bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer centers as potential knowledge hubs for emergency preparedness efforts.
Authors: Espinel Zelde , Shultz James , Aubry Vanina Pavia , Abraham Omar Munoz , Fan Qinjin , Sahar Liora , Nogueira Leticia M 
Published: June 2023

e18729 Background: Climate change is altering the frequency and behavior of extreme weather events making it harder for institutions to prepare and respond to increasingly unpredictable circumstances. Emergency preparedness efforts are crucial for meeting the health and safety needs of patients, providers, healthcare facilities, and communities before, during, and after a disaster. National Cancer Institute (NCI)-Designated Cancer Centers are at the forefront of quality cancer care and research, have greater access to resources through accreditation, and are nationally distributed, collectively acquiring a range of emergency preparedness and response experiences on a variety of disasters nationwide. This study evaluated emergency preparedness information provided in NCI-designated Cancer Centers’ websites. Methods: We systematically searched NCI-Designated Cancer Centers’ websites for the presence of information on emergency preparedness and response instructions, resources, and research efforts in September 2022. Results: Out of 71 centers, all (100%) were impacted by a climate-driven disaster between 2016 and 2020, 56 (78.9%) presented some emergency preparedness information, and 36 (50.7%) presented information specific to individuals diagnosed with cancer, all of which included information relevant for the COVID-19 pandemic. In contrast, only 17 (23.9%) of centers’ websites provided emergency preparedness information relevant for climate-driven disasters, and only 7 (9.5%) provided information on emergency preparedness for climate-driven disaster specific for individuals diagnosed with cancer. Just one center (1.4%) mentioned ongoing research on emergency preparedness for cancer patients. None of the centers provided emergency preparedness or response information in a centralized and structured manner. Conclusions: Emergency preparedness research efforts and information sharing on NCI-Designated Cancer Centers’ websites has not kept pace with the challenges posed by climate change. Prioritizing research efforts and structured information sharing of emergency preparedness and response expertise will be crucial to ensure receipt of quality cancer care in the era of compounding disasters.
Telemonitoring program for genito-urinary cancer patients treated with oral anticancer agents.
Authors: Seguin Lorene , Garcia Melanie , Dulac Morgane , Benizri Frederic , Vicier Cecile , Guerin Mathilde , Muscat Marie France , Monneur Audrey , Gravis Gwenaelle 
Published: June 2023

e18731 Background: Oral anticancer agents (OAA) used has dramatically increased in treating genito-urinary (GU) cancer. Patients with metastatic prostate and kidney cancers, have advanced age, with comorbidities. The risks of OAA for this population with adverse effects, drug interactions and ambulatory administration must be detected, prevented and managed to decrease toxicity, improve compliance and efficacy. Here, we report the data of our comprehensive cancer center telemonitoring program named Outside the walls of the hospital (OWH), combining medical oncologist coordination, clinical pharmacist (CP) evaluations, and nurse follow-ups. Methods: Data from patients treated with OAA for advanced and metastatic prostate or kidney cancers in our center during year 2022 were retrospectively evaluated. At the start of OAA, the patients benefit from a consultation with the oncologist, clinical nurse (CN), and CP. For each drug, a standard telemonitoring program has been planned according to the patient's age and comorbidities. Results: The mean age of the patients was 68 years (44-90), 42% of the patients were over 70 years, 84% were men and 96% were in a metastatic setting. Out of 347 GU patients, 118 were included in the OWH telemonitoring program in 2022, representing 14% of the whole cancers patients enrolled in this program. Of these 118 new GU patients, 80% had a CP consultation, 76% for next generation hormonal therapy (NGHT) for advanced or metastatic prostate cancer and 24% for tyrosine kinase inhibitors (TKI) for kidney cancer. At least one drug interactions was detected for 54% of patients (61% of the NGHT and 35% of TKI). The associations was strongly discouraged for 18% because of an increase or decrease in drug concentration requiring a switch or an adaptation of dosage at the outset (statin (11 patients), oral anticoagulant (5 patients), analgesic (1 patient)). At least 1 complementary alternative medicine was used by 29% with 55% of them had an interaction with OAA. During follow-up, the frequency of consultations with CN or physician is reduced over time, in order to give priority to telemonitoring and visits to the oncologist for tumor assessment and if necessary at the request of the nurse or the patient. Conclusions: The OWH program makes it possible to limit medical visits by ensuring safe monitoring. It promotes patient empowerment and allows for medical visits when necessary, in the current context of declining medical demographic for an often elderly and fragile population.
Quality of life during medical oncological treatment in a real-world study in a single-institution of Peru.
Authors: Rioja Patricia , Valencia Guillermo , Araujo Jhajaira M , Pinto Joseph A. , Godenzi Angel , Neciosup Beatriz , Montenegro Paola Catherine 
Published: June 2023

e18735 Background: Quality of life (QoL), defined as a state of physical, psychological and social well-being that provides satisfaction to the patient to be able to perform daily activities, has become a very important aspect in the evaluation of cancer patients. The aim of the study was to assess the QoL of cancer patients during cancer treatment. Methods: Patients undergoing intravenous systemic treatment within three months of diagnosis were identified as eligible patients. A total of 315 patients were selected of out-patient chemotherapy and hospitalization services were included between January and December 2022. QoL was measured using the EQ-5D-5L Quality of Life Questionnaire. The health personnel previously explained the questionnaire to the patient and then were applied electronically through tablets. The questionnaire had 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression; each dimension has 5 levels from no problems (level 1) to extreme problems (level 5). The Visual Analogue Scale (VAS) respondent’s self-rated health, this scale is numbered from 0 (“worst health you can imagine”) to 100 (“best health you can imagine”). Level 1 vs other levels were compared and Odds ratio, chi-square and ANOVA were used to determine associated factors. Results: A total of 315 patients were included, the mean of age was 53 (18-92) and 79.1% were women. Most patients (92%) were in good performance status (Zubrod 0-1). The proportion of patients in out-patient chemotherapy service (89%) was higher than in hospitalization service (11%). A total of 48% of patients received systemic treatment with curative intention and 52%, palliative. Chemotherapy was the most common treatment (78%). Compared to gastrointestinal and central nervous system tumors; the gynecological and thorax (GTC) (OR: 2.62; 95%CI: 1.32-5.21) and genitourinary cancers (GU) (OR: 4.57; 95%CI: 1.23-16.89) had worse mobility; GTC (OR: 3.50; 95%CI: 1.69-7.24); melanoma, breast cancer, and soft tumors (MBSC) (OR: 2.14; 95%CI: 1.12-4.11) had worse self-care; and GTC (OR: 4.00; 95%CI: 1.53-10.43) had more pain/discomfort. Besides, all patients in the out-patient chemotherapy service had worse mobility (OR: 3.15; 95%CI: 1.03-9.58) and more problems during their usual activities (OR: 3.52; 95%CI: 1.27-9.76), compared to hospitalization service. In regards to the VAS, there were differences between men and women (83.05±15.49 vs 76.08±21.13, p = 0.010 respectively) and services (78.32±19.64 vs 62.94±26.15, p = 0.011 ou-patient chemotherapy vs hospitalization, respectively). Conclusions: Our study indicates that patients with gynecologic, thoracic and genitourinary neoplasms have a poorer QoL than other diagnoses during their systemic treatments. The reasons behind this finding require further research.
Promoting adherence to germline genetic testing for pancreatic cancer.
Authors: Hannon Heather Alison 
Published: June 2023

e18737 Background: Updated NCCN guidelines support universal germline genetic testing (GGT) for pancreatic ductal adenocarcinoma (PDAC), and literature recommends ordering GGT for PDAC at or near first oncology consult (Chittenden et al., 2021). However, recent studies demonstrate that adherence to updated GGT guidelines for PDAC is poor, and testing rates remain suboptimal (Klatte et al., 2023). A three-month pre-intervention audit (4/2022-6/2022) revealed that less than half of patients diagnosed with PDAC at our community cancer facility underwent GGT in alignment with NCCN guidelines, and only 33% had GGT ordered at the first oncology visit and before treatment. Automated workflows can increase GGT rates for PDAC, but community hospitals may lack infrastructure to support this type of model. Oncology Nurse Navigators (ONN) represent a practical tool for fostering guideline-concordant care for cancer patients treated in the community. The present study explored whether the use of a prompt (or alert message) facilitated by the ONN could change compliance with current recommendations for GGT at a community cancer institute. Methods: We conducted a series of four specific strategies, over a three-month period (7/2022-9/2022). 1. Targeted education was provided to oncologists about NCCN updates. 2. ONN identified newly diagnosed PDAC patients. 3. ONN implemented a prompting process (sending a message to patient’s oncologist within one week of identification of PDAC diagnosis) to review/remind about GGT. 4. Chart review was performed at designated intervals to monitor GGT ordering. The health system’s ONN tracking tool was used to gather, monitor data. Analysis was performed with SPSS software. Results: Nine PDAC patients were identified that met inclusion criteria. Following the ONN prompting intervention there was a 56% increase in PDAC patients who had testing ordered as recommended by NCCN guidelines, a 103% increase in PDAC patients who had GGT ordered at first consult and before treatment initiation. While differences between pre and post intervention were not statistically significant (Fishers Exact Test), the prompting process stimulated valuable discussion between Medical Oncologists (MO) and the ONN, possibly shaping ordering decisions. This included two MOs who switched to ordering GGT at first consult and one MO who had not been planning to order GGT and did so following the prompt. Conclusions: An ONN facilitated prompt offers a simple yet effective means for promoting adherence to GGT guidelines for PDAC in the community setting. ONNs can play a key role in identification of patients and communication and collaboration with MOs before the first oncology consult. The prompting process opens conversation and provides opportunities to clarify, educate about NCCN guidelines in the community setting.
COVID-19 pandemic impact on the oncology care using a virtual survey in Peru.
Authors: Valencia Guillermo , Enriquez Daniel , Rioja Patricia , Lachira Lizbeth , Calderon Monica , Navarro-Vasquez Jeannie , Neciosup Silvia P. , Vidaurre Tatiana 
Published: June 2023

e18738 Background: Advocacy programs in oncology has shown to improve outcomes through education, patient empowerment and civil society awareness, enabling better actions and efforts for patient care, especially in COVID-19 era. We present the results of a virtual survey conducted with the support of a Peruvian advocacy program for cancer patients in COVID-19 pandemic. Methods: In October 2020, a Peruvian Advocacy Program at Instituto Nacional de Enfermedades Neoplasicas (INEN) (“Club de la Mama”) formed by advocates and supported by a team of health professionals developed a virtual survey between October 2020 and July 2021 with the purpose of evaluating the impact of interruption of diagnosis or oncological treatment, detect a degree of anxiety/depression due to quarantine and provide information on the response of the oncological institution to the pandemic; from the patient’s perspective. This virtual survey includes: alternative treatment options, degree of anxiety/depression, early access to medical prescription, mode of appointment and quality of care. Patients answered the survey anonymously via web promoted on social networks (Facebook/ WhatsApp) and person-to-person diffusion. Results: A total of 244 patients were included, 78.7% females. Most of patients (86.5%) were from Lima and 86.9% had public insurance. 16.8% of patients had COVID-19 in the period of time evaluated. According to education level, 50.8% were superior, 37.7% high school, 10.7% elementary school and 0.8% illiterate. The most common cancer type was breast (36.1%), followed by hematologic (27.9%) and cervical (7.0%). The most common modality of care was in-person (73%), followed by telemedicine (15%) and only 2% not received medical consult. Regarding the degree of depression: 39% were mild, 14% moderate, 12% moderate-severe, 5% severe and 30% none. The most common degree of anxiety was 42% mild, 16% moderate, 12% severe, and 30% no degree. The most frequent reasons for not attending to hospital were unavailability of appointments (31%), followed by fear to COVID-19 (26%), geographic (10%) and difficulty in transportation (9.0%). The appointment cancellation/postponement time [reported in days] was: 18.0% not canceled, 16% [ < 15], 14% [15-30], 19% [30-60], 10% [60-90], 23% [ > 90]. Of the patients with surgical indication, 72% did not undergo surgery. Regarding prescription, 83% of patients received oncologic treatment, 10% did not received, and the remaining 7% answered that they did not need medication. Quality of care: 18% were considered excellent, 67% good, 10% fair, and 5% poor. Conclusions: Although the survey showed higher degrees of anxiety/depression in patients and longer cancellation/postponement/medication changes during COVID-19 pandemic, there was a significant adherence of medicine prescription, with no negative impact on the perception of quality of oncology care.
A novel program to address acute food insecurity among patients with cancer in Philadelphia.
Authors: Rowe Michael , Mancuso Gina , Kelly William Kevin , Garber Greg D. , Sina Elliott , Leader Amy 
Published: June 2023

e18739 Background: Acute food insecurity (FI) is a significant yet poorly understood social risk factor facing cancer patients, with a prevalence greater than that of the general U.S. population. FI poses a particular risk for cancer patients, as FI-induced malnutrition is associated with fatigue, stress, depression, and a weakened immunological response to infection. Legacy of Hope is a non-profit organization based in Philadelphia, PA providing emergency support to cancer patients in financial distress. Partnering with local grocery stores to supply the food and local police districts to deliver the groceries, Legacy of Hope receives patient referrals from social workers at cancer centers in Philadelphia to identify patients and families in need. Cancer patients can receive one or more bi-weekly grocery deliveries until their acute FI needs are addressed. Legacy of Hope documents and tracks metrics associated with the patients who are served by the program. Beginning in 2023 is direct participant evaluation of the program, assessing outcomes in acute anxiety, quality of life, and acute FI. Methods: Legacy of Hope receives ongoing referrals from oncology social workers about cancer patients in need. Legacy of Hope documents the cancer diagnosis, age, race/ethnicity, and gender of the cancer patient as well as the size of the household and the number of children living in the house. Additionally, a participant evaluation survey collects data via an online survey at two time points: first, at the time of their grocery delivery and second, two weeks after the delivery. The survey uses validated measures (FACT-G7) to assess changes in quality of life and anxiety, as well as acute FI, over the two-week time period. Standard statistics, including a paired t-test, will evaluate the changes in the outcome measures of interest. Results: Legacy of Hope has served more than 1600 cancer patients representing more than 2000 food deliveries. About half (52.2%) were female and 58% were African American. The mean age was 60 years old. Breast cancer was the most common diagnosis (18%), followed by lung (8%) and colorectal cancer (5%), although almost all cancers are represented in the database. One in five patients (21%) lived alone, but most (45%) had between 2 and 3 persons in their household. Children were present in the home 21% of the time. Data for the participant evaluation survey will be available in Spring 2023. Conclusions: Acute FI is prevalent and devastating for cancer patients, although few resources exist within cancer centers to adequately address it. Legacy of Hope fills this gap through a novel program that leverages sustainable and trusted partnerships with local food distributors, civic organizations, and oncology social work teams at cancer centers throughout the Greater Philadelphia region.
Study of practice patterns in NGS vs single gene testing, provider-identified barriers to biomarker testing and utilization of liquid biopsy across multiple hospital-based cancer centers.
Authors: Simpson Lijo , Mathew Anju , Stapp Jeremy 
Published: June 2023

e18743 Background: Limited data exists on next-generation sequencing (NGS) testing rates, utilization of single gene tests for therapy matching, use of liquid biopsies in therapy selection, or physician-perceived barriers to testing in hospital-based cancer centers. Initial project goal is to establish a baseline for such metrics. Methods: 700 patient records of various solid tumor types were assessed as part of a quality improvement project at three different cancer centers over a six-month period: 1) a regional IDN, 2) an NCI center, and 3) a community cancer center/affiliate of an NCI center. This was combined with qualitative surveys on current state practices and barriers to NGS testing completed by thirty (30) respondents from these institutions (97% physicians, 3% nonphysicians). Site specific Physician champions were recruited to identify additional interventions to be implemented at their respective site(s). Results: Baseline findings show 45% of advanced cancers received any biomarker tissue testing, with testing rates of 53%, 25%, and 66% in lung, pancreas, and colon cancers, respectively. Broad-based panel testing made up 59% of tests, and 31% of patients continue to receive single gene testing only. Approximately one third of patients who developed recurrent disease had biomarker testing (38%) compared to patients with an initial diagnosis of advanced cancer where more than half received testing (51%). Use of liquid biopsies was limited, representing 4% of biomarker testing, but 71% of the time it was incremental to completed tissue testing. Three types of testing barriers were identified by survey respondents: 1) 63% cited limited quantity of tissue available, 2) 53% cited reimbursement concerns including “potential cost to patient,” and 3) 44% cited cumbersome process due to delays and long turnaround times for authorization, ordering, and/or delivery of results. Conclusions: 1) A lower number of patients with disease recurrence are obtaining broad panel NGS compared to patients with de novo metastatic disease; 2) There continues to be low utilization of liquid biopsies for patients with advanced cancers; and 3) Single gene tests continue to be used for therapy matching in a large number of patients with advanced cancers. Improving testing rates including use of broad panel tests and liquid biopsies appropriately will require ongoing education and/or automated reminders to cancer care teams. Further education needs to focus on reimbursement concerns at an institutional level and on testing patients who recur after initial cancer diagnosis and therapy.
The impact of patient demographics on involvement in cancer care decisions in the US.
Authors: Brierly Margaret , Drago Anthony , Moseley Angelena 
Published: June 2023

e18746 Background: As the oncology market continues to expand and more treatment options become available, the potential for highly personalized cancer care increases. In recent years, emphasis has been placed on patient involvement in treatment decisions, aiding physicians in generating care plans that focus on individual preferences and priorities. Shared decision making between patients and healthcare providers has been shown to improve patients’ perceptions and quality of life throughout the continuum of care (1). Methods: The Ipsos Global Oncology Monitor is an online, multi-center medical chart review of oncology patients receiving drug therapy. 470 cancer-treating physicians in the United States were screened for seniority and caseload and submitted data on 64,124 cancer patients (aggregate; all tumour types) between January 2022 to December 2022. Data included tumor type, age, gender identity, ECOG performance score and treatments received. The level of patient involvement in care decisions was determined by sampled physicians and recorded on a scale of 1-10 (1 = low involvement, 10 = high involvement). Results: Reported patient engagement with treatment was generally high, with an average involvement score of 7.50. 45% of sampled physicians rated patient involvement as a score of 9 or higher. In comparison to the entire study pool, reported patients diagnosed with breast cancer (7.89), non-small cell lung cancer (7.66), non-Hodgkin’s lymphoma (7.85) and colorectal cancers (7.64) all had significantly higher average involvement levels (p < 0.05). In contrast, individuals diagnosed with prostate tumors or myeloma recorded ratings significantly lower than the average (7.03 and 7.44, respectively). In relation to gender identity, reported female patients were significantly more likely to be engaged with their care decisions (7.70) than their male counterparts (7.25). Additionally, ECOG performance scores and individual involvement seemed to align: patients with an ECOG score of 0 had the highest rated involvement (7.82) and as ECOG scores worsened, the average scores fell near or below the wider reported patient cohort mean. Conclusions: Results from this study highlight that reported US patient involvement in cancer treatment decisions is generally high, reinforcing the importance of joint evaluation in bettering care outcomes. However, specific patient cohorts are more likely to be highly involved than others. These discrepancies merit a more conscious effort to support patient engagement and continue improving quality of care. Further investigation using comparator cohort is warranted. https://participatorymedicine.org/journal/columns/innovations/2017/04/13/the-future-of-patient-engagement-in-the-oncology-setting-how-practical-patient-engagement-recommendations-and-innovative-inter-professional-education-can-drive-change/.