bluuebunny/crossref_metadata_2025_split huggingface dataset:
YouTube as a reliable source of information on bispecific antibodies (BsAbs): A qualitative analysis.
Authors: Garg Tulika , Karass Susan Hosny , Singh Navpreet , Krishnakumaran Nithya , Sukaina Mahnoor , Kaur Suhana Preet , Kutheala Nikhil , Jain Rajat , Chahal Rutvi , Khosla Atulya Aman , Singh Rohit , Ahmed Shahid Sattar , Jatwani Karan 
Published: October 2023

322 Background: YouTube is an open-access source of information. It has more than 2.5 billion users. It can play a pivotal role in educating or misinforming our cancer patients. Emerging therapeutics like BsAbs have changed the treatment paradigm for cancer over the past decade. There is scarce data to evaluate the quality of information on BsAbs uploaded on YouTube. We aim to assess the quality and engagement parameters of the most viewed videos on YouTube. Methods: A systematic search was conducted on YouTube using the search terms (“bispecific antibodies” AND “cancer”). The 70 most viewed videos were selected only in the English language. We utilized the already validated PEMAT and DISCERN tools to assess the quality of these videos on BsAbs. Additionally, we looked at the number of views, comments, and likes. Descriptive statistics and Pearson correlation tests were performed using R studio v2022.12.0-353. Results: The videos in our study had up to 50,000 views (, and the overall quality of information was poor (46.38%). These videos were categorized into different sources academic (61%), media (14.5%), and commercial (24.5%). Only 27.5% of videos discussed the benefits, 17% discussed the risks, 8.7% discussed the effect on the quality of life (QoL), and 11% discussed shared decision-making. Financial barriers were discussed only in 4% of the videos, whereas the availability of the drug was discussed in 11% of the videos. Regarding side effects, 32% of videos mention cytokine release syndrome, while 20% mention neurological toxicity. The mean DISCERN score for the videos was 41.2. A significant trend of increased DISCERN and PEMAT scores was noticed with the increasing length of the videos. Conclusions: This is the first study to evaluate the quality of information on BsAbs on YouTube. This study highlights the poor quality of information available on YouTube; these videos are less likely to discuss the risks, effects on QoL, and shared decision-making. Further efforts are needed to improve the quality and engagement of these videos based on the validated scales.[Table: see text]
The transition tightrope: Optimizing post-discharge care for acute leukemia patients.
Authors: Garrigues Sarah K. , Hansen Jennifer , Settlemire Jillian , Dugala Anisia , Bergman Debbie , Conte Michael , Roy Mohana 
Published: October 2023

323 Background: Patients with acute leukemia who are discharged after a hospitalization are at high risk of complications and increased risk of readmissions. We reviewed discharge plans at an academic cancer center and found a gap of inconsistently scheduled follow-up appointments after discharge, and we sought to improve the transition of care for this population. Methods: Utilizing A3 methodology, we focused on ensuring acute leukemia patients had a follow-up visit in the clinic or infusion treatment area within 5 days of discharge, which was the timeline supported by literature review. Our improvement team performed a Gemba walk in November 2021 to observe discharge planning and outpatient follow-up appointment scheduling processes, and we mapped root causes of poor care transitions on a fishbone diagram. Many of the coordinated steps required for a seamless discharge and acceptance into outpatient care were not consistently performed. We utilized a pareto chart to stratify root causes and narrowed in on 3 key drivers: 1) standard process for discharge communication between in- & out-patient teams; 2) access to schedulers to secure appointments; and 3) escalation pathways when no appointment slots were available. We introduced 3 interventions: a direct phone line for the inpatient team to contact the infusion area schedulers for post-discharge appointments, an escalation pathway when schedules appeared fully booked, and a discharge navigator flowsheet in our electronic medical record (EMR) to anticipate discharge needs and facilitate standardized, efficient communication. Results: As a result of our interventions, the percentage of patients with an outpatient follow-up visit within 5 days increased from 61% to 94% between January and May 2022. Streamlining communication pathways (e.g., an automated EMR message to schedulers and a direct phone line for urgent escalation) led to initial improvements in timely follow-up visits. The EMR discharge navigator facilitated upstream identification of post-discharge needs and directed communication to the appropriate infusion area and clinic pools to schedule appointments. The discharge navigator continues to be used in the hematology service; one year after its launch, the EMR tool is utilized in 38% of all hematology discharges. Conclusions: Timely outpatient follow-up to address acute symptoms is a key method to decrease readmission risk, but inconsistent scheduling practices presented barriers at our cancer center. Instituting standardized scheduling protocols in the EMR and escalation pathways enabled nearly all our patients with acute leukemia to secure outpatient visits within 5 days of discharge. We are building on these initial efforts to disseminate and sustain utilization of the tool for all hematology and oncology patients in our center.
Associations of self-advocacy and perceptions of care coordination among rural patients with early-stage cancer.
Authors: Okado Izumi , Chang Shin , Liu Michelle , Wilkens Lynne , Holcombe Randall F. 
Published: October 2023

329 Background: Effective care coordination (CC) is an essential component of high-quality, patient-centered cancer care; however, many rural cancer patients experience significant CC-related challenges. For rural patients, one’s ability to self-advocate for their cancer care-related needs may play an important role in CC. To date, little is known about self-advocacy and care coordination in rural cancer patients. In this study, we examined associations between patient-reports of self-advocacy and CC among rural patients with early-stage cancer. Methods: 31 patients with early-stage (I-III) cancer completed the self-advocacy and care coordination questionnaires in 2021-2022. Participants were receiving active treatment and residing in rural areas of Hawaii at time of survey completion. Levels of self-advocacy were measured using the adapted Female Self-Advocacy in Cancer Survivorship Scale (FSACS; Hagan et al., 2018). The FSACS assesses overall self-advocacy and includes three subscales, Informed Decision Making, Effecting Communication, and Connected Strength. The validated Care Coordination Instrument (CCI) was used to assess patients’ perceptions of CC. The CCI assesses overall (total) and three CC domains, Communication, Navigation, and Operational. Pearson’s correlation analyses were conducted to examine associations between self-advocacy and CC. Results: Mean age of participants was 58.6, and 64.5% were female. The most common cancer types were breast (41.9%) and GI (32.3%). Overall, the total self-advocacy scores were positively associated with the total CCI and Operational domain scores ( r = .39 and .41, p < .05). Informed Decision Making and Effective Communication subscale scores were also positively correlated with the total CCI and CC domain scores ( r = .682-.945, p < .001). Connected Strength subscale scores were not associated with CCI scores. The presence of a patient navigator was associated with higher self-advocacy scores ( p = .011). Conclusions: Our findings indicate that higher levels of self-advocacy are associated with better perceptions of care coordination among rural patients with early-stage cancer. Conversely, patients with lower levels of self-advocacy report poorer CC and are less likely to present with a patient navigator. These findings suggest that interventions to enhance self-advocacy skills may be a potential strategy to improve rural patients’ CC experiences.
Impact of audio-visual tool on patient comfort level at a comprehensive cancer center infusion suite: Preliminary results.
Authors: Cheeti Apoorva , Hashemi-Sadraei Neda , Okino Candy , Cox Andrea , Kittson Ronald , Tawfik Bernard , Dayao Zoneddy R. , Crozier Nick 
Published: October 2023

348 Background: Patients receiving chemotherapy often experience anxiety which may result in dissatisfaction with care and decreased adherence to treatment, subsequently leading to unfavorable outcomes. Patient education is shown to ameliorate the anxiety and improve patient comfort. However, retention of information by patients may be sub-optimal in this setting and utilization of multiple information sources may enhance patient recall. We hypothesized that a short “welcome video” on what to expect at an infusion visit, in addition to nursing- patient education would improve patient comfort level. Methods: We conducted a single center prospective pre-post study at the University of New Mexico Comprehensive Cancer Center (UNMCCC) to evaluate the impact of an educational audio-visual tool on the comfort level of patients. An introductory welcome video was developed and made available on: (i) the UNMCCC website (ii) on iPads All patients receiving infusions are asked to complete a survey prior to their infusion. In the phase 1 patients completed surveys prior to the “welcome video” being released. In the phase 2, the video has been introduced. We plan to compare the comfort level of the two populations before and after the video release. Study was reviewed and approved by University of New Mexico Health Sciences IRB. Results: In the first phase, 43 patients completed the survey. Overall, patients felt to have a good understanding of what to expect on their infusion day (average score - 8.9/10), felt somewhat nervous (average score: 3/10), and were interested to learn more about treatment side effects (average score: 5/10), on the 10-point Likert scale (1- strongly disagree, 10- strongly agree (table 1). In the phase 2, preliminary data collection on 40 surveyed patients showed that only 15% (6/40) watched the welcome video. Strategies planned to enhance access including a text message link to the video at patient registration are being implemented as we continue to collect phase 2 survey results. Conclusions: At our center, patients already demonstrate a strong sense of comprehension regarding what to anticipate on their infusion day, primarily through nursing-patient education. Our goal is to further enhance their understanding by improving the delivery of our welcome video and refining the survey questions to yield more informative insights.[Table: see text]
Interdisciplinary implementation of a synoptic reporting template for melanoma nodal surveillance ultrasound.
Authors: Montgomery Kelsey B. , Duncan Zoey , Holder Ashley M. , Burgan Constantine , Galgano Samuel J. , Broman Kristy Kummerow 
Published: October 2023

35 Background: As nodal surveillance is increasingly used for sentinel lymph node positive (SLN+) melanoma following the Second Multicenter Selective Lymphadenectomy Trial (MSLT-II), availability of high-quality nodal surveillance ultrasonography (U/S) has become a critical need. Based on MSLT-II, U/S criteria concerning for nodal recurrence should be evaluated to determine indication for lymph node (LN) biopsy. We previously demonstrated low utilization of MSLT-II criteria for reporting nodal U/S at our tertiary cancer center, diminishing the clinical utility of these reports. Working in an interdisciplinary team of surgeons and radiologists, we aimed to implement and evaluate a synoptic reporting template for melanoma nodal ultrasound at our institution. Methods: Patients undergoing melanoma nodal surveillance at a tertiary cancer center from July 2017 to June 2023 who received at least one nodal U/S were identified retrospectively. Reporting language from each U/S was analyzed for number of MSLT-II criteria reported and presence of clinically actionable recommendations for the referring surgical team (e.g. normal LN appearance or abnormal LN with recommendation for biopsy or observation). The synoptic report was designed collaboratively by a group of radiologists and surgical oncologists to include MSLT-II U/S criteria and thresholds for biopsy versus continued surveillance, with the institutional U/S dictation template revised accordingly. Dissemination to clinical teams was conducted and utilization was monitored in the course of clinical care. Following implementation of the synoptic template in January 2023, post-implementation adherence and outcomes were reviewed. Descriptive statistics and bivariate analysis were performed. Results: 337 nodal U/S studies were performed on 94 SLN+ melanoma patients, with a median of 2.5 U/S per patient (range 1 to 12). Forty-two U/S (12.5%) were performed in the post-implementation period and eligible for synoptic reporting; of these, 32 (76.0%) were reported with the synoptic template. The mean number of MSLT-II criteria reported was greater post-implementation (Pre 0.5 ± 0.8 vs Post 2.5 ± 1.0, p<0.001). Abnormal findings were reported in 73 U/S (21.7%), with a significant increase in the proportion of clinically actionable recommendations for abnormal findings reported in the Post versus Pre group (93.0% vs 64.0%, p=0.037). Conclusions: Following the implementation of a collaboratively designed synoptic reporting template for melanoma nodal U/S, reports were much more likely to have MSLT-II criteria reported in addition to an actionable recommendation. There was notable improvement when ultrasounds had abnormal findings, when the application of these reporting criteria is most crucial. Further iterative improvement to increase adherence to the synoptic report and dissemination to other cancer centers is ongoing.
Cancer care in the context of COVID-19.
Authors: Cohn Eliza Brumer , Nelson Judy , Kreizenbeck Karma L. , Kestner Shannon , Hempstead Bridgette , Slim Jennifer Nadine , Ramsey Scott David 
Published: October 2023

359 Background: The COVID pandemic increased mental health challenges for cancer patients, overburdened oncology providers, and exacerbated health disparities. Using focus groups, this study aimed to understand the impact of COVID on people with cancer from underserved communities in WA state. Methods: In 4 focus groups (English and Spanish) people diagnosed with cancer from March 2020 or later in WA state were asked about their treatment, mental health, COVID testing and vaccine experiences, finances, and bias and racism during the pandemic. Focus groups included individuals with a cancer diagnosis in specific communities: Black and African American (n=8), English-Speaking Hispanic/Latinx (n=5), Spanish-Speaking Hispanic/Latinx (n=5), and Rural (n=4). Transcripts were analyzed using conventional content analysis in Dedoose 9.0. Initial coding used notes from preliminary data review. Codes were combined, deleted, and added during subsequent coding. Data was exported and themes were developed. Results: Several themes emerged from the discussions. See table. Conclusions: Cancer patients in WA State reported increased difficulties with navigating hospital policies, mental health, racism during treatment and at work, and economic stress during COVID. Some identified emotional support from family and community as mitigating factors. Feedback from the groups confirmed the need to prioritize mental health and social needs of people with cancer. Future research is needed on interventions to address such needs among individuals with cancer.[Table: see text]
Barriers to engagement of patients in medication reconciliation.
Authors: Hack Saidah , Powis Melanie Lynn , Ali Anum , Dara Celina , Macedo Alyssa , Kukreti Vishal , Krzyzanowska Monika K. 
Published: October 2023

362 Background: Medication reconciliation (MedRec) is a process where a detailed medication list is compiled and reviewed with an appropriate health care professional for completeness and drug-drug interactions, then communicated across all of the patient’s healthcare teams. While effective MedRec can minimize the risk of adverse events, uptake in outpatient oncology can be poor. Engagement of patients and caregivers in collection of medication lists through patient portals has been suggested as a potential change idea to improve uptake. To understand barriers and facilitators of patient engagement in the MedRec process through an electronic patient portal we undertook semi structured interviews in a comprehensive cancer center in Ontario, Canada. Methods: Patients in outpatient oncology clinics and chemo-daycare waiting areas were approached to participate in interviews; as we wished to understand barriers both users and non-users of the medication list feature of the patient portal were eligible to participate. Participant recruitment continued until saturation of data was reached. Interviews were carried out virtually following a semi-structured guide between 08/2022 and 12/2022. Interviews were recorded and transcribed verbatim; thematic coding was completed in NVIVO by two members of the study team. Results: A total of 10 patients participated in interviews; participants ranged in age between 30 to 89 years, and all completed post-secondary education. Patients’ emphasized issues with provider/care team communication expressing it was unclear why they were asked to enter medications and did not know if anyone was reviewing the medications entered. Additionally, patients had a fear of inputting erroneous medications resulting in their overall avoidance to use the portal. Portal features such as the use of generic vs trade name medications created lack of clarity for patients when entering medications into the system. Presently, the language is limited to English which may reduce the number of users. Accessibility issues such as font size and overall layout, especially on mobile devices were noteworthy during interviews. Patients recommended the addition of the following features: refill information including requests, medication reminder features via text/email and linkable medication information. Conclusions: Our findings indicate that although patients are using the portal to upload their medication lists, there are technical and systemic improvements that can be made to increase patient usage. In addition to updates to the patient portal to create added value to patients, and improve comprehension and accessibility, patient education is needed to raise awareness of the importance of MedRec and their role in the process and improve buy in.
Leveraging electronic patient-reported outcomes collected at six cancer centers to identify symptom clusters across the first four weeks of chemotherapy.
Authors: Pozzar Rachel A. , Tramontano Angela , Cronin Christine , Hassett Michael J. , Schrag Deborah , Osarogiagbon Raymond U. , Hazard-Jenkins Hannah W. , Bian Jessica J , Wong Sandra L. , Dizon Don S. , Wright Alexi A. 
Published: October 2023

366 Background: Symptom clusters are groups of two or more related concurrent symptoms. Interventions that target symptom clusters may be more efficient than those which address individual symptoms, yet few studies have identified symptom clusters using patient-reported outcomes collected in routine practice. The purpose of this study was to identify symptom clusters de novo using data reported in eSyM, an electronic health record-integrated cancer symptom management program deployed across six large and diverse health systems. Methods: Adults starting chemotherapy to treat thoracic, gastrointestinal, and gynecologic cancers used eSyM to report symptoms twice weekly for up to six months. We analyzed patient-reported symptom data from cycle 1, day 2 (T0), one week (T1), and two (T2), three (T3), and four (T4) weeks later. Patients reported attributes (i.e., frequency, severity, and interference) of 12 symptoms using items derived from the PRO-CTCAE. We calculated a composite grade (0, 1, 2, or 3) for each symptom and conducted an exploratory factor analysis using polychoric correlations and unweighted least squares estimation to identify symptom clusters at each time point. We considered rotated factor loadings ≥|0.30| meaningful and assessed the Eigenvalues, structure, and clinical relevance of two- through four-factor (i.e., cluster) models. Finally, we labeled each cluster according to its predominant symptoms using labels adopted from prior studies of symptom clusters in patients undergoing chemotherapy. Results: Our analytic sample at each time point included 730 (T0), 1605 (T1), 1571 (T2), 1617 (T3), and 1456 (T4) symptom reports. Of the two-, three-, and four-factor models, the two-factor model had the least cross-loading and was the most clinically relevant across time points. The two-factor model accounted for 100% of the total variance in symptoms. In this model, a gastrointestinal symptom cluster was comprised of vomiting, nausea, decreased appetite, trouble drinking, and diarrhea at all time points, while a psychoneurological symptom cluster was comprised of fatigue, pain, anxiety, shortness of breath, and constipation at all time points. Rash was present in the psychoneurological cluster at T0 but was not present in any cluster at T1-T4. Conclusions: Patients experience gastrointestinal and psychoneurological symptom clusters in the first four weeks of chemotherapy. Our findings suggest it is feasible to use routinely collected data to identify symptom clusters using composite PRO-CTCAE grades. Future research will investigate the prevalence of symptom clusters, clinical and demographic characteristics of patients at high risk for severe symptoms, and how to better manage symptom clusters.