bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical characteristics and outcomes of COVID-19 disease in patients with cancer.
Authors: Ozer Muhammet , Goksu Suleyman Yasin , Mahdi Mohammed , Gandhi Neel Jitendra 
Published: June 2022

e18678 Background: The Coronavirus Disease 2019 (COVID- 19) has been nominated as a pandemic by the World Health Organization short after has spreaded globally. Unfortunately, even after several effective vaccines approved by FDA, COVID-19 cases are still surging. Compared to the general population, patients with cancer are more susceptible to COVID-19 for many aspects. Therefore, better understanding of the clinical characteristics of cancer patients with COVID-19 is urgently needed to spare these vulnerable patients from severe disease course. Methods: This retrospective study was completed in Capital Health Regional Medical Center, New jersey, USA. Adult patients with COVID-19 diagnosed between March 2020 and May 2021 were included in this study. All selected COVID-19 patients were stratified as two groups: Patients with cancer and patients without cancer. Other variables were included as age at diagnosis, gender, race/ethnicity, insurance status, obesity, comorbidity score, treatment of COVID-19, oxygen requirement and vital status. The Charlson Comorbidity Index was used to calculate the comorbidity score. Results: A total of 562 COVID-19 patients were included in this study; 67 (12%) patients diagnosed with cancer. Patients with cancer were more likely to be older (73 vs. 62 years, p < 0.001), overweight (BMI 25-29.9) (39% vs 28%, p = 0.02), and have higher comorbidity score > 3 (58% vs 15%, p < 0.001) than patients without cancer. Patients with cancer more frequently received steroid therapies (52% vs. 34%, p = 0.003), remdesivir (21% vs. 4%, p < 0.001), and convalescent plasma (21% vs. 10%, p = 0.009). The rate of high flow oxygen therapy was higher in patients with cancer than patients without cancer (30% vs. 16%, p = 0.02). The days of mechanic ventilation, hospital stay, ICU admission were similar between two groups. Patients without cancer had better survival rate compared to patients with cancer (77% vs. 64%, p = 0.02). Patients with cancer had increased D-dimer level (2.4 vs. 1.6 mg/L, p = 0.08) compared to patients without cancer but it was not significantly different. Other laboratory findings were also similar between two groups, including WBC, neutrophils, lymphocytes, lactate, lactate dehydrogenase, creatine kinase, d-dimer, C-reactive protein, procalcitonin, fibrinogen, BNP, troponin, sodium, AST, ALT, and ferritin. Multivariable logistic regression analysis showed that patients with cancer were associated with increased odds of higher than 3 comorbidity score (OR 7.09 [3.85-13.05], p < 0.001) and oxygen therapy with nasal cannula up to 6 liters (OR 3.7 [1.04-13.5], p = 0.04). Conclusions: This present analysis showed that patients had increased risk of mortality compared to counterpart. Our results emphasize that cancer patients as a group are at higher risk due to advanced age and preexisting conditions.
Trend analysis of effect of COVID-19 pandemic on breast cancer staging.
Authors: Zhao Li , Singh Vinit , Khalid Farhan , Eng Margaret , Meghal Trishala 
Published: June 2022

e18682 Background: COVID-19 Pandemic has impacted the diagnosis and treatment of breast cancer and has been shown to increase the late stage cancer at presentation. Most of studies has made year-wise comparison with 2019 for this conclusion. Same studies have also concluded that there was no difference in treatment duration after the diagnosis. Methods: We conducted an IRB-approved retrospective chart review of 505 (255 in 2018 and 250 in 2019) patients diagnosed with Breast Cancer from January 2018 to December 2019 for pre-COVID era and 206 patients diagnosed from March to December 2020 i.e. COVID era. We compared the race, histology, and stage at presentation. Patients from COVID era were compared with newly diagnosed breast cancer in 2018, 2019 patients individually and together. All the above characteristics. were compared between COVID and Pre-COVID era. Continuous variable was compared by T-test and Categorical variable were compared with details were recorded. Descriptive statistics were used in the analysis. Results: Median age of diagnosis for 2018, 2019, and COVID era was 62 (38-83), 59 (37-80) and 64(39-97) respectively. The proportion of white Race during pre-COVID era was 87.52% compared to 89.32% during the COVID era without any significant difference between all 3 years. For Histology, there was significant difference between proportion of histology between 2019 and 2020 (p-value 0.003) whereas no difference between 2018 and 2020 (p-value – 0.21) or combined pre-COVID and COVID era. Incase of staging, significantly more late stage cancer was seen in the COVID era compared to 2019 but there was no significant difference (p-value – 0.225). Same finding was seen between combined pre-COVID and COVID era (p-value - 0.94). Conclusions: Findings from our study suggest that a longer-term trend analysis is required for to find out the accurate impact of COVID-19 pandemic on breast cancer and cancer in general. A population-based study incorporating data from multicenter and multiple year should be done to assess the real effect of COVDI pandemic.[Table: see text]
Hospitalization and post-discharge survival outcomes of adolescents and young adults with cancer.
Authors: Lazar Neto Felippe , Hidalgo Filho Cassio Murilo Trovo , Da Rocha Joao Wilson , Bonadio Renata Colombo , Hoff Paulo Marcelo 
Published: June 2022

e18687 Background: Cancer incidence has increased among adolescents and young adults (AYA) over the last two decades. Younger patients often present with late diagnosis, aggressive disease, and are more likely to receive chemotherapy during cancer treatment. We investigated admission outcomes and post-discharge survival of AYA who were hospitalized after urgent admission. Methods: Retrospective cohort of patients with solid tumor diagnosis and age between 18 and 39 years, hospitalized after urgent admission to a tertiary, publicly-funded, cancer hospital in São Paulo, Brazil, from February 1st to December 31th 2021. We excluded patients with positive COVID-19 RT-PCR. We collected data on gender, cancer diagnosis, length of hospital stay, in-hospital mortality, chemotherapy infusion either before and during hospitalization; and last-follow up date and status. AYA admissions were compared to older adults (≥ 40 years [non-AYA]) admissions with chi-squared test. Overall survival (OS) after discharge between groups was analyzed with the log-rank test. Results: Of 4011 admissions, 312 were AYA. The median age was 34 (IQR 29-38) and most patients were female (63%). Compared to older adults (N = 3699), a higher proportion of AYA patients had breast cancer (25% vs 15%), central nervous system cancer (8.4% vs 2.6%), cervical cancer (12% vs 2.7%) and germinative cancer (4.5% vs 0.3%). The median length of hospital stay was 6 days (IQR 4-10). AYA were more likely to be under chemotherapy treatment during (11% versus 4%, p = 0.001) and within 30 days before hospitalization (32% vs 20%, p = 0.001). The overall in-hospital mortality rate was lower among AYA compared to older adults during the same period (12% vs 20%, p = 0.01). However, of those who died, a higher proportion were prescribed chemotherapy infusion before (38% vs 19%, p = 0.004) and during (15% vs 3.3%, p = 0.003) hospitalization; and a higher number of patients deceased on intensive-care unit beds, although the difference was not statistically significant (46% versus 36%, p = 0.2). Despite similar rates of 30-days readmissions (29% versus 26%, p = 0.3), AYA had better prognosis after discharge (mOS 295 days versus 181 days, p = 0.002). Conclusions: AYA patients had better hospitalization outcomes and were more likely to receive aggressive care near the end of life. Despite similar rates of early (≤ 30 days) readmissions, AYA had higher median overall survival after discharge compared to older adults. These finding should be taken into consideration when discussing hospitalization goals during admission of AYA with cancer.
Leveraging PrOFILE data to illustrate and benchmark the Institute of Medicine quality aims in global pediatric oncology.
Authors: Gonzalez-Guzman Miriam , Riley Elizabeth , Le Mai An , Forrest Heather , Friedrich Paola 
Published: June 2022

e18706 Background: PrOFILE is a dynamic 360o evaluation of health service delivery that helps care teams and institutions committed to increasing childhood cancer survival define an improvement strategy. PrOFILE stands for Pediatric Oncology Facility Integrated Local Evaluation. As of December 2021, PrOFILE has been utilized in over 130 facilities from over 25 countries around the globe. The standard outputs are presented by module, which reflect the patient-care continuum. The Institute of Medicine (IOM) has proposed six aims for improvement to drive fundamental change in health care delivery. The IOM Committee recommends periodically evaluating progress and developing strategies for overcoming barriers.However, a tool to assist facilities to set a baseline and periodically assess progress does not exist. We evaluated the feasibility of leveraging PrOFILE data to identify (1) the status of each quality aim as defined by IOM and (2) the status compared to facilities in the same country or region. Methods: This study employed a multi-step mapping approach. We first mapped the 1,279 PrOFILE variables to the six IOM quality aims. Mapping was first performed independently by two authors, then reviewed by PrOFILE experts to achieve consensus. Each variable could only contribute to one aim. We then validated the mapping by running the previously collected data available from two cohorts (one with 13 and one with 17 facilities) and benchmarking institutional data to cohort data. Quality improvement experts and local stakeholders provided feedback on further use of the illustrations and benchmarks. Results: We identified 305 PrOFILE variables that reflect the IOM quality aims (Table). More PrOFILE questions could be used as proxy for safety, effectiveness, and timeliness aims, than patient-centeredness, efficiency, and equity (Table), however, all domains could be represented. Benchmarking the institution results to the regional or country cohort results allowed for context-relevant insightful benchmarking. Framing PrOFILE results utilizing the IOM six aims allowed local healthcare teams and relevant stakeholders to evaluate their baseline and set targets for improvement. Conclusions: This exercise demonstrates the feasibility of leveraging PrOFILE data to assess institutional alignment with the IOM quality aims. The results allow illustrating, benchmarking, and engaging with stakeholders in conversations aimed at improving delivery of pediatric oncology care in global real-world settings utilizing this perspective. Future PrOFILE reports will incorporate this feature, supporting establishing a baseline and tracking of progress over time.[Table: see text]
A real-world evidence of immunotherapy adoption in non-small cell lung cancer (NSCLC) treatment and its transition from platinum-refractory to the first line of therapy.
Authors: De Marchi Pedro , Nazareth Aguiar Pedro , Paes Rafael , Costa e Silva Matheus , Favato Barcelos Isabella , Taveira Gabriela Monte Tenorio , Montella Tatiane Caldas , Ferrari Bruno Lemos , Barrios Carlos H. , Ferreira Carlos G. M. , Dienstmann Rodrigo 
Published: June 2022

e18714 Background: over the past few years, multiple clinical trials have shown that immune checkpoint inhibitors (ICI) are active in NSCLC treatment. In 2015, survival improvement was demonstrated with second line immunotherapy. More recently, benefit was proven in the first line setting, both with ICI alone or in combination with chemotherapy. How fast the medical community has incorporated these advances into its clinical practice needs to be evaluated, as well as ICI efficacy in a real-world setting. Methods: retrospective analysis of the Oncoclinicas Data Lake was carried out to extract and curate information on the use of ICI in NSCLC patients from 2015 onwards, as well as survival outcomes from start of treatment to death or last follow-up. Patients with actionable driver alterations were excluded from this analysis. Results: 767 patients were identified. Median age was 72 years, 54% were male. The number of patients treated with ICI increased dramatically in the period, from 13 in 2015 to 243 in 2020. Most patients (86%) received ICI in the second line or beyond in 2015, while in 2019 and 2020 the preference was immunotherapy in the first-line setting (60%). The transition from platinum-refractory to the first line was observed for both ICI single agents and ICI combinations. As of 2021, 75% of ICI + chemotherapy treatments take place in the first line setting and 54% of ICI monotherapy treatments are given in first line setting. Overall, median overall survival was 15.7 months for first line setting use of ICI (CI 95% 12.2-19.6) and 11.6 months for second line and beyond (CI 95% 8.9-14.2). Survival rates at 12 and 24 months for first line ICI use were 56% and 48.5% and for second line and beyond 35% and 25.5%, respectively. Conclusions: ICI was promptly incorporated into the treatment of NSCLC and its use has shifted from platinum-refractory to treatment-naïve setting, mostly with combination regimens. Our cohort shows real-world overall survival rates comparable with published literature, despite a more elderly population than clinical trials.
Is ECOG-PS ≥3 appropriate to guide rehabilitation referral decisions? Using patient-reported outcome measures to examine the prevalence of functional disability in patients with ECOG-PS 0-2.
Authors: Wood Kelley C , Hidde Mary , Kendig Tiffany , Ronnen Ellen A. , Carroll Rachel , Giri Smith , Williams Grant Richard , Pergolotti Mackenzi 
Published: June 2022

e18724 Background: Outpatient physical or occupational therapy (PT/OT) can optimize cancer patients’ performance status and ability to complete instrumental activities of daily living (IADL). The American College of Sports Medicine recommends referral to PT/OT for those with Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥3/5. However, ECOG-PS alone may not accurately indicate needs for PT/OT. We used functional patient reported outcome measures (F-PROM) to quantify the prevalence of functional disability for cancer patients with favorable ECOG-PS (0-2) starting a new line of systemic therapy. Methods: Patients with cancer at a multi-office community-based oncology private practice who were enrolled in a clinical trial (NCT04852575) completed a validated online geriatric assessment (the Cancer Aging Resiliency Evaluation) including F-PROM before starting a new line of systemic treatment. F-PROM included: Patient Reported Outcome Measurement System (PROMIS) - Cognitive Function (4 item, T-score = 41-80); impact of physical/emotional problems on social activities (social impact, 1-item); ability to walk one block (1-item); pain (0-10); and ability to perform nine IADL (3-point Likert scale). We extracted clinical characteristics from medical records, then used descriptive statistics and established F-PROM disability cut off to quantify the prevalence of functional disability. Results: Most patients (N = 86) were female (58%) and diagnosed with stage 3 or 4 (68%) breast (33%) or gastrointestinal cancer (24%). The mean±SD age was 64.3±10.7 years. ECOG was 0 (66%) or 1 (34%); none had ECOG-PS of >2. Across F-PROM, prevalence of disability ranged 24% (cognitive function) to 42% (social impact), see Table. IADL disability was reported by 31% of patients; median number of unique IADL disabilities was 3 (IQR = 1-4). Most common IADL disabilities were housework (29%), shopping (19%), ability to get to places out of walking distance (16%), and meal preparation (14%). Conclusions: Despite favorable ECOG-PS (0-1), 24 to 41% of patients starting a new line of systemic therapy in this study had one or more needs amendable to PT/OT. Future work should identify strategies to integrate F-PROM into routine oncology practice to identify rehabilitation needs and evaluate if subsequent PT/OT improves patient outcomes. Clinical trial information: NCT04852575. [Table: see text]
Real-world evidence of impact of atrial fibrillation (AF) on clinical and economic outcomes in patients with chronic lymphocytic leukemia (CLL).
Authors: Yang Keri , Liu Tom , Tang Boxiong , Chanan-Khan Asher 
Published: June 2022

e18729 Background: While the incidence of AF in CLL has been increasing, the implications of AF in real-world CLL patients remain understudied. This study aimed to assess the impact of AF on clinical and economic outcomes in CLL patients. Methods: This retrospective observational study used the US IBM MarketScan® commercial claims/Medicare supplement database (2017-2020) to identify newly diagnosed CLL patients (≥18 years) and incidence of AF after index date, defined as the first CLL diagnosis date. Patients were followed for ≥3-months pre-index, and from index to last follow-up or death. In addition to patient characteristics, clinical outcomes (incidence of heart failure [HF], bleeding and stroke) and economic outcomes (costs and healthcare resource utilization [HRU]) were compared between CLL patients with AF (CLL+AF) and CLL patients without AF (CLL-AF). HRU was evaluated by inpatient, outpatient, ER, and pharmacy visits. Multivariable regression analyses were conducted to examine the association between AF and clinical outcomes. Results: Among a total of 16,800 newly diagnosed CLL patients included in the study, 20% developed AF. CLL+AF were significantly older than CLL-AF (median: 77 vs 62 years; P < .001). Compared to CLL-AF, CLL+AF also had significantly more comorbidities at baseline, as shown by higher Charlson comorbidity index (CCI) (median: 1.0 vs 3.0; P < .001) and more patients with previous AF history (0.3% vs 8.4%; P < .001). Further assessing clinical outcomes in CLL+AF vs CLL-AF, significantly higher incidence of HF (26.3% vs 3.0%; P < .001), bleeding (12.2% vs 4.8%; P < .001) and stroke (6.6% vs 1.2%; P < .001) were observed. For HRU, CLL+AF were reported to have significantly higher rates of ER visits (29.4% vs 12.9%; P < .001) and hospitalizations (42.2% vs 14.5%; P < .001) than CLL-AF. In CLL+AF, the average total AF-related costs were $13,520.21 within 30 days after AF diagnosis, and $22,304.82 within 60 days after AF diagnosis. Controlling for demographics and comorbidities, multivariable regressions reported statistically significant associations between AF and HF, as well as AF and stroke (Table). Conclusions: This real-world study reported significantly higher incidence of HF, bleeding and stroke incurred by CLL patients who developed AF compared with those who did not. The presence of HF, bleeding and stroke further increased HRU and costs. These findings highlight the importance of better disease management and treatment selection to prevent AF in CLL patients.[Table: see text]
Complementary and alternative medicine exposure in oncology (CAMEO) study: A multi-institutional cross-sectional analysis of patients receiving cancer treatment.
Authors: Hutten Ryan J. , Weil Christopher R. , Barney Brandon M. , Fagerlin Angela , Gaffney David K. , Gill David Michael , Whipple Gary , Rhodes Terence Duane , Scherer Laura , Suneja Gita , Tward Jonathan David , Werner Theresa Louise , Evans Jaden , Johnson Skyler B 
Published: June 2022

e18739 Background: Compared to standard of care treatments, complementary and alternative medicine (CAM) use has been associated with decreased survival in cancer patients. CAM includes a broad range of treatments including vitamins/minerals, herbs/supplements, special diets, and mind/body interventions. An improved understanding of contemporary prevalence, predictors and intended goals of CAM use is needed to improve the cancer patient experience and guide shared decision-making regarding risks and benefits of their use. Methods: A cross-sectional survey of prospectively enrolled adult cancer patients treated at a large regional non-profit cancer center and an NCI-Designated Comprehensive Cancer Center between 2020 and 2021 was collected. Patients receiving cancer treatment were selected for analysis and grouped based on reported CAM use. Differences between CAM users and nonusers were assessed by chi-squared for categorical and two-sample t-test for continuous variables. Predictors of CAM use were identified with univariable and multivariable logistic regression. Results: Of 749 respondents, 83.31% had heard of or been recommended a CAM. Rates of CAM use during cancer treatment were highest for vitamins/minerals (56%), mind/body (52%), herbs/supplements (38%), special diets (30%), and other (12%). In the most common primary cancers, overall rates of CAM use were high (Breast: 84%, prostate: 66%, lung: 79%). Most patients (91%) use CAM in addition to conventional treatments. The intended goal of CAM therapy was most often management of symptoms (42%), treatment of cancer (30%), and mental health (15%). CAM users were younger than non-users (median age 62 years [y] vs 65y, p = 0.03). Females had higher rates of CAM use compared to males (86% vs. 78%, p < 0.01). Patients with incurable cancer had higher rates of CAM use than those with curable cancer (82% vs. 72%, p < 0.01). Predictors of CAM use on multivariable model include female gender (OR 2.5, p < 0.01) and incurable cancer (OR 2.5, p < 0.01). During cancer treatment, patients using CAM used multiple therapies and therapy types, including an average of 3.3 vitamins/minerals, 3.1 herbs/supplements, 2.5 mind/body exercises, and 1.6 special diets. Conclusions: CAM use is common among cancer patients receiving radiation, chemotherapy, and or surgery. Many patients are taking multiple CAM therapies during treatment with one third of patients using CAM with the intended goal of treating their cancer. This data provides details about and predictors of CAM use and provides information to guide patient-physician discussions.