence of triple negative BC is higher in B women who also have the highest death rates from BC. In this study, we aimed to identify an association between race/ethnicity and outcomes following hospitalization for mastectomy using a large national database. Methods: This study isa retrospective analysis of the National Inpatient Sample database, the largest all-payer inpatient database in the United States, of hospitalizations between 2016-2019. Patients (pts) ≥18 years of age, admitted for mastectomy for BC were included and stratified by race/ethnicity. The outcomes of the study were in-hospital mortality rate, prolonged hospital length of stay, surgical site infection, bleeding complication, cardiac complication, respiratory complication, acute kidney injury, urinary tract infection, and wound dehiscence. Hospitalizations and outcomes were identified using ICD-10 diagnosis and procedure codes. Logistic regression analysis was done to identify an association between race and outcomes. Results: A total of 302,208 pts who were hospitalized for mastectomy were included. Of these 218,092 (72.2%) pts were W, 36,242 (12.0%) were B, 25,130 (8.3%) were Hispanics, and 22,744 (7.5%) were of another race. Among B pts, adverse outcomes were significantly higher (p<0.001), including in-hospital mortality rate (0.2%), prolonged hospital length of stay (64.1%), surgical site infection (0.8%), bleeding complication (4.2%), cardiac complication (0.8%), respiratory complication (0.3%), and acute kidney injury (1.4%). After adjusting for various factors including age, insurance, hospital region, hypertension, diabetes, obesity, peripheral vascular disease, alcohol use, Elixhauser comorbidity index, whether pts underwent axillary lymph node dissection and others, logistic regression was performed. This analysis identified that B pts had significantly higher odds for mortality (adjusted odds ratio [aOR], 2.99, 95% CI: 1.62-5.73), prolonged hospital length of stay (aOR, 1.32, 95% CI: 1.18-1.49), and bleeding complication (aOR, 1.28, 95% CI: 1.13-1.48). Conclusions: Results of our study show that adverse hospital outcomes following mastectomy for BC were significantly higher among Black patients. These outcomes remained significant after adjusting for clinical covariates, raising the possibility of other contributing factors to these differences in outcomes. Study limitations include the lack of information on stage at diagnosis, receptor status, and that Hispanics were categorized under race. Further studies are needed to develop effective interventions to reduce these disparities.
Health equity regional symposia: Convening local stakeholders to address health disparities in the US.
Authors: Moadel Alyson B. , Price-Haywood Eboni , Bell Kimberly , Halmos Balazs , Dinkins Yvette , Simpson Audrea Juny , mckenzie meghan , Alvarez Daniel , Lebantino Kristopher , Theodore Pierre , Sandoval Veronica 
Published: May 2024

e13695 Background: Health inequities among underserved populations in the U.S. are complex and derive from unequal access to quality healthcare. Addressing these disparities requires a coordinated effort among multiple stakeholders. Genentech’s Health Equity Regional Symposia Program was created to reduce healthcare disparities by convening stakeholders representing community, patient, academic, policy, and health care interests. Methods: Specific criteria were employed to identify hosting locations, including regions with documented health disparities; areas serving a significant proportion of patients of color; sites with a vested interest in engaging historically underserved and/or underrepresented communities in clinical studies; organizations that have built a trusted relationship with the community. Since 2022, 79 programs have been funded and several organizations hosted multiple events. To date, 58% of programs focused on oncology and applied a range of formats including patient panels, research posters, and interactive presentations. Symposium topics were driven by local community needs and included: cancer prevention, screening, treatment barriers, and research; social drivers of health; and mental health. For each symposium, the cultural and preferred language of attendees was considered, and active discussions were held and centered on generating actionable solutions. Results: The symposia have reached more than 11,000 attendees including an estimated 63% healthcare professionals and 37% community members/patient advocates. A diverse mix of health-focused community organizations participated representing 23 states. Building community trust was a consistent theme across the symposia. Key results reported by the hosting organizations included: in a post-event survey, attendees reported more trust in cancer research and clinical trials, and expressed increased motivation to get screened (Bronx, NY); patient educational materials were developed with input from cancer survivors on tips to stay healthy (New Orleans, LA); due to the trusted relationship with patients, primary care physicians act as a crucial gatekeeper in diagnosis and care (Memphis, TN); increased community commitments to conduct cancer screenings (Cleveland, OH). Conclusions: Through our symposia, we successfully convened influential stakeholders focused on generating tangible solutions to improve the health of their communities. This approach can serve as a model to advance patient outcomes.
Factors associated with delays in care of suspicious lung nodules at an academic medical center.
Authors: Rama Nihar , Nordgren Rachel , Husain Aliya N. , Juloori Aditya , Bestvina Christine M. , Thawani Rajat , Garassino Marina Chiara , Murgu Septimiu , Wagh Ajay , Hogarth Douglas Kyle , Barth Carrie , Bryan Darren , Ferguson Mark K. , Donington Jessica , Madariaga Maria Lucia 
Published: May 2024

e13705 Background: Shorter time to lung cancer diagnosis and treatment are associated with improved outcomes. Here, we assessed factors contributing to delays in each phase of care to identify targets for improving the timeliness of suspicious lung nodule care in a diverse patient population. Methods: We conducted a retrospective study of patients evaluated for suspicious lung nodules at an academic medical center from 2020 to 2022. Patients with presumed or proven stage I/II lung cancer were included. Patients with stage III/IV and non-primary lung cancers were excluded. Multivariable Cox regressions were performed. Results: Of 157 patients, mean age was 70±8.6 years, 59% were female, and 53% were Black. Most lung nodules were biopsied bronchoscopically (61%) or surgically (26%). Most (83%) nodules were stage I/II non-small cell lung cancer, 10.2% were benign and 4.4% were other. Treatment was surgery in 48% and stereotactic body radiotherapy (SBRT) in 41%. Median intervals were 4 (IQR 0-18) days from nodule identification to referral, 7 (IQR 3-14) days from referral to consultation, 20 (IQR 12-34) days from consultation to biopsy, 4 (IQR 2-6) days from biopsy to diagnosis, and 28 (IQR 8-43) days from diagnosis to treatment initiation. Multivariable Cox regression showed that longer time from referral to diagnosis (TTD) was associated with Black race, widowed status, and referral > 1 year from the start of the COVID-19 pandemic. Longer time from referral to treatment (TTT) was associated with female gender, widowed status, 4th Area Deprivation Index (ADI) quartile, frailty, BMI > 18.5, ECOG performance status < 2, bronchoscopic biopsy, and initial treatment with SBRT. Longer time from consultation to biopsy was associated with female gender, widowed status, frailty, no cardiovascular disease, and living >12.5 miles from the hospital. Longer time from diagnosis to treatment was associated with Medicaid, referral > 1 year from the start of the pandemic, cardiovascular disease, and SBRT. Conclusions: The longest delays in lung nodule care are associated with time from consultation to biopsy and from diagnosis to treatment. Efforts to address disparities and modifiable factors could improve the timeliness of care for patients with suspicious lung nodules. [Table: see text]
Individual and neighborhood-level factors associated with disruptions in patients with gynecologic cancers undergoing radiation treatment.
Authors: MacArthur Emily Claire , Froehlich Allison , Wethington Stephanie L. , Rositch Anne , Santos Sydney , Lewis Dana , Ferriss James Stuart , Beavis Anna 
Published: May 2024

e13713 Background: Disparities in cancer health outcomes are driven in part by social determinants of health (SDOH). Health-related social needs (HSRN) are downstream modifiable manifestations of SDOH. It is critical to identify patients with HRSN who may benefit from early intervention to improve health outcomes. Methods: We identified all patients who received radiation treatment (RT) for gynecologic cancer at an urban, academic center from January 2021-August 2023 and completed HRSN screening. HRSN screening queries patients on food, housing, transportation, and financial insecurity as well as help reading hospital materials. We extracted demographic and clinical data, self-reported HRSNs, and separately screened each chart for additional evidence of transportation insecurity. We extracted area deprivation index (ADI), a measure of neighborhood level socioeconomic disadvantage, based on home address. Any RT disruption was the primary outcome. We compared patients with and without any RT disruption using Fisher’s exact tests. Univariate Poisson regression was used to examine the magnitudes of association between individual and neighborhood level factors and RT disruption. Results: A total of 127 patients met inclusion criteria. Median age was 62 (interquartile range 25%-75%: 53-71). Most (54%, n=69) patients were White, 32% were Black (n=41), and 14% were another race (n=17). Sixteen percent (n=20) reported at least one HRSN. Six percent of patients (n=8) resided in neighborhoods in the 81st-100th percentile ADI. A total of 26% (n=33) of patients had any RT disruption, and these patients differed on individual and neighborhood factors (Table). Patients with public insurance were 2.4 times as likely to have RT disruption compared to those with private insurance (95% confidence interval [CI]: 1.4-4.2). Self-reporting at least one HRSN was associated with a 2.3 times higher risk of RT disruption (95% CI: 1.31-4.11). Chart-derived evidence of transportation insecurity was associated with a 2.6 times higher risk (95%CI: 1.5-5.6) of RT disruption. Residing in a neighborhood with an ADI above the 80%ile was associated with a 3.3 times higher risk (95% CI: 2.0-5.5) of disruption. Conclusions: A variety of measures of SDOH both at the individual and neighborhood-level were associated with RT disruptions. While we did not have the power to perform multivariate analyses, our results suggest the ADI – which can be readily obtained from a patient’s home address – could help identify those patients most at risk of disruption to care. [Table: see text]
Clinical practice guidelines for adolescent and young adult cancer: A literature review.
Authors: Atway Rayann , Ritzwoller Dawn , Moreton Elizabeth , Haines Emily Ruth , Thom Bridgette , Lux Lauren , Smitherman Andrew Brian , Stein Jacob Newton 
Published: May 2024

e13727 Background: Cancers among adolescents and young adults (AYA, aged 15-39) are rising in incidence, yet formal guidelines for diagnosis, treatment, and management of AYA-specific cancers are not widely known or disseminated. Practice patterns vary widely, contributing to a lack of improvement in outcomes for this underserved population. Clinicians and health systems have reported a need for additional guidance in care delivery for AYAs. Methods: We conducted a comprehensive literature review to identify clinical practice guidelines for cancer care delivery specific to AYAs published in PubMed or MEDLINE since 2010. MeSH and other key words were applied, using a search strategy guided by a health science librarian (EM). 795 papers were identified, with 690 excluded based on title and abstract review. 105 papers underwent full text review, and 64 papers underwent complete data extraction. Using Covidence software, two team members independently reviewed articles at the data extraction phase, with disagreements resolved through discussion. Results: We identified 22 papers that met our inclusion criteria as clinical practice guidelines specific to AYA cancer care. Clinical focus included breast cancer (4), sarcoma (4), brain tumors (2), gynecologic malignancies (2), acute lymphoblastic leukemia (1), colorectal cancer (1), NUT carcinoma (1), and proton therapy (1). Six papers covered general principles of caring for AYAs, regardless of cancer diagnosis. Key themes across guidelines included the importance of fertility preservation and psychosocial support, multidisciplinary care provided at specialized centers, and consideration of long-term toxicities of treatment. Conclusions: Clinical practice guidelines exist to inform clinicians and health systems on best practices for caring for AYAs with cancer, a growing and underserved population. Further dissemination of these guidelines may assist with improving outcomes. Comprehensive summary of these and other AYA specific guidelines is forthcoming and may serve as a useful clinical reference. [Table: see text]