bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social determinants of health factors and palliative care services use among patients with metastatic breast cancer in Florida.
Authors: Giap Fantine , Hong Young-Rock , Bradley Julie Ann , Oladeru Oluwadamilola Temilade 
Published: June 2023

1102 Background: ASCO recommends palliative care (PC) as an adjunct to the oncologic standard of care for patients with metastatic cancer. However, current evidence on PC utilization in patients with breast cancer and its relationship with area-level social determinants of health (SDoH) factors is limited. Therefore, we examined the associations between county-level factors and PC utilization among patients with metastatic breast cancer (mBC) in Florida. Methods: We extracted patient-level data (n = 23,539 patients diagnosed with mBC between 2012 and 2021) from the OneFlorida+ Data Trust and linked it to county-level data (67 Florida counties) from the AHRQ-SDoH Database. PC utilization since cancer diagnosis was identified using ICD-9 code V66.7 or ICD-10 code Z51.5. We assessed differences in PC utilization with county-level SDoH factors (e.g., poverty rate, transportation resource, provider supply, racial segregation) using bivariate analysis. Multivariable Poisson regression, including significant factors from bivariate analysis, was used to compare the PC utilization for the SDoH factors. Results: Our study population's overall prevalence of PC utilization was 16.1%. PC utilization was higher for patients with mBC residing in counties with a higher proportion of residents living in poverty and with a greater supply of advanced practice providers (APP: NP, PA), general surgeons, and nursing homes. Patients with mBC in counties with higher proportions of residents who identified as immigrants, with limited English proficiency, without personal transportation, and having higher racial segregation had lower PC utilization. In adjusted analysis, the supply of APP (coefficient:0.12) and nursing homes (coefficient:0.09) was associated with increased PC utilization. Conversely, racial segregation (White vs. non-White) was associated with decreased PC utilization (coefficient: -0.07). Conclusions: PC utilization among patients with mBC was associated with several SDoH at the county level. Notably, low PC utilization was associated with racial residential segregation and fewer APPs and nursing homes. Further research is needed to identify mediators in these relationships to improve PC effectiveness for patients with mBC in Florida.
The impact of physician gender on patient satisfaction in an academic hematology/oncology practice.
Authors: Turchi Alaina Marie , Khalid Ahmed Bilal , Nguyen Chi Mai , Su Jing , Ballinger Tarah Jean , Jalal Shadia Ibrahim 
Published: June 2023

11022 Background: Gender disparities continue to remain under addressed in medicine. While prevalent in many forms, patient bias and perceptions toward their healthcare team can impact patient compliance and care. Health systems often gauge patient satisfaction with physicians and post these ratings online. It is possible that gender biases affect patient satisfaction scores and evaluations. Here, we assess the impact of physician gender on patient satisfaction scores and comments in an academic hematology/oncology practice. Methods: A retrospective mixed-method analysis was conducted from patient satisfaction scores and comments obtained between January and June of 2021. Patients were asked a series of three questions about their care. Patients’ response to the question, “How likely would you be to recommend this providers office to friends and family?”, was analyzed on a score of 0-10, with 10 being extremely likely and 0 being not at all likely. Patients were then asked for the primary reason for their scoring, in an open-ended format. Mixed-gender codified data was quantified from de-identified, de-gendered patient comments. To identify the differences in patient perception between male and female physicians, we specifically examined the data of positive and negative impressions of variables including professional behaviors, expertise, kindness, compassion, and interactions with ancillary staff amongst providers. Results: Patient satisfaction scores from 199 unique patients were reviewed; 140 (70.4%) were about male-identifying physicians while 59 (29.6%) were related to female-identifying physicians. The mean satisfaction score was 9.95 ± 0.29 for female physicians and 9.64 ± 1.38 for male physicians (p = 0.011). Of patients responding, 76 (38%) were male and 123 (63%) were female. Female physicians scored higher than male physicians for both male and female patients (10.0 ± 0 versus 9.65 ± 1.37 (p = 0.011) and 9.77 ± 0.60 versus 9.62 ± 1.40 (p = 0.011), respectively). Kindness and compassion were mentioned in 36% and 42% of all female physician scores, respectively, and in 29% and 33% of all male physician scores; these did not reach statistical significance (p = 0.587 and p = 0.257). 21% of all male physician scores positively mentioned physician expertise, compared to 15% of female physician scores; this also did not reach statistical significance (p = 0.434). Conclusions: Female physicians had a higher mean satisfaction score in patient evaluations than their male counterparts by both male and female patients. Numerically, more patient comments about female physicians mentioned kindness or compassion, while fewer mentioned expertise. This early work will be expanded to a larger dataset of evaluations in addition to further exploration of how female and male oncology providers are perceived by patients in multiple other categories.
Bringing the teaching close to home: Implementation of a near-peer model for an introductory hematology-oncology fellowship lecture series.
Authors: Berry Jonathan L , Chase Matthew L , Drews Reed , Freed Jason , Patell Rushad , Rangachari Deepa 
Published: June 2023

11025 Background: Hematology/oncology fellowship has a steep learning curve. Foundational knowledge at the start of fellowship is essential, given limited exposure to key disease-specific concepts in prior training. We have previously employed an expert faculty-led “introductory boot camp” during the first 2 months of fellowship training. Trainees provided feedback that this was not best meeting fellows’ needs. We hypothesized that a near-peer teaching model, led by senior fellows, would better align lecture content and scope with the needs of new fellows and improve senior fellows’ mastery of clinical knowledge and comfort with teaching skills. Methods: Using a constructivist theory of learning, we selected the most relevant topics from the curriculum and assigned each senior fellow 1-2 hour-long sessions on clinical areas of interest, paired with expert faculty. A one-hour workshop on lecturing techniques and instructional design was held for all senior fellows. Educational sessions led by senior fellows and expert faculty occurred July-September 2022 in a hybrid format. An IRB-exempt anonymous survey was sent to participating fellows and faculty regarding effectiveness of the educational sessions and the process of preparing to lead sessions. Results: 15 of 17 fellows (88%) and 12 of 15 faculty (80%) completed the survey. Overall, 71% (95% CI 33-82) of fellows and 75% (95% CI 43-95%) of faculty felt the new series was taught at an appropriate level for new fellows. All fellow respondents felt the approach was helpful for clinical practice and board preparation. All participating senior fellows felt equipped to teach and that the exercise improved confidence in the content and their teaching skills. No fellows proposed a return to the prior model, and 80% of faculty felt the near-peer approach should be continued in future years. Qualitative analysis of narrative responses identified several strengths, including emphasis on focused, introductory frameworks and the generation of living resources for future reference. Areas identified for future improvement include providing more guidance and structure for pre-lecture faculty-fellow preparations. Conclusions: A near-peer model of introductory lectures is feasible to implement, produces improved satisfaction with the curriculum, and can be a means of presenting foundational content in hematology and oncology concordant with the learners’ needs. This method has important implications for developing learner-concordant, expert-driven curricula in large and rapidly changing content areas within hematology/oncology.
Utility of a novel trainee-level hematology/oncology podcast in graduate medical education.
Authors: Mistry Ronak , Patel Vivek , Hausrath Daniel 
Published: June 2023

11027 Background: Despite the popularity of podcasts in medical education, there are a limited number of trainee-level hematology/oncology (H/O) podcasts. We created & implemented a novel H/O podcast curriculum to address this barrier. Here, we evaluated the utility of this podcast for H/O fellows & internal medicine (IM) residents on H/O rotations. Methods: We included IM residents & H/O fellows at Vanderbilt University Medical Center in the 2022-2023 academic year. Each IM resident starting on a H/O inpatient rotation received an email prior to their rotation with list of recommended episodes. H/O fellows were encouraged to listen to episodes at their discretion. We developed anonymous surveys using a 5-point Likert scale (1, “strongly disagree” to 5, “strongly agree”) to understand how the podcast helped prepare them clinically & if H/O podcasts were effective educational tools. Results: A total of 20 trainees completed the survey including 7 residents (35%) & 13 fellows (65%). All post-graduate years were represented. Results of the survey are presented in the table. Most felt the podcast material helped with inpatient rotations & consults, was clinically relevant, & helped with clinical decision-making with a mean score of 4.76, 4.79, and 4.50, respectively. Respondents agreed the fundamentals of H/O are amenable to a podcast platform & are likely to continue to use podcasts as learning tools in H/O with a mean score of 4.68 and 4.40, respectively. When restricting to the fellow cohort, the majority felt that the podcast material helped them prepare for their clinic patients with a mean score of 4.62. Most found the podcast convenient & the most common activities while listing to our podcast were driving (70%), doing chores (35%), exercising (25%), and eating (25%). Conclusions: H/O fellows & IM residents found the trainee-level podcast curriculum clinically relevant and helped with clinical decision making. The respondents also all agreed or strongly agreed that podcasts are an effective medium to teach hematology/oncology. Our successfully piloted podcast curriculum can be adapted to other training programs to improve foundational knowledge in oncology. [Table: see text]
Efficacy of a hematology/oncology podcast curriculum at a community-based internal medicine program.
Authors: Fitzpatrick Madeline Campbell , Carter Jacob , Mistry Ronak , Hausrath Daniel , Patel Vivek 
Published: June 2023

11036 Background: Medical podcasts have gained increasing popularity; however, there is limited evidence regarding their utility as an effective learning resource in Graduate Medical Education. Community-based internal medicine (IM) residents often have less exposure and education in hematology and oncology. To address this barrier, we developed a novel trainee-level hematology/oncology podcast curriculum to improve foundational knowledge for IM residents. Methods: A hematology/oncology podcast curriculum was implemented for IM residents at a community-based residency program in the 2022-2023 academic year. We developed ten episodes regarding workup and management of cytopenias, oncologic emergencies, and hematologic emergencies. We distributed anonymous pre- and post-intervention surveys to understand the impact of the podcast curriculum on a 5-point Likert scale on residents’ self-perception of their knowledge. Two sample paired t-test was used to compare mean differences in surveys. Results: A total of 17/27 residents (63%) completed the pre-intervention survey, and 9/27 residents (33%) completed the post survey. The pre-survey was more heavily weighted towards residents earlier in their training with 53% PGY1s, 29% PGY2s, and 18% PGY3s. With 5 being entirely comfortable, there was a statistically significant increase in mean comfort level in the workup and management of various cytopenias (2.65 to 4.0, p < 0.01) and the management of oncologic emergencies (2.29 to 4.2, p < 0.01). Comfort level in the management of hematologic emergencies numerically improved from 3.35 to 3.57 but was not statistically significant. Most residents (90%) agreed or strongly agreed that the fundamentals of hematology/oncology were amenable to a podcast platform. Many residents found this modality convenient and performed other activities while listening to the podcast including driving (82%) and exercising (55%). The majority of residents who completed the post-survey (64%) reported that they will continue to use podcasts to supplement their medical education. Conclusions: Community based IM residents’ comfort with the field of hematology/oncology improved following the medical podcast educational intervention. Residents found the learning platform amenable to the fundamentals of hematology/oncology and will continue to utilize medical podcasts to supplement their education. Our successfully piloted podcast curriculum can be adapted to other IM programs to improve foundational knowledge in hematology/oncology.
Effects of a focused one-day interactive session on oncology research on medical students’ interest in and understanding of oncology research.
Authors: Alrawabdeh Jawad , Alzubi Marah , Odeh Nada Wael , Hamadneh Yazan , Odeh Mahmoud , Khasawneh Enas Yousef , Al-Ani Abdallah , Hammouri Muhammad , Ahram Mamoun , Abbadi Abdalla 
Published: June 2023

11037 Background: Literacy and proficiency in medical research are crucial for the development of modern-day physicians. The need to equip future doctors with sufficient research skills is particularly important in oncology research, as cancer is the second leading cause of death in Jordan and the first worldwide. With the support of the University of Jordan ASCO-OSIG, we explored the efficacy of an interactive research intervention in highlighting the foundations of cancer clinical, basic, and translational research among undergraduate medical students. Methods: We designed and implemented a one-day educational program about all types of cancer research: clinical, basic, and translational. To evaluate the impact of this ASCO-OSIG initiative, students were asked to voluntarily fill surveys before and after the event. Medical students in both their pre-clinical and clinical training were invited to attend the event. Prominent researchers and experts from multiple tertiary cancer centers in Jordan presented 50min lectures on the foundations of clinical, basic, and translational oncology research. Results: A total of 111 participants filled the pre and post surveys, of which ASCO-OSIG members comprised 28.8% of the sample. Approximately 51.4% of participants were pre-clinical students and 48.2% were in their clinical years. About half of our cohort (50.2%) have previously engaged in research projects with only 10.2% of participants have been involved in oncology research. The event was effective in promoting participants’ understanding and familiarity of the fundamentals of clinical (p-value < 0.001), translational (p-value < 0.001), and basic oncology research (p-value < 0.001). Most students were satisfied with the event; with 55% and 32.4% of students reporting being very satisfied and extremely satisfied with the event, respectively. Moreover, 83.8% of participants felt that oncology research was easier to get into after the event. About 96% of students reported that they would recommend this event to a colleague. Conclusions: We demonstrated that a focused one-day cancer research conference had improved medical students’ understanding towards oncology research. Due to its design simplicity, other global ASCO-OSIG coordinators could implement the model within their respective institutions. Future efforts should expand on the available research initiatives and include other medical schools worldwide.
Web-based patient educational material on chimeric antigen receptor T-cell therapy: Quantitative assessment of readability.
Authors: Thakur Rahul Kumar , Adhikari Anurag , Neupane Karun , Hammami M Bakri Bakri , Vegivinti Charan Thej Reddy , Al Hamed Rama , Atalla Eleftheria , Vikash Sindhu , Mehta Ansh , Kumar Abhishek 
Published: June 2023

11040 Background: Chimeric antigen receptor (CAR) T-cell therapy is another paradigm-shifting advancement for hematologic malignancies, creating unprecedented treatment options. However, there is still a lack of knowledge and understanding among patients regarding this novel therapy. Most patients turn to online resources, ranging from social media to federal websites, to gather health information to supplement decision-making. Given that the average American adult reads between the sixth- and eighth-grade levels, national organizations recommend that patient resources be written at the sixth-grade level or below. The purpose of this study was to evaluate web-based patient educational material on CAR -T cell therapy resources using measures of readability and compare it to national guidelines. Methods: Online patient information on CAR-T cell therapy from the top 20 U.S Cancer center as per US news ranking was collected. We analyzed the content by six of the most common readability tests- Flesch Reading Ease score (FRE), Gunning Fog (GF), Flesch-Kincaid Grade Level (FKGL), Coleman-Liau Index (CLI), Simple Measure of Gobbledygook (SMOG) Index, and the Automated Readability Index (ARI). The text from each article was carefully reviewed and analyzed using the software Readable, and the readability scores with standard deviation (SD) were obtained. Results: The mean score FRE score was 48.5 (SD: 6.7), which corresponds to college level and is difficult to read. The mean GF score was 8.7(SD: 1.5), which represents the writing of an 8th grader. The FKGL score was 8.6 (SD: 1.1), which represents a level of 8th grade or above. The mean CLI score was 11.5(SD: 1.3), which is the text level for high school juniors. The mean SMOG index was 10.9 (SD: 1), which is the level of a 12th grader. The ARI score was 7.8 (SD: 1.3), indicating a 7th-grade level. Conclusions: Overall, web-based CAR- T cell therapy patient educational materials scored poorly and does not meet the national recommendations. Authors of patient resources should incorporate readability criteria and prompt a revision or creation of new educational materials including videos and audio to support general patient understanding. By making CAR-T therapy information easily understandable, internet users can be better informed about their treatment decisions.
Clinicians’ experiences with patients with cancer or their families who endorse medical misinformation.
Authors: Palmer Amitabha , Gallagher Colleen M. 
Published: June 2023

11042 Background: Medical misinformation causes delays in cancer care, forgoing of treatment, economic harms, potentially toxic effects, and harmful medical interactions with standard curative treatments. Previous literature has examined patients’ traits and beliefs. However, effectively caring for patients with cancer who endorse medical misinformation also requires better understanding the experiences, competencies, and concerns of the clinicians who treat them. We conducted an IRB approved study of physicians and advanced practice providers at a large cancer center. Methods: We surveyed clinicians about following themes: i) prevalence of misinformation, ii) attitudes towards patients endorsing misinformation, iii) strategies and competence, iv) resources to help them successfully address patients. Results: 87 clinicians responded to the survey. The median response was 15% of patients endorse claims that are false or misleading about standard-of-care cancer treatments and 20% endorse claims that overstate the benefits or understate the risks of unconventional treatments. The most common misinformation concerned herbs and supplements. Clinicians ranked provides hope and poor medical literacy as the top reasons for why their patients endorse medical misinformation followed by distrust in conventional medicine, cultural factors, and religiosity. The primary attitude clinicians project to patients when they request unconventional treatments was Openness/Equanimity (75.6%), Curiosity (43.9%), Skepticism (18.3%), Disdain/Disappointment (0, 0.0%), Other (6.1%). The primary internal attitude clinicians experienced in these situations was Openness/Equanimity (25.6%), Skepticism (57.3%), Curiosity (40.2%), Disdain/Disappointment (22.0%), Other (6, 7.3%). When asked if they’d be open to a patient using a harmless unconventional treatment that had no evidence of therapeutic benefit, 17.1% said yes, 17.1% said no, and 65.9% said it depends. Correcting misinformation is difficult: 38.2% report success rates below 60% for correcting misinformation and 68.5% report success rates below 80%. Several factors contributed to low success: Only 26% said that they have enough time to adequately address patients who endorse misinformation. Moreover, 46.9% report insufficient resources, 65% claim insufficient training, and 51.3% claim insufficient institutional support. Conclusions: Many cancer care providers feel insufficiently trained and supported to address patients who endorse medical misinformation. Cancer care institutions must develop training and resources to help clinicians effectively address patients who endorse misinformation about their care.