bluuebunny/crossref_metadata_2025_split huggingface dataset:
An analysis of the trends and distribution of political contributions from hematologists and oncologists in the United States.
Authors: Waris Shanawar Ali , Siva Nanda , Waris Imtisaal , Saifuddin Adnan , Dasu Sriram , Safi Salah Ud Din 
Published: June 2024

e23041 Background: In today's increasingly tumultuous political landscape, understanding how healthcare providers are engaging the system to contribute to shaping the future of healthcare policy has become increasingly important. Policy can directly influence funding priorities, research agendas, and regulations for providers. This cross-sectional study aims to assess political contributions made by hematologists and oncologists across the United States from 2009-2022. Methods: Political donations to the U.S. Presidential, Senate, and House of Representatives campaigns made by hematologists and oncologists between 2009-2022 were collected from the Federal Election Commission database. Keywords used in the occupation search query were “oncologist”, “hematologist”, “oncology”, and “hematology”; the raw data was filtered to remove non-physicians. Each individual contribution was addressed to a recipient committee, which were characterized as “Democratic”, “Republican”, or “Independent”. Results: From 2009 to 2022, a total of 2889 contributions were made by hematologists and oncologists to campaigns for presidential and national legislative campaigns grossing a total of 1,324,397 with a mean donation value of $458 per contribution. Of campaign contributions, 68% ( $905,388), 31% ($405,257), and 1% ($13,751) went to democratic, republican, and independent campaigns respectively. The total number of contributions increased from 77 totaling a sum of $48,902 in 2009 to 203 totaling a sum of $107,281 in 2022. Republicans experienced an increase in total dollar amount of contributions of 9.42% from 2009 to 2022. The top five states with the highest contributions in dollar amount were California, Texas, Maryland, Florida, and Georgia, in descending order. Conclusions: The total political contribution amount made by hematologists and oncologists in the United States has increased from 2009 to 2022. Further investigation of how physician contributions influence the development and implementation of healthcare policies is imperative.
Disparities by sex in Hispanic patients with cutaneous melanoma: A national database analysis.
Authors: Mishra Anjali , Taylor Mitchell , Ituarte Bianca , Clausen Michaela , Barett Erin 
Published: June 2024

e23045 Background: Melanoma is the fifth most common form of malignancy in the United States.1 Studies have established that Hispanic patients have worse melanoma-specific survival compared to non-Hispanic White individuals.2 However, there is a paucity of literature investigating sex differences in patient characteristics and outcomes within Hispanic melanoma patients. Thus, the aim of this study is to further examine sex differences in melanoma characteristics and disease-specific survival within Hispanic patients. Methods: Individuals of Hispanic descent diagnosed with microscopically confirmed cases of cutaneous melanoma (ICD-O-3 codes 8720/3-8780/3; Primary Site codes C44.0-C44.9) between 2000 and 2020 were identified through the Surveillance, Epidemiology, and End Results (SEER) database. Statistical analyses involved Chi-squared tests, Kaplan-Meier and log-rank methods, and multivariate Cox regression, with significance set at a p-value < 0.05. Results: In a cohort of 12,328 Hispanic melanoma patients (43.3% male, 56.7% female), a significant association between sex and age was found (p < 0.001). The greatest proportion of males were in the 60-79 age group (39.7%), while females were predominantly in the 40-59 age group (39.0%). Greater number of males had truncal melanomas (31.4%) compared to females having lower extremity melanomas (35.2%) (p < 0.001). Females exhibited higher rates of localized disease (80.3% vs 70.2%) while males were more frequently diagnosed with regional (18.5% vs 13.8%) and distant disease (11.3% vs 5.9%) (p < 0.001). Males demonstrated greater mean Breslow thickness (1.80 vs 1.44; p < 0.001), elevated rates of lymph node positivity (37.2% vs 27.2%; p < 0.001), and metastatic disease (2.8% vs 1.6%; p < 0.001). On univariate Kaplan-Meier analysis, males demonstrated significantly reduced disease-specific survival (182.9 months) compared to females (214.2 months) (p < 0.001). After adjusting for age, disease stage, annual income, rural vs urban residence, and primary tumor site, male sex independently increased disease-specific mortality compared to females (HR = 1.31; 95% CI 1.16-1.48; p < 0.001). Conclusions: Our investigation reveals that Hispanic males tend to receive melanoma diagnoses at older ages, advanced-stage disease, and primarily on the trunk.3 Furthermore, our study is the first to highlight a significantly reduced disease-specific survival in males compared to females. The observed sex differences may arise from a complex interplay of behavioral factors and immunological, hormonal, or genetic influences.4 Men exhibit a lower likelihood of engaging in skin self-examinations and seeking medical assistance. Limitations to this study include use of data reported through a national database. Nonetheless, this study underscores the significance of sex-specific variations in presentation and disease-specific survival among Hispanic patients.
Thromboembolic incidents in prostate cancer patients: A nationwide propensity-matched study.
Authors: Devarkonda Vishal , Ali Shafaqat , Kumar Manoj , Farooq Faryal , Byreddi Laxman Yashwant , Sultan Muhammad , Afzal Muhammad Sohaib , Nasir Bilal , Atluri Sundeep 
Published: June 2024

e23082 Background: Venous thromboembolic events (VTE) are a major cause of morbidity and mortality in cancer patients. We aim to investigate the outcome and incidence of acute DVT and PE in prostate cancer compared to all other malignancies. Methods: The National Readmission Database (2016-2020) was utilized to identify all-cause admissions for patients with a history of prostate cancer. A Propensity Score Matching (PSM) model, matched such patients with subjects having any type of other malignancies. Pearson’s x2 test was applied to the PSM-2 matched cohorts to compare outcomes. Results: Among 3.2 million all-cause hospitalizations of prostate cancer patients, about 3.3% suffered a VTE. The majority had acute DVT (1.6%), followed by PE (1.1%) & DVT with PE (0.6%). On a propensity-matched & multivariate analysis, patients with prostate cancer have a lower incidence of acute PE (1.1% vs 1.9%, aOR: 0.57), DVT (1.9% vs 2.8%, aOR: 0.65) & combined DVT with PE (0.6% vs 1%, aOR: 0.62) [p < 0.001] as compared to other malignancies. Among different VTEs, the mortality was highest for Acute PE (aOR: 2.69), followed by DVT with PE (aOR: 1.68) & DVT (aOR: 1.55) [p < 0.001] in prostate cancer. Resource utilization is also higher in prostate cancer hospitalizations complicated by VTE, with patients suffering a DVT having the highest LOS (9 vs 3 days) & total cost of hospitalization ($20,425 vs $14,452) [p < 0.001] followed by DVT with PE and only PE [p < 0.05]. Interestingly, patients with DVT have higher readmission rates as compared to PE at 30 days (16.6% vs 13.5%, p < 0.001) and subsequently at 90-day intervals. Conclusions: The odds of venous thromboembolism were lower in prostate cancer when compared to all other patients with active cancer. The mortality was highest for PE in this cohort, while healthcare-related burden and readmission rates were higher for DVT. [Table: see text]
Employing machine learning (ML) and explainable artificial intelligence (XAI) to predict and explain suicidal ideation among patients with prostate cancer.
Authors: Poolakkad Sankaran Satheesh Kumar , Mohan Minu , Epstein Joel Brian , Pili Roberto 
Published: June 2024

e23086 Background: It is anticipated that implementing machine learning (ML) strategies will impact the clinical decision-making process in the future. This study aimed to compare the accuracy of various machine learning algorithms in predicting suicidal ideation in patients who were receiving treatment for prostate cancer (PC). Further, to predict suicidal ideation and explain the burden of illness (BOI) by utilizing ML algorithms and XAI-based interpretability. Methods: We analyzed the United States 2017 National Inpatient Sample database for patients hospitalized for PC using linear and non-linear ML methods. Using techniques such as forward selection (FS) and backward elimination (BE), Random Forest (RF), decision trees, Multivariate Adaptive Regression Splines, and Gradient Boosting Machine (GBM), we determined subsets and features. We used linear and non-linear MLs-- Lasso, Ridge, RF, and Neural Networks (NN). A 70% and 30% partitioning was performed on the training and test datasets. The performance of the model was tested using discrimination (C-statistics), the Receiver-Operating Characteristics (ROC) curve, and the Hosmer-Lemeshow tests on both the training data and the test data. Several XAI approaches, including permutation significance, global surrogate marker, feature interpretation, interactivity, and local interpretability, were also utilized to examine the BOI (Length of stay (LOS)) among PC cancer cohort with suicide ideation. Results: We identified 680 patients with suicidal ideation among 208,730 PC patients. The most important variable derived through FS and BE were depression, drug abuse, psychiatric disorder, alcohol dependence, race, Medicaid beneficiaries, cardiac arrhythmias, metastasis, weight loss, congestive heart failure, and un-complicated hypertension, further confirmed through the GBM and other methods. There was successful documentation of demographic, socioeconomic, and clinical characteristics through feature selection approaches. Linear models, Lasso, and Ridge demonstrated an excellent area under the ROC for all cohorts ( > 0.9 in train and test datasets). On the other hand, tree-based models, such as RF, performed poorly (AUC 0.72 for train and 0.66 for test). The findings of the XAI methodologies showed that among PC suicide ideation, higher BOI was associated with patients staying in low-income neighborhoods, Whites, Medicaid beneficiaries, and those with weight loss. Conclusions: We showcase the increasing capability of predictive analytics, particularly XAI, in predicting suicidal ideation. The combination of the vast amount of data generated by the digitalization of healthcare systems with the advanced processing power of modern servers enables the development of machine learning-based care pathways, which has the potential to revolutionize clinical decision-making in cancer.
Investigations of the quality of fertility preservation education provided to patients with cancer at a large community hospital.
Authors: Zhao Chelsey ShengQi , Fenech Melissa , Miklas Maegan , Ntienjem-Sherwood Isidora , Hamm Caroline M. 
Published: June 2024

e23087 Background: Infertility is a challenge many young cancer patients face as a consequence of aggressive treatments. Moreover, many eligible patients do not receive discussion about their fertility, and even fewer obtain referrals to fertility specialists. The goal of the investigation was to examine the frequency and quality of fertility preservation education provided to eligible patients at the Windsor Regional Cancer Program (WRCP). Methods: The first part of the investigation involved a retrospective chart review which identified 203 patients that presented to the WRCP between January 15, 2018 to January 15, 2020 under the age of 40. Amongst these patients, we identified 54 patients that were eligible for fertility preservation. These 54 patients were contacted to participate in the survey and we received 11 responses. The survey data collected include demographics and experience with fertility preservation. The data were analyzed using University of Windsor RedCap. Windsor Regional Hospital REB approval number: 22-426. Results: The retrospective chart review revealed that 34% of the 54 eligible patients did not receive documented fertility preservation counseling. Amongst the survey respondents that had fertility preservation discussions, 86% (6 patients) cited that it was initiated by a healthcare provider. In addition, we found that only 27% (3 patients) of survey respondents were interested in pursuing fertility preservation. The reasoning cited most often included not wanting children, already had children, and barriers such as finances, time and effort to pursue fertility preservation and fear of delaying fertility preservation. Moreover, the 3 survey respondents successfully pursued fertility preservation in the form of sperm collection (2 patients) and freezing eggs/embryos (1 patient). Conclusions: We identified the need to improve standardization of fertility preservation education in eligible patients. Moreover, we found that few patients desired fertility preservation. Although this is a small number of patients, providing appropriate fertility education is essential in cancer survivorship. Our next steps include piloting and implementing an improved fertility education program.
Access to and equity in cancer clinical trials in Oregon.
Authors: Oyogoa Emmanuella , Crespo Michael , Marsh Trisha , Castro David , Mayer Kathleen , Turk Eliana , Shannon Jackilen , Nemecek Eneida R. 
Published: June 2024

e23100 Background: Approximately 20,000 people per year are diagnosed with cancer in Oregon. The OHSU Knight Cancer Institute is the only academic cancer center in the state, with the nearest center located almost 200 miles away. Clinical trials (CT) are essential for cancer care but only a small proportion of eligible people participate due to multiple factors. In this retrospective study, we identified the association between sociodemographic factors and cancer CT participation at OHSU. Methods: Adult patients referred to OHSU for evaluation and treatment of a new cancer 2019-2022 were included. Data collected included age, gender, race/ethnicity, zipcode, insurance, type of cancer and CT participation. Zip-codes were used to estimate poverty level as defined by the American Community Survey, rural vs. urban location and distance to the cancer center. Multivariate analysis was conducted to identify factors associated with CT participation. Results: A total of 14,261 patients with median age 65 (18-101) years were treated at OHSU from 2019-2022 (86% for solid tumors, 14% hematologic malignancies). Of these, 53% were > 65yrs, 51% male and 8.5% self-identified as non-White (including Hispanic). These numbers are similar to those reported in the statewide cancer registry. About 61% of those < 65 yrs were privately insured, 84% of those > 65 yrs had Medicare, and 31% were from areas at or below the national poverty level. About 40% lived > 30 miles from OHSU (29% > 60 miles, 14% > 120 miles) and 31.5% lived in rural areas. A total of 2134 patients (15%) participated in cancer CT (8% interventional, 6% interventional therapeutic and 10% noninterventional). Factors independently associated with decreased CT participation on multivariate analysis included age > 65yrs regardless of type of insurance, < 65yrs with public insurance, female, racial/ethnic minority, solid tumor diagnosis and cancer care at a community-based clinic (Table 1). Conclusions: Patient with cancer treated at OHSU are representative of the population in our catchment area and region. However, there is room to improve access and CT participation for older adults and persons from racial/ethnic minorities and disadvantaged backgrounds. Our study highlights the importance of understanding the catchment area and accounting for social determinants of health when implementing community outreach strategies for CT participation. [Table: see text]
Disparities in gynecologic oncology clinical trial availability in the United States: A state-level analysis.
Authors: Ko Emily Meichun , Tubridy Elizabeth , Spataro Solorzano Sebastian , Simpkins Fiona , Smith Anna Jo Bodurtha , Boland Mary 
Published: June 2024

e23128 Background: Disparities in minority participation in gynecologic cancer clinical trials is well documented. FDA guidance stipulates geographic informed analyses to reduce barriers to trial participation. We performed a geographical analyses of gynecologic cancer clinical trials in the United States relative to racial distribution and social vulnerability indices to identify areas of increased need. Methods: We performed a cross-sectional analysis of NIH ClinicalTrials.gov by retrieving all trials first posted 1/1/2013 through to 1/10/2024. We searched for ovarian, uterine, cervical, endometrial, vaginal/vulvar and gynecological cancer. We reviewed enrollment criteria to exclude non-gynecological cancers (1643 trials) or non-invasive gynecological conditions (224 trials). We aggregated census data, state-level total population size, percent Non-Hispanic White (NHW), and the FEMA Expected Annual Loss per state as a measure of social vulnerability. Using R statistical software (v 4.3.1), we measured the association between these variables and the number of gynecological trials per 100,000 persons using Pearson’s correlation. Results: We identified 3,428 trials, filtered down to 1,561 invasive cancer trials. The most common trials were ovarian (911, 58.3%) and cervical (438, 28.0%), followed by endometrial (385, 24.6%), uterine (158, 10.1%), vulva-vaginal (78, 4.99%), and 7.62% genetic-based. Texas had the highest number of trials (501) followed by California (454) and New York (427). The state with the highest population-adjusted number of trials was South Dakota (8.57 trials per 100,000 persons), followed by Rhode Island at 8.38 per 100,000 persons. California, Mississippi, and Puerto Rico had the lowest number of trials per 100,000 persons with 1.148, 0.979, 0.466 respectively. States/territories with greater than 4 trials per 100,000 were comprised of populations that were > 50% NHW. The correlation between the state-level percentage of NHW in 2020 and the number of trials per 100,000 persons was p = 0.057 indicating that there was a correlation between Whiteness at the state-level and trial availability. We found that states with higher FEMA expected annual loss had lower numbers of gynecological trials per 100,000 persons (p < 0.001). Conclusions: We found a disparity in the geographical distribution of trials available for gynecological cancers that was correlated with racial disparities and social vulnerability. Efforts to increase decentralization of trials and improve access and availability of gynecologic cancer clinical trials are necessary to increase equity for minority representation in clinical trials at the national level.
Evaluation of clinical adherence measures for oral oncolytics: A systematic review.
Authors: Lee Eugene , Klos Laura , Zhong Rui , Carlson Rebecca , Dark Erin , Muluneh Benyam 
Published: June 2024

e23130 Background: Despite the critical importance of adherence monitoring for oral oncolytics, there are no standard measures for clinical practice. Methods: We conducted a systematic review using 4 databases aiming to characterize validated adherence monitoring tools utilized in either pre-implementation or evaluation of clinical programs. Various Medical Subject Headings (MeSH) and other search terms related to cancer, oral oncolytics, adherence, metrics, and outcomes were included. Measures used only for research (outside of clinical use) were excluded. Two independent reviewers screened articles with a third reviewer resolving discrepancies. Data extraction and quality assessments concluded the review. Results: Out of 751 screened articles, 73 proceeded to full-text review, with 6 selected for data extraction and quality assessment (Table 1). Two studies focused on the Morisky Medication Adherence Scale-8 (MMAS-8) tool, while others examined Michigan Oncology Quality Consortium Patient Reported Outcome Measure (MOQC PROM), 6-Item Girerd Scale, Medication Adherence Self-Efficacy Scale (MASES), and EXPeriencia con y ADherencia a AntiNEoplasicos Orales (EXPAD-ANEO). Among the five tools, MASES featured the most questions (24). All tools were implemented by healthcare professionals. Girerd and MASES were used specifically in hematologic and solid tumor populations respectively, whereas the remaining tools were applied in both cancer types. MMAS-8 and MASES were employed to evaluate current clinical programs, while MOQC PROM, Girerd, and EXPAD-ANEO were used during pre-implementation for future programs. Common biases from studies included limited generalizability, patient self-reported adherence credibility, and variability in patient baseline characteristics. Conclusions: Our findings highlight the paucity of validated adherence monitoring tools in clinical practice. The five tools discussed above exhibit potential in measuring adherence in a clinical setting; however, small sample size and short duration limit generalizability. Further investigation of new and existing tools in broader settings is needed. [Table: see text]
Evaluating the impact of depression on self-reported quality of life measurements for patients with a history of cancer: A 2022 behavioral risk factor surveillance system questionnaire study.
Authors: Ward Erin Patricia , Sood Divya 
Published: June 2024

e23131 Background: Patients with cancer are known to have higher rates of depression than the general population. Depression is known to impact cancer-specific outcomes. We aimed to understand if a history of depression for patients with a history of cancer impacts self-reported quality of life measurements. Methods: We identified patients with a history of cancer and patients with a history of depression using the 2022 phone based Behavioral Risk Factor Surveillance System Questionnaire. The demographics and reported outcomes for several quality-of-life questions, including perceived emotional support, social isolation, cancer-related pain, memory, and ability to complete daily activities independently, were compared using a Chi-Square analysis. Results: Of the 441,339 patients over the age of 18 who completed the 2022 survey, 72,765 (16%) reported a history of cancer, and 90,489 (21%) reported a history of depression. Of those patients who reported a history of cancer 72,443 (99.6%) answered if they had ever been diagnosed with depression, and of these 14,987 (21%) reported a history of depression. Compared to patients with cancer alone, patients with a history of cancer and depression were younger (10% vs. 4% under the age of 45, p < 0.001), less often married (45% vs.59%, p < 0.001), more likely to be in the lowest income bracket (8% vs. 3%, p < 0.001), more likely to be obese (36% vs. 26%, p < 0.001), and more often active smokers (16% vs. 7%, p < 0.001). Several quality-of-life questions were asked of the participants, although not everyone answered each question. Overall, among patients with cancer, patients with a history of depression were more likely to report > 14 poor mental health or physical health days (35% vs. 6% and 34% vs. 14%, respectively, p < 0.001) and more likely to report their general health as fair or poor (41% vs. 21%, p < 0.001). Cancer patients with depression were less likely to report always having the social or emotional support that they need (33% vs. 55%, p < 0.001) and more likely to report always or usually feeling socially isolated (17% vs. 5%, p < 0.001). Cancer patients with depression were more likely to report pain associated with their cancer (16% vs. 7%, p < 0.001) and five times as likely to report issues with making decisions and memory (31% vs. 6%, p < 0.001). Finally, patients with depression were also more likely to report an inability to run errands alone (21% vs. 7%) and report difficulty getting dressed or bathing (12% vs. 4%, p < 0.001). Conclusions: Among people with a history of cancer, those with a history of depression are more likely to report worse physical and mental health, report worse social and emotional support and report less independence in activities of daily living. Further work is needed to understand the complex interactions between depression and quality-of-life measures for cancer patients.