bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multifaceted approach to wellness in a hematology/oncology fellowship program.
Authors: Srikumar Thejal , Ansari Norin , Fanucci Kristina , Goldberg Sarah B. , Hurwitz Michael E. , Podoltsev Nikolai Alexandrovich , Lee Alfred Ian , Sanft Tara B. 
Published: June 2023

11006 Background: Burnout is widespread among physician trainees and is a growing problem despite increasing awareness. We describe multiple efforts in a single institution’s Hematology/Oncology (HO) fellowship program to help support trainees’ wellness. Methods: A needs assessment was conducted to identify wellness topics and programming important to fellows. Anonymous surveys were distributed to all fellows in Yale’s HO fellowship program at the start of the academic year. Three senior fellows reviewed the results and, with the support of core faculty, designed initiatives to address top priorities. The interventions included off-campus debrief sessions for fellows only, Schwartz Rounds-style discussions during weekday didactic slots, faculty-led didactics on Imposter Syndrome and Perfectionism, and several off-campus, after-hours social activities. A follow-up survey was conducted six months after the initial survey (mid-academic year) to garner feedback. Results: Of the 23 fellows who were sent the initial survey, 17 responded (73.9%). The most requested discussion topics were Perfectionism Traps, Imposter Syndrome, Achieving Happiness/Defining Success at Work, and Myths About Work/Life Balance. Most fellows (76.5%) responded that they would attend off-site debrief sessions if offered. In response to the initial survey, several initiatives were undertaken as described in Methods. The mid-year survey was completed by 16 of 23 fellows (69.6%). Of these 16 respondents, attendance was as follows: 31.3% for after-hours debrief sessions, 75% for Schwartz Rounds-style discussion, 75% for Imposter Syndrome and Perfectionism lecture, and 75% for at least one social activity. The majority of fellows who attended these events reported them to be helpful (range 75-100%). Themes identified from written comments included universal appreciation for wellness programming efforts and a desire for more sessions for group reflection. One fellow noted these activities were “helpful for wellness and fostering a pleasant work environment.” Other fellows noted the Imposter Syndrome discussion “should be mandatory” and “would be helpful earlier in the year.” Several fellows expressed their wellness was linked to clinical workload, and one fellow noted sessions outside of regular work hours are difficult to attend. Conclusions: Structured needs assessment and implementation of wellness programming in a HO training program appeared to be beneficial to the majority of fellows. To our knowledge, this is the first description of comprehensive fellow-directed wellness initiatives in HO training. Continued efforts must be made to better support fellows, including options in location, timing, faculty presence, and optimizing work responsibilities and expectations. Further study is necessary to quantify the impact of these initiatives and to tailor the most effective approach to fellows’ wellness.
Tumor board tuesday and awareness of novel therapies and toxicities in solid tumor oncology.
Authors: Ebben Johnathan , Rothbaum Alison , Pishvaian Michael J. 
Published: June 2023

11008 Background: Social media platforms, including Twitter, offer novel tools to accelerate discussion and learning that crosses national borders, flattens hierarchies, and enables collaborations not previously possible. Here, we report on a new initiative, Tumor Board Tuesday (TBT), which facilitates the presentation of cases with active discussion from thousands of stakeholders across the oncology community, highlighting new practice changes and precision oncology strategies. Herein, we sought to evaluate 1) the nature of participation by individuals and groups, as well as their scope of participation in TBT; 2) the impact of participation in TBT, including new collaborations forged, practice changes, increased knowledge of the use of novel agents, and their associate toxicities, as well as emerging clinical trials available to patients. Methods: TBT performed a survey designed to assess the demographics, experience, and opinions of platform users. This survey was collated with voluntary pre/post TBT presentation knowledge checks to assess knowledge acquisition. Results: Based on the survey of TBT participants (n = 38), participant gender is roughly balanced (48.4% women, 48.4% men; 3.2% prefer not to answer). 83.6% of respondents reside in the United States, 8% in Brazil, 5.4% in India, and 3% in Ireland. Interestingly, the majority of respondents identified Twitter as their primary source for oncologic and practice changing updates. Among self-identified oncologists, 12.9% identified as senior members of the field, 51.6% as mid-career, 16.1% as early career, and 12.9% as fellows/trainees. Despite the wide variation in career stage, 81.1% of respondents noted that they had become aware of a new treatment option or modality through TBT participation, which caused 78.4% to change or re-think their treatment approach. In addition, 75.7% of respondents noted that TBT had helped them to become more aware of novel agent toxicities, and 78.4% became aware of a clinical trial option because of TBT participation. Finally, 78.4% of respondents identified TBT as a tool that had helped grow professional connections and networks. On average, there were 56 respondents to knowledge-based questions within each TBT presentation. Analysis of responses to pre and post TBT questions focused on breast, GU, and pulmonary malignancies revealed a 12%, 13%, and 6% respective increase in correct answer choices. Conclusions: Social media, specifically, the use of the TBT platform engages oncology professionals across the career spectrum, enhances learning about novel therapies and corresponding toxicities, and broadens professional connections.
Quality and accessibility of liquid biopsy information: An analysis of online content.
Authors: Litt Henry Kazunaru , Greenstreet Akman Emma , Trejo Evelin , Florez Narjust , Velazquez Manana Ana I. 
Published: June 2023

11010 Background: Circulating tumor DNA assays, also known as liquid biopsies, are increasingly used by oncologists to evaluate residual disease, cancer genomic composition, resistance mechanisms, and guide therapy selection. Since patients often use the internet as a source of medical information, we evaluated the quality, accessibility, and understandability of publicly available online information on liquid biopsies. Methods: We performed a cross-sectional study of 100 videos and 100 webpages that resulted from the search of “liquid biopsy” on a commonly used search engine (Google) and social network (YouTube). Videos over 5 min, scientific articles, and non-English content were excluded. Videos were evaluated for content, intended audience, and perceived sex and race/ethnicity of speakers. Two independent reviewers evaluated understandability and quality of health information using two validated tools for consumer health information (PEMAT, DISCERN). Any disagreements were resolved by a 3rd independent reviewer. Webpages were evaluated for accessibility (use of visual aids, other languages), quality of information (authors, citations, indications, limitations, cost), reading level, and presence of commercial bias. Reading level was evaluated using the validated Flesch-Kincaid (FK), Gunning Fog (GF), and SMOG indices. Data was summarized with descriptive statistics. Results: We reviewed 100 videos, with 190 median views per video (IQR: 75-719). Most videos were intended for a scientific audience (72%) and lacked diversity of speakers. The majority of featured speakers were perceived as male (65%) and non-Hispanic white (72%). Overall, liquid biopsy videos were complex and low quality. Only 9% of videos were understandable and 8% presented moderate to high quality health information. Furthermore, we reviewed 100 webpages about liquid biopsies; key characteristics are summarized in the table. About a third of webpages included indications (36%) and limitations (35%) of liquid biopsies. Webpages had a median text reading level of 14.1 (IQR: 12.1-15.8), 16.4 (IQR: 14.4-18.6), and 15.9 (IQR: 13.9-16.9) based on FK, GF, and SMOG indices, respectively. Only 2 websites had one index reading level of 8th grade or lower as recommended by the NIH and CDC. Conclusions: Online content about liquid biopsies is complex and requires education levels exceeding the reading level of the general US population. Extensive shortcomings in sources of unbiased and understandable information for patients with cancer exist. As novel diagnostic technologies and treatments emerge, efforts should be made to develop understandable, unbiased, and high-quality information resources for patients with cancer. Characteristics of liquid biopsy webpages. [Table: see text]
Novel curriculum for training in medical cannabis in oncologic populations for oncology trainees.
Authors: Patell Rushad , Bindal Poorva , Dodge Laura E. , Nagaraj Gayathri , LaCasce Ann S. , Buss Mary K. , Schonberg Mara A. , Braun Ilana Monica , Freed Jason , Rangachari Deepa 
Published: June 2023

11013 Background: There is continued uptake in the use of medical cannabis (MC) among patients with cancer. Our group previously conducted a national study that showed that while a majority of oncology fellows discussed MC with patients, very few feel well informed in doing so. We hypothesized that an evidence-based curriculum on the use of MC for oncology trainees is feasible to develop and would be effective in improving confidence to discuss MC with patients. Methods: A multidisciplinary expert team designed an evidence-based educational curriculum in 5 modules specifically for MC in oncology populations that included pharmacology/history, symptom management, cancer-directed effects, toxicities and practical/logistic concerns. The curriculum was piloted as a one-hour webinar at three US hematology oncology fellowship training programs in 2022-2023. Anonymous incentivized survey instruments that were designed to assess self-perceived knowledge, attitudes and behaviors pertaining to MC (on a 5-point Likert scale; strongly agree to strongly disagree) were distributed anonymously via email at the pilot (t = 0) and immediately after (t + 7 days); additional delayed surveys (t+90 days) are in progress. Results: Of 35 eligible trainees, 31 completed the pre-training surveys (88.6%), and 26 (74.3%) completed the post-training surveys. Most trainees indicated that the curriculum is helpful (88.5%, 95% CI: 69.8-97.6) and that they would recommend it to their colleagues (80.8%, 95% CI: 60.6-93.4). Following the webinar, there was significant improvement in self-reported comfort with discussing MC for symptom management (3.2% vs. 92.3%, P < 0.001), risks of MC (9.7% vs. 76.9%, P < 0.001) and modes of MC use (16.1 vs. 80.8%, P < 0.001). The majority of participants (80.0%, 95% CI: 59.3-93.2) reported that they were more likely to initiate conversations about MC with their patients after attending the webinar. Conclusions: In this multi-center study, we demonstrate that it is feasible to develop and deliver a fellow-focused, evidence-based curriculum for MC use in patients with cancer. The webinar was well received and demonstrated significant improvement in fellow-reported attitudes surrounding MC efficacy, risks, and modes of use. Further work to assess durability of the curriculum on knowledge, attitudes, and behaviors is ongoing.
Creating an infrastructure to address physician and advanced practice provider burnout at a complex community cancer care delivery system.
Authors: Tray Alison , Eanniello Mary Kate , Yu Peter Paul 
Published: June 2023

11015 Background: Oncology clinicians are at risk for developing burnout due to work-related factors such as high acuity patients, long work hours, limited autonomy, administrative and documentation demands (Copur, 2019; Eelen et al, 2014). The COVID-19 Pandemic has intensified burnout due to rapid and multiple changes in clinical practice, lack of fulfillment, and heightened moral distress and personal challenges (Hlubocky et al 2021). As a multi-center community cancer care system, an infrastructure was created and operationalized to address the work-related factors contributing to burnout. The purpose of the project was improved identification and prioritization of clinician (physician and APP) needs with subsequent targeted intervention. Methods: To measure success, a partnership with the American Medical Association (AMA) was formed to deploy the Mini-Z burnout survey. The survey was administered on July 2-August 20, 2021 to all Medical Oncology physicians and Advanced Practice Providers (APPs), n = 60. The survey was re-deployed from July 13-September 2nd, 2022. Data was collated by the AMA and presented back to executive leadership. Through this survey and follow up focus groups, it was identified that physicians tended to struggle more with the EHR and inability to disconnect from work compared to APPs. Our APPs identified several areas of opportunity including onboarding/orientation, mentorship/professional development, pay and scope of practice. An EHR Well-being Committee was established to evaluate EPIC signal reports to address both system and individual clinician needs. To address APP needs, key factors were addressed in the realm of professional development/orientation, compensation and scope of practice. This was approached with the goal of short-term gains and long-term sustainability. Results: The results indicated a 23.8% improvement in job satisfaction, 4.9% improvement in job stress, and 26.3% improvement in employment outlook. A decrease was also noted in EHR Time outside of work (4.5%) and burnout (16.1%). All areas of improvement met or exceeded national benchmarks. Analysis of these results indicate statistical significance for job satisfaction (p = 0.028, CI 2.8-40.4%) and employment outlook (p = 0.033, CI2.4-45.8%). Results that indicated improvement but were not statistically significant were job stress (p = 0.688, CI 17.6-27.4%), burnout (p = 0.191, CI 7.4-37.5%) and EHR time outside of work (p = 0.806). Conclusions: While the survey data does not account for clinician turnover between 2021 and 2022, initial review indicates a positive impact on job satisfaction and employment outlook which may be an early indication of improved colleague appreciation. Further study, post-pandemic is needed to evaluate effectiveness of care team efficiency and ongoing work to streamline EHR usage.
Reliability of audiovisual information on lung cancer from cancer organizations.
Authors: Dand Hardik , Macarulay Celinne , Reddy Preetham , Papakonstantinou Michael 
Published: June 2023

11020 Background: In the US, lung cancer is the leading cause of cancer death and second most common cancer. YouTube (YT), a social media platform with billions of users, can improve knowledge but also disseminate inaccurate information. Research has shown YT plays a key role in public health. This study assesses the reliability of YT videos about lung cancer using its own algorithm compared to videos from three cancer organizations. Methods: We searched “lung cancer” on YT and selected 8 videos with the most views. Then, “lung” was searched from YT profiles of American Cancer Society (ACS), National Cancer Institute (NCI), and National Comprehensive Cancer Network (NCCN). Criteria required videos to be less than 10 minutes and have “lung” in the description. Videos were excluded if not in English, older than 15 years, patient stories, or sponsored by pharmaceutical entities. The videos were graded by 3 independent medicine residents using the validated methods of Patient Education Materials Assessment Tool Understandability and Actionability (PU and PA) and Journal of the American Medical Association (JAMA) scoring. Higher percentages of PU and PA represented more understandable and actionable material. Higher JAMA score (up to 4) indicated better quality of information. Descriptive statistics and non-parametric Kruskal-Wallis tests were done. Results: A total of 36 videos were identified. PU mean was 74.2% (SD 21.4) in YT compared to 62.4% (SD 15.2), 53.1% (SD 28), and 58.8% (SD 13.9) for ACS, NCI, and NCCN respectively. PA mean was 46.6% (SD 46.8) for YT compared to 12.9% (SD 31.7), 38.9% (SD 53.6), and 8.2% (SD 21.2) for ACS, NCI, and NCCN respectively. A statistically significant higher median actionability score can be seen in YT. The JAMA average was 1.9 (SD 0.2) for YT compared to 2.1 (SD 0.1), 2.3 (SD 0.6), and 2.0 (SD 0) for ACS, NCI, and NCCN respectively. While a statistically significantly higher median JAMA score is seen in NCI videos, no meaningful difference can be extrapolated given all average scores of roughly 2. Conclusions: YT produced videos of higher understandability and actionability compared to videos from cancer organizations. As patients continue to rely on social media for information, trusted cancer sources should develop more reliable material for improved patient education. Comparison of scores from averages of 3 reviewers. [Table: see text]
How reliable are post-mastectomy breast reconstruction videos on YouTube?
Authors: Morena Nina , Ben-Zvi Libby , Hayman Victoria , Hou Mary , Nguyen Diana , Rentschler Carrie A. , Meguerditchian Ari N. 
Published: June 2023

11021 Background: Social media are a significant source of information for young women with breast cancer (YWBC) undergoing post-mastectomy breast reconstruction (PMBR). The emphasis on visual storytelling and building community in online spaces renders YouTube (YT) to be a common platform for discussions of BR. This study aims to assess the quality of YT videos about PMBR, identify themes related to the PMBR experience, and quantify perceptions of BR as an option PM. Methods: YT was searched incognito with terms “young women breast cancer reconstruction” in 08/2022, in order from most to least viewed. Title, upload date, length, poster identity, number of likes and comments were collected. The Patient Education Materials Assessment Tool for audiovisual materials (PEMAT A/V) evaluated understandability and actionability. DISCERN assessed quality and reliability. Presence of sponsorship, intended audience, patient and healthcare professional narratives, and perceptions of PMBR were collected. Reviewers noted whether PMBR was shown and how. Themes were collected inductively and deductively for thematic analysis. Results: 193 videos were identified. Mean video length was 14.6 minutes (SD 20.0 min). 87.1% included sponsorships. 95.9% of videos were posted by an organization. 60.6% were information-based; 45.6% experience-based. Mean PEMAT scores for understandability and actionability were 71.3% (SD 13.4) and 35.7% (SD 41.8), respectively. Mean DISCERN was 2.6/5 (SD 1.2). Patient narrative was present in 52.6% and healthcare professionals’ in 68.4%. PMBR was visually presented 22.8% of the time. 13.5% of videos explicitly recommended PMBR. 2.6% explicitly discouraged it. Patients (77.7%) represent the majority of the intended audience. Most common deductively identified themes included treatment (87.1%), family relationship (17.1%), motherhood (15.5%), fertility (11.9%). Inductively identified subthemes included differentiating between various options for PMBR surgery, BRCA genetic testing, psychosocial effects of breast cancer and PMBR, and recovery from surgery. Conclusions: YT is a platform wherein various PMBR options are widely discussed and explained. PMBR videos are highly understandable but have moderate levels of actionability, quality, and reliability. Videos are highly sponsored, demonstrating significant institutional bias. Themes are overwhelmingly treatment and surgery-based. Personal themes were present but not dominant. Distribution of PEMAT and DISCERN scores. [Table: see text]
A review of diversity, equity, and inclusion (DEI) efforts by medical oncology journals.
Authors: Abuali Inas , Parikh Aparna Raj , Kunz Pamela L. 
Published: June 2023

11023 Background: In recent years, there has been a growing awareness of the ongoing structural inequities impacting all facets of academic medicine. Efforts are underway to adopt an intentional and systemic approach to meaningful incorporation of DEI in academia. Here, we review the ongoing efforts by scientific peer-reviewed journals to ensure an equitable publication process, and an inclusive and diverse participation and distribution of oncological research. Methods: Medical oncology journals with the highest impact factor were identified using the SCImago Journal Rank (SJR), a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus database. 39 Journals in the first ranking quartile (Q1) with the highest impact were identified to have an SJR >2. An online review of journal websites’ content was performed between Jan 8th – Feb 8th, 2023, to extract the data available in the accompanying table. Results: 38.5% of journals include a DEI statement on their website. One journal has a dedicated editorial director of equity. Three journals (8%) have a specific online DEI corner highlighting related articles and initiatives. 20% of the journals publicly outlined specific DEI policies, such as formalizing the process for assessment and reporting, and identifying and inviting peer reviewers with DEI expertise. Finally, 20% of journals published limited specific metrics assessing the impact of their DEI efforts, such as data regarding the primary corresponding authors at country and region level in the last five years, and the gender diversity of their editorial boards. Conclusions: Our study highlights the limited publicly available data online regarding ongoing DEI initiatives and dedicated editorial positions in high impact medical oncology journals. It is imperative that we aim for greater intentionality and transparency about such efforts, with reporting of clear and specific impact metrics. In addition, these efforts cannot be performative and must foster a more equitable scholarly publication process, promote accountability, and assist in formulating best practices. Our analysis suggests a clear unmet need and represents a call to action. High impact oncology journals have an opportunity to set the tone for the entire oncology medical community. [Table: see text]