bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of provider education on hepatitis B screening practices prior to patients receiving cancer treatment.
Authors: Adashek Michael , Culver Jacob , Carrera Carolyn Anne 
Published: June 2022

1539 Background: Hepatitis B virus (HBV) reactivation is a known side effect of CD20 targeted therapies with complications ranging from transient hepatitis to fulminant hepatic failure and death. In 2020 the American Society of Clinical Oncology (ASCO) expanded its provisional clinical opinion (PCO) to recommend HBV screening for all patients prior to receiving non-hormonal systemic anti-cancer therapies and if positive, offer viral prophylaxis or treatment. We assessed in a single-institution prospective study if a provider-led educational session on the 2020 ASCO PCO was effective in increasing HBV screening among patients receiving systemic non-hormonal anti-cancer therapies. Methods: An educational session for 30 minutes on the benefits outlined in the ASCO 2020 PCO discussing hepatitis B screening was held at a community-based hematology/oncology practice in Michigan. HBV screening panel was added to pre-chemotherapy lab order sets. Provider compliance with HBV screening recommendations was assessed monthly. Patients with positive HBV serology were identified and referred to Hepatology for monitoring and anti-viral treatment/prophylaxis as indicated. Data from 1,984 patient encounters for cancer treatment utilizing either chemotherapy or rituximab among 12 providers from March of 2020 to December 2021. Multivariate and logistic regression analysis was performed. Results: The educational intervention on the best practices of screening for Hepatitis B was effective in raising screening. Prior to intervention, 79.3% of all patients receiving rituximab (N = 140) and 15.7% of all patients receiving chemotherapy (N = 1277) had documentation for Hepatitis B before cancer treatment. Post-intervention hepatitis B testing increased both among patients receiving rituximab to 95.8% (N = 48) and chemotherapy to 29.9% (N = 519). In summary, prior to intervention, just 22.0% of 1,417 patient encounters had documentation for Hepatitis B screening before undergoing a treatment regimen. Post-intervention this level was raised to 35.45% (= 37.41,). In this study, 3 cases (0.5%) of acute and 12 cases (2.0%) of chronic HBV were identified from the 603 tested patients. A mixed effects logistic regression model controlling for treatment type and provider found patient encounters occurring post-intervention were 2.30 times more likely to be screened (OR = 2.30, 95% CI = [1.81, 2.93], p < 0.001). Conclusions: Our single educational session discussing the 2020 ASCO PCO and testing techniques for HBV was effective at increasing the odds of screening 2.3 times among patients receiving non-hormonal systemic anticancer therapies adjusting for therapy and provider. This may serve as a model for other implementations of PCOs. Further research will assess long-term oncologic outcomes of those identified with HBV and effects of anti-viral interventions.
Analysis of the likelihood of depression versus distress screening to identify need for intervention.
Authors: Csik Valerie Pracilio , Hannan Emma , Waldman Lauren , Garber Greg D. , Worster Brooke 
Published: June 2022

1544 Background: Psychosocial assessments are increasingly used to evaluate a patient-centered approach to quality cancer care delivery. Value-based oncology programs endorse screening metrics at every encounter. To comply with expectations of these programs, our cancer center utilizes two standardized tools: Patient Health Questionnaire (PHQ) to screen for depression at every encounter; National Comprehensive Cancer Network Distress Thermometer (NCCNDT) to screen for acute distress at clinically meaningful intervals. In 2021, oncology patients completed, on average, 5 annual appointments at Sidney Kimmel Cancer Center (SKCC), with a median appointment frequency of once every 19 days. Given the high encounter-per-patient ratio, we aimed to assess utility of frequent screening leading to supportive intervention. Methods: A retrospective analysis was conducted of medical oncology patients seeking care at SKCC with a completed depression and/or distress screening, as recorded in the patient’s electronic health record, between 1/1/2021 and 12/31/2021. This analysis intended to evaluate the percentage of patients whose scores indicate need for intervention. Patients who received more than one screening were attributed the highest score recorded during the measurement period. Results: A total 13,342 patients were screened at least once for either depression (n = 7,433), distress (n = 1,325), or both (n = 4,584). 3% of all patients screened ever met the intervention threshold (IT) for depression; 33% met the IT for distress. Of the patients who received both types of screenings, 31% met the IT for distress without meeting the threshold for depression. Those 1,418 patients would not have been referred for intervention through depression screening alone. Conclusions: This analysis highlights routine depression screening among a cancer population with a high encounter-per-patient ratio may not be sensitive in identifying need for supportive intervention. It also suggests that distress screening is more likely to lead to a supportive intervention than depression screening alone. This analysis combined with the anecdotal assessment by social workers supports the value of distress at clinically meaningful intervals over depression screening at each encounter. [Table: see text]
Feasibility of an explainable AI-based therapeutic recommendation-tool utilizing tumor gene expression profiles in advanced and refractory solid tumors.
Authors: Al Jarroudi Ouissam , Williams Coralie , Santos Rita , Dufresne Armelle , Attignon Valéry , Ferrari Anthony , Boyault Sandrine , Tonon Laurie , Tabone-Eglinger Séverine , Cassier Philippe Alexandre , Corradini Nadège , Vinceneux Armelle , Swalduz Aurélie , Viari Alain , Chabaud Sylvie , Pérol David , Afshar Mohammad , Blay Jean-Yves , Tredan Olivier , Saintigny Pierre 
Published: June 2022

1554 Background: Precision oncology aims to guide patient (pts) treatment decisions by matching biological features with available drugs. Extensive genomic analysis allows to identify an actionable alteration in 40-60% of patients. In a recent study of 50 pts with advanced refractory diseases included in PROFILER (NCT01774409), whole exome and fusion transcripts had a limited value over a 90-tumor gene panel (TGP) to increase molecular-based treatment recommendations (MBTR). Herein, we evaluated the feasibility, in the same cohort of pts, of the AI-transcriptional-based therapeutic recommendation-tool OncoKEM to guide treatment recommendations. Methods: 77 fresh frozen (FF) and/or FFPE samples including paired specimens for 53 pts with available RNA-Seq gene expression profiles were included. For each pts, a tumor transcriptional profile (TTP) was generated by identifying differentially expressed genes between the pts tumor and a cohort of matched healthy tissue. A large database of drug transcriptional signatures (DTS) was queried in order to identify a “reversal relationship” between the TTP and a DTS. A total of 205 drugs were ranked, including a subset of 61 FDA and/or EMA approved targeted therapies (aTT). Results: Most common diagnoses were breast cancers (21% of which 63% were TNBC), followed by ovarian cancers (OC, 18%) and soft-tissue sarcomas (STS, 13%). The median number of previous treatment lines was 4 (range: 1 - 10). Among the 77 tumor samples analyzed, 54 (70%) specimens led to the generation of an OncoKEM report, with no differences between FF and FFPE samples (p = 0.85). The overlap between the top 10 proposed drugs between paired FF and FFPE samples was 56% on average. All patients had at least 2 propositions (range: 2-9) of aTT among the top 10 ranked drugs in the Onco KEM reports. Most frequently proposed drugs among the top 10 were palbociclib, talazoparib, infigratinib in TNBC; bosutinib, sapanisertib, SAR125844 in OC; ipilimumab, cabozantinib, sapanisertib in STS. Among the 30 pts (79%) without any MBTR based on TGP/WES/fusion transcript analysis, all had at least 2 proposed aTT in the Onco KEM report (median: 4, range: 2-9). Top ranked drugs were MET (18%), VEGFR (12%), Abl (12%), FGFR (11%), PI3K/AKT/mTOR (11%), PARP (10%) and CDK4/6 inhibitors (7%). Conclusions: AI-transcriptional-based therapeutic recommendation-tool OncoKEM is feasible and has the potential to expand personalized cancer treatment in pts with advanced & refractory diseases without tractable genomic alterations. The clinical relevance assessment is planned in an upcoming clinical trial.
Participation in cancer research in BNSSG, England: A Health Equity Audit 2021.
Authors: Hamilton Kathryn , Winter Helen , Benton Diana , Lewis-White Helen , Ainsley Owen , Eyles Emily 
Published: June 2022

1565 Background: Cancer is a cause of health inequalities, and nationally, patients from deprived communities have lower participation rates in cancer research. Equitable access to research benefits patients, healthcare organisations and improves applicability of research. Methods: We undertook a health equity audit of participation in cancer research (trials and non-trials based) in Bristol, North Somerset and South Gloucestershire (BNSSG), England from 1.4.2019-30.3.2020 using data from the Acute Trust patient datasets. Comparison cohorts were extracted from a regional primary care dataset (the system wide dataset). Firstly, an incident cancer cohort: diagnosed from 1.11.2019-1.10.2020. Secondly a “living with cancer” cohort: cancer flag in the 5 years prior to 1.7.2021. Deprivation is measured by IMD of home postcode small area (LSOA). Results: Results are presented for the audit in the table below, with 95% confidence intervals where appropriate. Compared to people newly diagnosed with cancer, adults aged 70 or older were 56% less likely to take part in research (OR 0.44, 95% CI 0.39-0.51), and adults aged 80 or older were 77% less likely to take part in research (OR 0.23, 95% CI 0.18-0.29). Compared to people newly diagnosed with cancer, people from the most deprived 20% of the population were 27% less likely to take part in research (OR 0.73, 95% CI 0.88-0.92). The most deprived research participants were more likely to be younger, have one or more comorbidities and a recent emergency admission. Patients from outside BNSSG (18%) appear similar in profile to those from within BNSSG, including for deprivation. Better data are needed for other factors relevant to equity, including ethnicity and Inclusion Health. Conclusions: This health equity audit confirms and quantifies inequities in access to cancer research in our region. Under-representation of deprived and older patients appeared multifactorial in this audit, but further work to understand facilitators and barriers to recruitment is needed. These results are a call to action. [Table: see text]
A retrospective cohort analysis of return-to-work outcomes for cancer survivors using a digital coaching intervention.
Authors: Aung Yuri Yin-Moe , Smith Justin , Ballurkar Kieran , Fox Simonie , Tynan Kate , Lo Jonathon , Murali-Ganesh Raghav , Boyer Michael J. 
Published: June 2022

1566 Background: Return-to-work (RTW) is a key unmet need for working age cancer survivors, with up to 40% failing to RTW 1 to 2 years post-diagnosis. This study sought to evaluate RTW outcomes of a multidisciplinary digital coaching intervention provided as routine employee support. Methods: A retrospective cohort analysis was conducted from October 2018 to February 2020 where cancer patients with more than 3 months absent from work were provided by their insurance carriers with a multidisciplinary intervention comprising digital resources and telephone calls with a health coach. A logit regression model was used to calculate a propensity score using covariates of age, gender, insurance benefit type, cancer diagnosis date and time from diagnosis. Participants were then matched on a 1:1 basis using the nearest-neighbour method without replacement to create a matched control group out of 1,856 participants who did not receive the intervention. Primary outcomes, derived from insurance-claims data as standard business practice, included rate and time to RTW, along with death and other reasons for claim closure. Results: 220 participants enrolled in the intervention, of which 125 met the criteria for analysis (median age 53, IQR 45-58, 91% female). These participants were matched with 125 controls (median age 53, IQR 47-59, 94% female). Median follow-up from cancer diagnosis was 79 weeks (IQR 60-106). Of the matched controls, 22 returned to work (17.6%) compared with 38 (30.4%) in the intervention group (P =.02). 19 matched controls died prior to claim closure (15.2%) compared with 13 in the intervention group (10.4%; P =.26). Finally, Kaplan-Meier method estimated median time for the first 15% of participants to RTW was 87.1 weeks for controls (CI 60.0-109.1 weeks) compared with 70.6 weeks for the intervention group (CI 52.6-79.6 weeks; P =.08). Conclusions: This study evaluated the impact of a digitally delivered coaching program in a real-world setting for cancer patients, demonstrating a 12.8% increase in RTW rate over 18 months compared to matched controls. These findings corroborate and add to the literature on cancer as a chronic and manageable disease in the workplace.
Evaluating an AI-based nutrition expert platform delivered via SMS-text to support patients with cancer.
Authors: Buchan Marissa Lubin , Tang Hao , Bratton Susan , Padmanabhan Sridevi , Raben David 
Published: June 2022

1569 Background: Interventions incorporating nutritional strategies can prevent and manage nutrition-related symptoms, however, due to a shortage of oncology dietitians (RD CSO) combined with healthcare access disparities, many patients do not receive the support they need, resulting in poor outcomes and quality of life (QoL). High rates of cell phone utilization among all demographics offers a unique opportunity to provide interventions using mobile technology. Methods: Launched to select groups in 2019, Ina (trademarked by Savor Health LLC) is a virtual nutrition assistant powered by an artificial intelligence (AI)-enabled expert platform, to facilitate self-management of cancer treatment side effects. The platform combines evidence, expertise, and unique patient data to deliver the personalized guidance patients would receive from an RD CSO, “on-demand” via text. This study applied the RE-AIM framework to evaluate the intervention from five dimensions. Results: Reach: The program reached 1,706 users as of 2021. Based on self-report among 1209 users, 78% are patients, 18% are caregivers, and 5% are healthcare professionals with 66% female and 34% male. Ina supports all cancer types, and top diagnoses among users are genitourinary (28%), lung (20%), gynecologic (16%), gastrointestinal (15%), and breast (11%). Disease burden is high, with 62% of users reporting they are experiencing nutrition-addressable symptoms at any given time. Effectiveness: Based on weekly patient reported outcome (PRO) surveys, 87% of respondents report Ina helps them manage symptoms, and 80% report that using Ina has improved their QoL. The cumulative likelihood to recommend is 4.1 on a 5-point scale. Adoption: Users are from over 18 cancer organizations, proving the feasibility and accessibility of this intervention. Implementation: Ina is accessible 24/7 via text, and is offered to patients in a B2B2C model. Users typically receive responses to nutrition-related questions within seconds from the AI platform (or 1-3 minutes with live RD oversight). Each active user (one that engages at least once in a given month) asks an average of 2.8 questions per month. Maintenance: The median time users remain on the platform is 156 days (range 0-884) and 57% of evaluable users stayed on the platform 6 months or longer. The platform’s database, which includes over 54,000 referenced interventions, grows daily via supervised machine learning supported by RD CSOs. When surveyed on future feature development, respondents are most interested in tele-nutrition (57%), mental health (65%), and stress management (62%). Conclusions: Initial data suggests this is a feasible and accessible tool to support cancer patients’ unique nutrition and symptom-management needs. Clinical trials are needed to validate feasibility and assess impact on clinical and QoL outcomes. Product development to integrate language and cultural preferences is ongoing.
Exploring country priorities and contextual considerations for implementing national cancer control plans (NCCP) among participants of International Cancer Control Partnership (ICCP) ECHO.
Authors: Kizub Darya Aleksandrovna , Eldridge Linsey , Tittenbrun Zuzanna , Cira Mishka K. , Duncan Kalina , Hohman Karin , Given Leslie , Foxhall Lewis E. , Adsul Prajakta 
Published: June 2022

1581 Background: Promoting NCCP implementation by low- and middle-income countries (LMICs) is key to addressing inequities in cancer outcomes and the global burden of cancer. We explored contextual factors that may influence implementation of NCCP priorities in LMICs. Methods: Seven countries participated in the 2021 International Cancer Control Partnership ECHO (R) geared toward creating a community of practice to inform NCCP implementation. Using qualitative methods, we conducted focus group discussions (FGDs) with country teams who were asked to identify NCCP priorities and provide contextual considerations around implementing these in the 12-months program. FGDs were audio-recorded, transcribed, double-coded, and underwent thematic analysis. Results: Thirty-three participants from 6 Sub-Saharan African countries and 1 country in Asia took part in 7 FGDs, including 14 physicians, 9 non-governmental organizations, 6 Ministry of Health/NCCP and 4 cancer registry representatives. All seven country teams (100%) prioritized cancer early detection, especially for cervical (71%) and breast (57%) cancer, including by educating primary care clinicians (57%) and general population (43%) about cancer signs and symptoms. Related contextual factors included late-stage diagnosis of cancer (43%) and low knowledge about cancer among primary care clinicians and the general population (29% each), respectively. Finding resources for implementation of NCCP priorities was important given lack of funding (57% each). Harmonizing programs and building partnerships for implementation (57%) was prioritized given perceived fragmentation of efforts and benefit of leveraging limited resources (29% each). Improving access to treatment (43%) was a priority given a lack of oncology specialists (29%) and unaffordable treatment (14%). Improving access to palliative care (43%), including by writing guidelines (29%), was prioritized due to late-stage diagnosis and insufficient access to palliative care (14% each). Improving cancer registry data was essential for NCCP program planning (43% each), while cancer research (43%) was key to answering specific questions related to cancer registry data (14%) and program impact (29%). Additional contextual considerations for making progress on these priorities dicussed by country teams included leveraging existing programs (100%) and learning from other countries and ICCP technical experts (57% each). Conclusions: There were similarities in country NCCP priorities and contextual factors affecting implementation. These results allow for future exploration of how LMIC country teams implement NCCPs and examine the value of communities of practice promoted by ICCP and facilitated by ECHO, towards improving cancer outcomes.
Financial payments from the pharmaceutical industry to U.S. cancer centers, 2014-2019.
Authors: Mitchell Aaron Philip , Brown Meredith , Trivedi Niti U. , Bach Peter Brian 
Published: June 2022

1582 Background: Payments from the pharmaceutical industry to US health care providers were made public through Open Payments in 2013. Since then, industry payments to individual physicians have been studied extensively, but payments to hospitals remain uncharacterized. The goal of this study was to examine trends in industry payments to US cancer centers. Methods: We identified all US cancer centers that were National Comprehensive Cancer Network (NCCN) members or were National Cancer Institute (NCI) comprehensive cancer center as of 2019. Each institution was manually mapped to Open Payments, which contains industry payment data. Where applicable, subsidiary hospitals were included with the parent center. Among the NCCN centers, we used National Plan and Provider Enumeration System data to identify medical oncologists practicing there. Oncologists were linked to Open Payments by name and address. We analyzed “research payments” (RP), which include payments related to preclinical and clinical research, and “general payments” (GP), which include non-research-related payments in categories such as speaker fees, consulting fees, meals, grants, charitable contributions, and licensing fees. We ascertained public research support from NIH data, and included all research project grants. We used correlation analysis and linear regression models to assess the association between industry payments to a cancer center and to oncologists practicing at that center. All dollar values were inflation-adjusted to 2019 dollars using the Consumer Price Index for medical care from the US Bureau of Labor Statistics. Results: Overall industry RP to US cancer centers increased from $527 million in 2014 to $653 million in 2019, while GP increased from $346 million to $786 million. NCI research funding increased from $1,397 million in 2014 to $1,583 million in 2019 (13.3% increase) while overall industry payments (RP+GP) increased from $873 million to $1,439 million (64.8% increase). Industry payments were highest as a portion of total income (industry + NCI) at MD Anderson (64.2%) and lowest at St. Jude (0.1%). Among NCCN institutions, industry payments to cancer centers and the oncologists practicing at those centers were correlated (coefficient = 0.382). A $1,000 increase in GP to a cancer center from a given pharmaceutical company was associated with a $1.00 ($0.61 - $1.30) increase in GP from that company to oncologists at that cancer center. Conclusions: From 2014-2019, cancer center funding from industry sources grew quickly, driven by an increase in non-research payments, and now approaches the amount of public research funding cancer centers receive. Cancer center acceptance of industry payments is associated with increased industry payments to its employed physicians, which are known to sway prescribing practices. These trends raise concerns regarding the ability of these institutions to fulfill their public missions.