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Worden F, Rajkovic-Hooley O, Reynolds N, Milligan G, Zhang J. Real-world treatment patterns and clinical outcomes in patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) treated with first line lenvatinib monotherapy in the United States. Endocrine 2024; 84:663-669. [PMID: 38102498 PMCID: PMC11076410 DOI: 10.1007/s12020-023-03638-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Lenvatinib was approved for the treatment of patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) in the United States (US) in 2015. The main objective of the current study was to assess real-world clinical effectiveness in RAI-R DTC patients treated with first line lenvatinib monotherapy in the US. METHODS A retrospective chart review was conducted in RAI-R DTC patients who initiated lenvatinib monotherapy as first line treatment between February 2015 and September 2020. Anonymized data were abstracted by prescribing physicians from individual patient's electronic health records. Clinical outcomes included provider-reported real-world best overall response (rwBOR), real-world progression-free survival (rwPFS), and overall survival (OS). Time-to-event endpoints were assessed using Kaplan-Meier methods. RESULTS Our study included 308 RAI-R DTC patients treated with first line lenvatinib. At lenvatinib initiation, patients' median age was 60 years, 51.6% were female, and 26.0% of patients had an ECOG performance score of ≥2. Over the follow-up period, 32.5% of patients discontinued first line lenvatinib permanently, with others remaining on treatment. The median duration of lenvatinib therapy was 17.5 months overall. Provider-reported rwBOR (complete or partial response) to lenvatinib was 72.4%. Median rwPFS was 49.0 months. Estimated rwPFS rates at 24 and 48 months were 68.5% and 55.0%, respectively. Estimated OS rates at 24 and 72 months were 78.4% and 57.0%, respectively; median OS was not reached. CONCLUSION The current study reinforces the clinical effectiveness of first line lenvatinib as standard of care in patients with RAI-R DTC in real-world clinical practice in the US.
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Affiliation(s)
- Francis Worden
- University of Michigan Health System, Ann Arbor, MI, USA.
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Chaudhuri KR, Azulay JP, Odin P, Lindvall S, Domingos J, Alobaidi A, Kandukuri PL, Chaudhari VS, Parra JC, Yamazaki T, Oddsdottir J, Wright J, Martinez-Martin P. Economic Burden of Parkinson's Disease: A Multinational, Real-World, Cost-of-Illness Study. Drugs Real World Outcomes 2024; 11:1-11. [PMID: 38193999 DOI: 10.1007/s40801-023-00410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Parkinson's disease is now one of the fastest-growing neurodegenerative disorders in the developed world, with an increasing prevalence and associated socioeconomic costs. Progression of the disease leads to a gradual deterioration in patients' quality of life, despite optimal treatment, and both medical and societal needs increase, often with the assistance of paid and/or unpaid caregivers. OBJECTIVE We aimed to quantify the incremental economic burden of Parkinson's disease by disease severity in a real-world setting across differing geographic regions. METHODS Demographics, clinical characteristics, health status, patient quality of life, caregiver burden, and healthcare resource utilization data were drawn from the Adelphi Parkinson's Disease Specific Program™, conducted in the USA, five European countries, and Japan. RESULTS A total of 563 neurologists provided data for 5299 individuals with Parkinson's disease; 61% were male, with a mean age of 64 years. Approximately 15% of individuals were deemed to have advanced disease, with significantly more comorbidities, and a poorer quality of life, than those with non-advanced disease. Overall, the mean annual healthcare resource utilization increased significantly with advancing disease, and resulted in a three-fold difference in the USA and Europe. The main drivers behind the high economic burden included hospitalizations, prescription medications, and indirect costs. CONCLUSIONS People with Parkinson's disease, and their caregivers, incur a higher economic burden as their disease progresses. Future interventions that can control symptoms or slow disease progression could reduce the burden on people with Parkinson's disease and their caregivers, whilst also substantially impacting societal costs.
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Affiliation(s)
- K Ray Chaudhuri
- Parkinson Foundation Centre of Excellence, King's College Hospital and Kings College, London, UK.
| | - Jean-Philippe Azulay
- Department of Neurology and Movement Disorders, APHM Timone University Hospital and Institut de Neurosciences de la Timone, AMU-CNRS UMR 7289, Marseilles, France
| | - Per Odin
- University of Lund, Lund, Sweden
| | | | - Josefa Domingos
- Parkinson's Europe, Sevenoaks, UK
- Egas Moniz School of Health and Science, Almada, Portugal
| | | | | | | | | | | | | | | | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
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Mallio CA, Bernetti C, Sertorio AC, Zobel BB. ChatGPT in radiology structured reporting: analysis of ChatGPT-3.5 Turbo and GPT-4 in reducing word count and recalling findings. Quant Imaging Med Surg 2024; 14:2096-2102. [PMID: 38415145 PMCID: PMC10895108 DOI: 10.21037/qims-23-1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/20/2023] [Indexed: 02/29/2024]
Affiliation(s)
- Carlo A Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Caterina Bernetti
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Andrea C Sertorio
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Bruno Beomonte Zobel
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
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Keenan A, Le HH, Gandhi K, Adedokun L, Jones E, Unsworth M, Pike J, Trenholm E. Shared Decision-Making in the Treatment of Multiple Sclerosis: Results of a Cross-Sectional, Real-World Survey in Europe and the United States. Patient Prefer Adherence 2024; 18:137-149. [PMID: 38249686 PMCID: PMC10799568 DOI: 10.2147/ppa.s440410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Multiple sclerosis (MS) is a neurodegenerative disease characterized by progressive deterioration of cognitive and physical functioning, reducing activities of daily living and quality of life (QoL). Several treatments are available that modify the course of the disease and reduce the frequency of relapses. Although effective, all treatment options are accompanied by adverse events, and this study aimed to assess the extent to which patients were involved in the choice of treatment. Methods Data were drawn from the Adelphi Multiple Sclerosis Disease Specific Program (DSP)™, a cross-sectional survey of healthcare practitioners (HCP) and their patients with MS in real-world clinical settings in Europe and the United States (US) between December 2020 and July 2021. HCPs reported patient demographics, clinical characteristics, current and previous treatment, and treatment outcomes. Patients voluntarily completed questionnaires reporting the physical and psychological impact of their MS and its treatment. Regression analysis with inverse probability of treatment weighting was used to compare treatment outcomes in patients actively involved in their current treatment choice with those who were not. Results Of a total of 692 patients, median age 40 years and 64% female, mostly diagnosed with relapsing-remitting MS, those who were involved in shared decision-making tended to choose oral therapies such as dimethyl fumarate more often than HCPs. MS had greater impact on physical and psychological functioning in patients whose HCP made treatment decisions solely. Patients involved in decision-making reported greater satisfaction with their treatment and a better QoL. Discussion Because no single optimal therapy exists for patients with MS, treatments should be individualized with consideration of patients' preferences. Our study shows that shared decision-making is under-utilized in the management of MS and supports the benefits of patient involvement. Conclusion Patients who have an active role in treatment decision-making show improved wellbeing and QoL, and overall treatment satisfaction.
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Affiliation(s)
- Alexander Keenan
- Scientific Affairs, Janssen Pharmaceuticals Inc., Titusville, NJ, USA
| | - Hoa H Le
- Scientific Affairs, Janssen Pharmaceuticals Inc., Titusville, NJ, USA
| | - Kavita Gandhi
- Research and Development, Janssen Pharmaceuticals Inc., Titusville, NJ, USA
| | - Lola Adedokun
- Research and Development, Janssen-Cilag Ltd, High Wycombe, UK
| | - Eddie Jones
- Central Nervous System, Adelphi Real World, Bollington, Cheshire, UK
| | - Mia Unsworth
- Central Nervous System, Adelphi Real World, Bollington, Cheshire, UK
| | - James Pike
- Statistics & Data Analytics, Adelphi Real World, Bollington, Cheshire, UK
| | - Emily Trenholm
- Central Nervous System, Adelphi Real World, Bollington, Cheshire, UK
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Chua ME, Silangcruz JM, Kim JK, Koyle MA, Sriharan A. A Scoping Review on Learning Health Networks Available in Pediatric Surgical Specialties. J Pediatr Surg 2023; 58:2416-2428. [PMID: 37544802 DOI: 10.1016/j.jpedsurg.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Learning health networks (LHN) are consortia of institutions that collaborate and embrace the elements of the learning health system (LHS), including quality improvement, education, research, and stakeholder involvement. Their ultimate goal is rapid information dissemination in clinical care. Pediatric surgical specialties perform unique yet high-impact procedures that could benefit from LHN, thereby improving surgical outcomes and care through LHS approaches. Consequently, health system leaders should be aware of LHN and their importance in enhancing surgical care and improving outcomes. This scoping review aims to map and characterize the existing LHN applied in pediatric surgical specialties. METHODS A systematic literature search was performed on Medline, EMBASE, and Scopus up to June 2022, with an update search conducted in May 2023. Additionally, Google Scholar, ProQuest and inquiry from topic experts were used for cross-referencing relevant review articles to identify grey literature. This scoping review was conducted and reported according to the PRISMA-scoping review extension. RESULTS A total of 56 publications for 19 LHN were identified and included in this scoping review. Out of 19 identified LHN in pediatric surgical specialties, 18 were organized in North America. Eight of the networks are related to pediatric general surgery and another eight were related to pediatric transplantation. The 16 out of 19 LHN were initiated after 2001. To date, only eight of the LHNs generated reports of comparative improved outcomes. CONCLUSION This scoping review provides an overview of the available LHNs in pediatric surgical specialties. Over the past decade, several pediatric surgical specialties have embraced the principles of learning health systems, forming inter-institutional collaborations that utilize information technology to generate big data on patient-level clinical information, engage in quality improvement cycles, adopt evidence-based practices, and actively involve patients and stakeholders. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Michael E Chua
- Global Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Urology, St. Luke's Medical Center, Quezon City, NCR, Philippines.
| | | | - Jin Kyu Kim
- Department of Surgery, Faculty of Medicine and Surgery, University of Toronto, ON, Canada
| | - Martin A Koyle
- System Leadership and Innovation, Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada
| | - Abi Sriharan
- System Leadership and Innovation, Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada
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Casella B, Riviera W, Aldinucci M, Menegaz G. MERGE: A model for multi-input biomedical federated learning. PATTERNS (NEW YORK, N.Y.) 2023; 4:100856. [PMID: 38035188 PMCID: PMC10682752 DOI: 10.1016/j.patter.2023.100856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 12/02/2023]
Abstract
Driven by the deep learning (DL) revolution, artificial intelligence (AI) has become a fundamental tool for many biomedical tasks, including analyzing and classifying diagnostic images. Imaging, however, is not the only source of information. Tabular data, such as personal and genomic data and blood test results, are routinely collected but rarely considered in DL pipelines. Nevertheless, DL requires large datasets that often must be pooled from different institutions, raising non-trivial privacy concerns. Federated learning (FL) is a cooperative learning paradigm that aims to address these issues by moving models instead of data across different institutions. Here, we present a federated multi-input architecture using images and tabular data as a methodology to enhance model performance while preserving data privacy. We evaluated it on two showcases: the prognosis of COVID-19 and patients' stratification in Alzheimer's disease, providing evidence of enhanced accuracy and F1 scores against single-input models and improved generalizability against non-federated models.
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Affiliation(s)
- Bruno Casella
- Department of Computer Science, University of Turin, 10149 Turin, Italy
| | - Walter Riviera
- Department of Computer Science, University of Verona, 37134 Verona, Italy
| | - Marco Aldinucci
- Department of Computer Science, University of Turin, 10149 Turin, Italy
| | - Gloria Menegaz
- Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy
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Cheng H, Deng X, Li J, Tang Y, Yuan S, Huang X, Wang Z, Zhou F, Lyu J. Associations Between Dysphagia and Adverse Health Outcomes in Older Adults with Dementia in Intensive Care Units: A Retrospective Cohort Study. Clin Interv Aging 2023; 18:1233-1248. [PMID: 37554511 PMCID: PMC10405813 DOI: 10.2147/cia.s409828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/17/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Dysphagia is common in elderly patients with dementia and is one of the common clinical geriatric syndromes. It imposes a heavy burden on patients and their caregivers and is becoming an important public health problem. This study examined the association between dysphagia in older dementia patients in the ICU and the subsequent adverse health outcomes they experience. PATIENTS AND METHODS A retrospective analysis of adults (≥65 years) with dementia in ICUs of a Boston tertiary academic medical center was conducted. Using the International Classification of Diseases' Ninth and Tenth Revisions, dementia patients were identified. The study cohort comprised 1009 patients, median age 84.82 years, 56.6% female, predominantly White (72.9%). Patients were grouped based on swallowing function: dysphagia (n=282) and no-dysphagia (n=727). Dysphagia was identified via positive bedside swallowing screening. Primary outcomes were 90- and 180-day mortality, secondary outcomes included aspiration pneumonia, pressure injury, and delirium. Cohort characteristics were compared using the Wilcoxon rank-sum and chi-square tests. Dysphagia and outcomes correlations were examined via Kaplan-Meier survival analysis, Cox proportional-hazards regression models, logistic regression models, and subgroup analysis. RESULTS After adjusting for covariates, the results from multivariate Cox proportional-hazards regression indicated that dysphagia was significantly associated with increased 90-day (HR=1.36, 95% CI=1.07-1.73, E-value=1.78) and 180-day (HR=1.47, 95% CI=1.18-1.82, E-value=1.94) mortality; the multifactorial logistic regression results indicated that dysphagia was associated with significant increases in pressure injury (OR=1.58, 95% CI=1.11-2.23, E-value=1.83) and aspiration pneumonia occurrence (OR=4.04, 95% CI=2.72-6.01, E-value=7.54), but was not significantly associated with delirium prevalence (OR=1.27, 95% CI=0.93-1.74). CONCLUSION Dysphagia is likely to increase the risk of adverse health outcomes in older adults with dementia in ICU, and these adverse outcomes mostly include 90- and 180-day mortality, aspiration pneumonia, and pressure injury.
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Affiliation(s)
- Hongtao Cheng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
- School of Nursing, Jinan University, Guangzhou, People’s Republic of China
| | - Xingwen Deng
- Department of Medical Information, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
| | - Jieyao Li
- Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
| | - Yonglan Tang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
- School of Nursing, Jinan University, Guangzhou, People’s Republic of China
| | - Shiqi Yuan
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
| | - Xiaxuan Huang
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
| | - Zichen Wang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
| | - Fuling Zhou
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, People’s Republic of China
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8
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Deik A. Potential Benefits and Perils of Incorporating ChatGPT to the Movement Disorders Clinic. J Mov Disord 2023; 16:158-162. [PMID: 37258279 PMCID: PMC10236019 DOI: 10.14802/jmd.23072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Affiliation(s)
- Andres Deik
- Parkinson’s Disease and Movement Disorders Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
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9
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Global retrospective analysis of clinician- and patient-reported clinical characteristics and humanistic burden of patients with gastroesophageal cancers on first-line treatment. BMC Cancer 2023; 23:186. [PMID: 36823552 PMCID: PMC9951421 DOI: 10.1186/s12885-023-10553-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/16/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Gastric cancer (GC), gastroesophageal junction cancer (GEJC), and esophageal adenocarcinoma (EAC), together, are leading causes of cancer deaths worldwide. Patient health-related quality of life (HRQoL) and well-being has become increasingly important alongside traditional oncologic outcomes for both patients and clinicians and may aid treatment decisions. We conducted a survey to examine the clinical characteristics, humanistic burden, and the effects of first-line (1L) treatment in patients with GC/GEJC/EAC, across different geographic regions, to address the paucity of real-world data. METHODS Clinicians treating patients with unresectable advanced or metastatic GC/GEJC/EAC in China, France, Germany, Japan, the United Kingdom, and the United States, during April-October 2019, were invited to provide data on their patients' demographics, clinical characteristics, treatment, and HRQoL via medical chart reviews, clinician surveys, and patient questionnaires. Data were analyzed using descriptive statistics, regression analyses comparing active treatment and best supportive care. Patients were also stratified into subgroups that were identified either as human epidermal growth factor receptor 2 (HER2) positive, HER2 negative (which has a higher prevalence but for whom there are limited treatment options), or unknown HER2 status. RESULTS Survey data were analyzed for 995 patients, 87% of whom were on active treatment, most commonly dual or triple chemotherapy. Demographics and clinical characteristics were similar across countries with most patients having GC and the lowest incidence of GEJC and EAC in China. Overall, most patients had de novo disease with good response to 1L treatment, while their HRQoL and well-being was significantly worse than the general population. In 682 patients on active treatment with HER2 negative or unknown status, HRQoL also appeared to be worse in those with recurrent disease. Regression analysis identified several drivers of treatment decisions and factors impacting patients' HRQoL, including stage of disease and comorbidities. CONCLUSIONS In patients with advanced GC/GEJC/EAC, screening and assessment of HER2 status as well as patient-reported HRQoL outcomes are invaluable in aiding treatment decisions. The introduction of appropriate therapy soon after diagnosis has the prospect of achieving improved HRQoL and survival in these patients.
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Arvisais-Anhalt S, Ravi A, Weia B, Aarts J, Ahmad HB, Araj E, Bauml JA, Benham-Hutchins M, Boyd AD, Brecht-Doscher A, Butler-Henderson K, Butte AJ, Cardilo AB, Chilukuri N, Cho MK, Cohen JK, Craven CK, Crusco S, Dadabhoy F, Dash D, DeBolt C, Elkin PL, Fayanju OA, Fochtmann LJ, Graham JV, Hanna JJ, Hersh W, Hofford MR, Hron JD, Huang SS, Jackson BR, Kaplan B, Kelly W, Ko K, Koppel R, Kurapati N, Labbad G, Lee JJ, Lehmann CU, Leitner S, Liao ZC, Medford RJ, Melnick ER, Muniyappa AN, Murray SG, Neinstein AB, Nichols-Johnson V, Novak LL, Ogan WS, Ozeran L, Pageler NM, Pandita D, Perumbeti A, Petersen C, Pierce L, Puttagunta R, Ramaswamy P, Rogers KM, Rosenbloom ST, Ryan A, Saleh S, Sarabu C, Schreiber R, Shaw KA, Sim I, Sirintrapun SJ, Solomonides A, Spector JD, Starren JB, Stoffel M, Subbian V, Swanson K, Tomes A, Trang K, Unertl KM, Weon JL, Whooley MA, Wiley K, Williamson DFK, Winkelstein P, Wong J, Xie J, Yarahuan JKW, Yung N, Zera C, Ratanawongsa N, Sadasivaiah S. Paging the Clinical Informatics Community: Respond STAT to Dobbs v. Jackson's Women's Health Organization. Appl Clin Inform 2023; 14:164-171. [PMID: 36535703 PMCID: PMC9977563 DOI: 10.1055/a-2000-7590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Simone Arvisais-Anhalt
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, United States
| | - Akshay Ravi
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Benjamin Weia
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Jos Aarts
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hasan B. Ahmad
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
| | - Ellen Araj
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Julie A. Bauml
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Marge Benham-Hutchins
- College of Nursing and Health Science, Texas A&M University, Corpus Christi, Corpus Christi, Texas, United States
| | - Andrew D. Boyd
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, Illinois, United States
| | - Aimee Brecht-Doscher
- Department of Obstetrics and Gynecology, Ventura County Healthcare Agency, Ventura, California, United States
| | | | - Atul J. Butte
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, California, United States
| | - Anthony B. Cardilo
- Department of Emergency Medicine, NYU Langone Health, New York, New York, United States
| | - Nymisha Chilukuri
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - Mildred K. Cho
- Departments of Medicine and Pediatrics, Stanford University School of Medicine, Stanford, California, United States
- Stanford Center for Biomedical Ethics, Stanford University, Stanford, California, United States
| | - Jenny K. Cohen
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Catherine K. Craven
- Division of Clinical Research Informatics, Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio, Texas, United States
| | - Salvatore Crusco
- The Feinstein Institutes for Medical Research, Northwell Health, New Hyde Park, New York, United States
| | - Farah Dadabhoy
- Department of Emergency Medicine, Mass General Brigham, Boston, Massachusetts, United States
| | - Dev Dash
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Claire DeBolt
- Department of Pulmonary Critical Care, University of Virginia, Charlottesville, Virginia, United States
- Department of Clinical Informatics, University of Virginia, Charlottesville, Virginia, United States
| | - Peter L. Elkin
- Department of Biomedical Informatics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, United States
| | - Oluseyi A. Fayanju
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Laura J. Fochtmann
- Department of Psychiatry, Stony Brook University, Stony Brook, New York, United States
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, United States
| | | | - John J. Hanna
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - William Hersh
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
| | - Mackenzie R. Hofford
- Division of General Medicine, Department of Medicine, Washington University in St. Louis, St Louis, Missouri, United States
| | - Jonathan D. Hron
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Sean S. Huang
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Brian R. Jackson
- Department of Pathology, University of Utah, Salt Lake City, Utah, United States
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, United States
| | - Bonnie Kaplan
- Bioethics Center, Information Society Project, Solomon Center for Health Care Policy, Yale University Center for Medical Informatics, New Haven, Connecticut, United States
| | - William Kelly
- Department of Biomedical Informatics, University at Buffalo, Buffalo, New York, United States
| | - Kyungmin Ko
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, United States
- Department of Pathology, Texas Children's Hospital, Houston, Texas, United States
| | - Ross Koppel
- Department of Medical informatics, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Department of Medical informatics, University at Buffalo, Buffalo, New York, United States
| | - Nikhil Kurapati
- Department of Family Medicine Soin Medical Center, Kettering Health, Dayton, Ohio
| | - Gabriel Labbad
- Enterprise Information Systems, Cedars Sinai, Los Angeles, California, United States
| | - Julie J. Lee
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - Christoph U. Lehmann
- Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Stefano Leitner
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, United States
| | | | - Richard J. Medford
- Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Edward R. Melnick
- Department of Emergency Medicine and Biostatistics (Health Informatics), Yale School of Medicine, New Haven, Connecticut, United States
| | - Anoop N. Muniyappa
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Sara G. Murray
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Aaron Barak Neinstein
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Victoria Nichols-Johnson
- Department of OB/Gyn (Emerita), Southern Illinois University School of Medicine, Springfield, Illinois, United States
| | - Laurie Lovett Novak
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - William Scott Ogan
- Division of Bioinformatics, Department of Medicine, University of California San Diego Health, La Jolla, California, United States
| | - Larry Ozeran
- Clinical Informatics, Inc., Yuba City, California, United States
| | - Natalie M. Pageler
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - Deepti Pandita
- Department of Medicine, Hennepin HealthCare, Minneapolis, Minnesota, United States
| | - Ajay Perumbeti
- University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, United States
| | - Carolyn Petersen
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, United States
| | - Logan Pierce
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Raghuveer Puttagunta
- Department of Internal Medicine, Geisinger Health, Danville, Pennsylvania, United States
| | - Priya Ramaswamy
- Department of Anesthesiology and Critical Care, University of California San Francisco, San Francisco, California, United States
| | - Kendall M. Rogers
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, United States
| | - S Trent Rosenbloom
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Angela Ryan
- Australasian Institute of Digital Health, Sydney, New South Wales, Australia
| | - Sameh Saleh
- Department of Biomedical and Health Informatics/Department of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Chethan Sarabu
- Department of Information Services, Penn State Health, Hershey, Pennsylvania, United States
| | - Richard Schreiber
- Department of Information Services, Penn State Health, Hershey, Pennsylvania, United States
- Department of Medicine, Penn State Health, Hershey, Pennsylvania, United States
| | - Kate A. Shaw
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, United States
| | - Ida Sim
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
- University of California San Francisco University of California Berkeley Joint Program in Computational Precision Health, University of California San Francisco and University of California Berkeley, San Francisco, California, United States
| | - S Joseph Sirintrapun
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, United States
| | - Anthony Solomonides
- Research Institute, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Jacob D. Spector
- Information Services Department, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Justin B. Starren
- Division of Health and Biomedical Informatics, Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Michelle Stoffel
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Vignesh Subbian
- College of Engineering, The University of Arizona, Tucson, Arizona, United States
| | - Karl Swanson
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Adrian Tomes
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Karen Trang
- Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Kim M. Unertl
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Jenny L. Weon
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Mary A. Whooley
- Departments of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States
- San Francisco Veterans Affairs Healthcare System, San Francisco, California, United States
| | - Kevin Wiley
- Department of Healthcare Leadership and Management, Medical University of South Carolina, Columbia, South Carolina, United States
| | - Drew F. K. Williamson
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Peter Winkelstein
- Institute for Healthcare Informatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States
| | - Jenson Wong
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, United States
| | - James Xie
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Julia K. W. Yarahuan
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Nathan Yung
- Department of Hospital Medicine, University of California San Diego Health, La Jolla, California, United States
| | - Chloe Zera
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
| | - Neda Ratanawongsa
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco Center for Vulnerable Populations, San Francisco, California, United States
| | - Shobha Sadasivaiah
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
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11
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Xu NY, Nguyen KT, DuBord AY, Pickup J, Sherr JL, Teymourian H, Cengiz E, Ginsberg BH, Cobelli C, Ahn D, Bellazzi R, Bequette BW, Gandrud Pickett L, Parks L, Spanakis EK, Masharani U, Akturk HK, Melish JS, Kim S, Kang GE, Klonoff DC. Diabetes Technology Meeting 2021. J Diabetes Sci Technol 2022; 16:1016-1056. [PMID: 35499170 PMCID: PMC9264449 DOI: 10.1177/19322968221090279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diabetes Technology Society hosted its annual Diabetes Technology Meeting on November 4 to November 6, 2021. This meeting brought together speakers to discuss various developments within the field of diabetes technology. Meeting topics included blood glucose monitoring, continuous glucose monitoring, novel sensors, direct-to-consumer telehealth, metrics for glycemia, software for diabetes, regulation of diabetes technology, diabetes data science, artificial pancreas, novel insulins, insulin delivery, skin trauma, metabesity, precision diabetes, diversity in diabetes technology, use of diabetes technology in pregnancy, and green diabetes. A live demonstration on a mobile app to monitor diabetic foot wounds was presented.
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Affiliation(s)
- Nicole Y. Xu
- Diabetes Technology Society,
Burlingame, CA, USA
| | | | | | | | | | | | - Eda Cengiz
- University of California, San
Francisco, San Francisco, CA, USA
| | | | | | - David Ahn
- Mary & Dick Allen Diabetes Center
at Hoag, Newport Beach, CA, USA
| | | | | | | | - Linda Parks
- University of California, San
Francisco, San Francisco, CA, USA
| | - Elias K. Spanakis
- Baltimore VA Medical Center,
Baltimore, MD, USA
- University of Maryland, Baltimore,
MD, USA
| | - Umesh Masharani
- University of California, San
Francisco, San Francisco, CA, USA
| | - Halis K. Akturk
- Barbara Davis Center for Diabetes,
University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Sarah Kim
- University of California, San
Francisco, San Francisco, CA, USA
| | - Gu Eon Kang
- The University of Texas at Dallas,
Richardson, TX, USA
| | - David C. Klonoff
- Diabetes Research Institute,
Mills-Peninsula Medical Center, San Mateo, CA, USA
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12
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Xiao H, Bertwistle D, Khela K, Middleton-Dalby C, Hall J. Patient and caregiver socioeconomic burden of first-line systemic therapy for advanced gastroesophageal adenocarcinoma. Future Oncol 2022; 18:1199-1210. [PMID: 34984914 DOI: 10.2217/fon-2021-1449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim: This study assessed the work productivity and financial impact of advanced gastroesophageal adenocarcinomas, comprising gastric, esophageal and gastroesophageal junction cancers, on patients of working age and their caregivers. Patients & methods: A multicenter medical chart review and surveys of patients with advanced gastroesophageal adenocarcinoma and their caregivers was conducted in France, Germany, the UK, China, Japan and the USA. Results: Across differing regions, the study highlighted the impact of cancer on patients' ability to work, to function normally and on their wellbeing, as well as the economic burden placed on patients and their caregivers. Conclusion: Advanced gastroesophageal adenocarcinomas have a significant impact on patients' and caregivers' well-being and are associated with reduced work productivity, and income loss.
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Affiliation(s)
- Hong Xiao
- Bristol Myers Squibb, Princeton, NJ, USA
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13
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The 21st Century Cures Act and Emergency Medicine - Part 1: Digitally Sharing Notes and Results. Ann Emerg Med 2021; 79:7-12. [PMID: 34756447 DOI: 10.1016/j.annemergmed.2021.07.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Indexed: 01/13/2023]
Abstract
Among the provisions of the 21st Century Cures Act is the mandate for digital sharing of clinician notes and test results through the patient portal of the clinician's electronic health record system. Although there is considerable evidence of the benefit to clinic patients from open notes and minimal apparent additional burden to primary care clinicians, emergency department (ED) note sharing has not been studied. With easier access to notes and results, ED patients may have an enhanced understanding of their visit, findings, and clinician's medical decisionmaking, which may improve adherence to recommendations. Patients may also seek clarifications and request edits to their notes. EDs can develop workflows to address patient concerns without placing new undue burden on clinicians, helping to realize the benefits of sharing notes and test results digitally.
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14
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Rahimian M, Warner JL, Salmi L, Rosenbloom ST, Davis RB, Joyce RM. Open notes sounds great, but will a provider's documentation change? An exploratory study of the effect of open notes on oncology documentation. JAMIA Open 2021; 4:ooab051. [PMID: 34661067 PMCID: PMC8518311 DOI: 10.1093/jamiaopen/ooab051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/02/2021] [Accepted: 06/22/2021] [Indexed: 11/14/2022] Open
Abstract
Objective The effects of shared clinical notes on patients, care partners, and clinicians ("open notes") were first studied as a demonstration project in 2010. Since then, multiple studies have shown clinicians agree shared progress notes are beneficial to patients, and patients and care partners report benefits from reading notes. To determine if implementing open notes at a hematology/oncology practice changed providers' documentation style, we assessed the length and readability of clinicians' notes before and after open notes implementation at an academic medical center in Boston, MA, USA. Materials and Methods We analyzed 143 888 notes from 60 hematology/oncology clinicians before and after the open notes debut at Beth Israel Deaconess Medical Center, from January 1, 2012 to September 1, 2016. We measured the providers' (medical doctor/nurse practitioner) documentation styles by analyzing character length, the number of addenda, note entry mode (dictated vs typed), and note readability. Measurements used 5 different readability formulas and were assessed on notes written before and after the introduction of open notes on November 25, 2013. Results After the introduction of open notes, the mean length of progress notes increased from 6174 characters to 6648 characters (P < .001), and the mean character length of the "assessment and plan" (A&P) increased from 1435 characters to 1597 characters (P < .001). The Average Grade Level Readability of progress notes decreased from 11.50 to 11.33, and overall readability improved by 0.17 (P = .01). There were no statistically significant changes in the length or readability of "Initial Notes" or Letters, inter-doctor communication, nor in the modality of the recording of any kind of note. Conclusions After the implementation of open notes, progress notes and A&P sections became both longer and easier to read. This suggests clinician documenters may be responding to the perceived pressures of a transparent medical records environment.
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Affiliation(s)
- Maryam Rahimian
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jeremy L Warner
- Department of General Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Liz Salmi
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - S Trent Rosenbloom
- Department of General Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Roger B Davis
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Robin M Joyce
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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15
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Azad G, McClain MB, Haverkamp C, Maxwell B, Shahidullah JD. Interagency Collaboration for Pediatric Autism Spectrum Disorder: Perspectives of Community-Based Providers. ACTA ACUST UNITED AC 2021; 24. [PMID: 34307902 DOI: 10.1016/j.xjep.2021.100433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background Interagency collaboration between community and school settings is one mechanism to serve the complex needs of pediatric patients with autism spectrum disorder (ASD). Purpose We surveyed a national sample of community-based providers to examine their perspectives on interagency collaboration with school-based providers when serving pediatric patients with ASD. Method Medical and behavioral/mental health professionals practicing in community settings were recruited. Participants (N = 116) completed an online survey about their interagency collaboration experiences with schools. Results The majority of the sample reported engaging in interagency collaboration with school-based providers; however, the frequency was limited and was associated with the number of years working in the field. Community-based providers wanted more didactic and hands-on experiences in collaboration. Barriers and facilitators were related to schools' administration, school personnels' training in ASD, information exchange, and delineating between identification systems. Discussion and Conclusion Our findings highlight the importance of leadership support and the need for innovative training experiences to support school-community interagency collaboration.
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Affiliation(s)
- Gazi Azad
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, U.S
| | | | - Cassity Haverkamp
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84322, U.S
| | - Barbara Maxwell
- National Center for Interprofessional Practice and Education, A.T. Still University of Health Sciences, 5850 East Still Circle, Mesa, AZ 85206, U.S
| | - Jeffrey D Shahidullah
- Department of Psychiatry, Dell Medical School, The University of Texas at Austin, 1501 Red River St. Austin, TX 78712, U.S
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