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Nasser S, Fotopoulou C, Gültekin M, Dimitrova D, Bilir E, Inci G, Morice P, Mirza MR, Martin AG, Berek J, Sehouli J. Patient care and access to clinical trials in gynaecological oncology: global implications of the early phase of the COVID-19 pandemic. Arch Gynecol Obstet 2024; 310:577-586. [PMID: 38836928 PMCID: PMC11168972 DOI: 10.1007/s00404-024-07511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/07/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Our prospective international survey evaluated the impact of the early phase of the COVID-19 pandemic on the management gynaecological malignancies from the multidisciplinary physicians' perspective with particular focus on clinical infrastructures and trial participation. METHODS Our survey consisted of 53 COVID-related questions. It was sent to healthcare professionals in gynaecological oncology centres across Europe and Pan-Arabian region via the study groups and gynaecological societies from April 2020 to October 2020. All healthcare professionals treating gynaecological cancers were able to participate in our survey. RESULTS A total of 255 answers were collected from 30 countries. The majority (73%) of participants were gynaecological oncologists from university hospitals (71%) with at least an Intensive Care Unit with cardiopulmonary support available at their institutions. Most institutions continued to perform elective surgeries only for oncological cases (98%). Patients had to wait on average 2 weeks longer for their surgery appointments compared to previous years (range 0-12 weeks). Most cases that were prioritised for surgical intervention across all gynaecological tumours were early-stage disease (74%), primary situation (61%) and good ECOG status (63%). The radicality of surgery did not change in the majority of cases (78%) across all tumour types. During the pandemic, only 38% of clinicians stated they would start a new clinical trial. Almost half of the participants stated the pandemic negatively impacted the financial structure and support for clinical trials. Approximately 20% of clinicians did not feel well-informed regarding clinical algorithm for COVID-19 patients throughout the pandemic. Thirty percent stated that they are currently having trouble in providing adequate medical care due to staff shortage. CONCLUSION Despite well-established guidelines, pandemic clearly affected clinical research and patientcare. Our survey underlines the necessity for building robust emergency algorithms tailored to gynaecological oncology to minimise negative impact in crises and to preserve access to clinical trials.
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Affiliation(s)
- Sara Nasser
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.
| | - Christina Fotopoulou
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
- Department of Gynecological Oncology, Queen Charlotte's Hospital, Imperial College London, London, UK
| | - Murat Gültekin
- Department of Gynecology and Obstetrics, Hacettepe University Hospitals, Ankara, Turkey
| | - Desislava Dimitrova
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - Esra Bilir
- Department of Global Health, Koç University Graduate School of Health Sciences, Istanbul, Turkey
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Gülhan Inci
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
| | | | - Mansoor Raza Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jonathan Berek
- Stanford Women´S Cancer Center, Stanford University, Palo Alto, CA, USA
| | - Jalid Sehouli
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
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Lichtenstein MRL, Levit LA, Schenkel C, Kirkwood K, Fashoyin-Aje LA, Bruinooge SS, Kelley MJ, Mailman JA, Magnuson A, Mirda DP, Natesan D, Hershman DL. Researcher Experience and Comfort With Telemedicine and Remote Patient Monitoring in Cancer Treatment Trials. Oncologist 2024; 29:356-363. [PMID: 37676048 PMCID: PMC10994398 DOI: 10.1093/oncolo/oyad237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/26/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Since the onset of COVID-19, oncology practices across the US have integrated telemedicine (TM) and remote patient monitoring (RPM) into routine care and clinical trials. The extent of provider experience and comfort with TM/RPM in treatment trials, however, is unknown. We surveyed oncology researchers to assess experience and comfort with TM/RPM. METHODS Between April 10 and June 1, 2022, we distributed email surveys to US-based members of the American Society of Clinical Oncology (ASCO) whose member records indicated interest or specialization in clinical research. We collected respondent demographic data, clinical trial experience, workplace characteristics, and comfort and experience with TM/RPM use across trial components in phase I and phase II/III trials. TM/RPM was defined as clinical trial-related healthcare and monitoring for patients geographically separated from trial site. RESULTS There were 141 surveys analyzed (5.1% response rate). Ninety percent of respondents had been Principal Investigators, 98% practiced in a norural site. Most respondents had enrolled patients in phase I (82%) and phase II/III trials (99%). Across all phases and trial components, there was a higher frequency of researcher comfort compared to experience. Regarding remote care in treatment trials, 75% reported using TM, RPM, or both. Among these individuals, 62% had never provided remote care to trial patients before the pandemic. CONCLUSION COVID-19 spurred the rise of TM/RPM in cancer treatment trials, and some TM/RPM use continues in this context. Among oncology researchers, higher levels of comfort compared with real-world experience with TM/RPM reveal opportunities for expanding TM/RPM policies and guidelines in oncology research.
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Affiliation(s)
- Morgan R L Lichtenstein
- Division of Medical Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Laura A Levit
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Caroline Schenkel
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Kelsey Kirkwood
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Lola A Fashoyin-Aje
- Oncology Center of Excellence, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Suanna S Bruinooge
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Michael J Kelley
- Department of Medicine, Duke Cancer Institute and Medical Oncology, Duke University Medical Center, and Hematology-Oncology, Durham VA Medical Center, Durham, NC, USA
| | | | - Allison Magnuson
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Daniel P Mirda
- Providence Medical Group Northern California Napa, CA, USA
| | | | - Dawn L Hershman
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
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3
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Keogh RJ, Harvey H, Brady C, Hassett E, Costelloe SJ, O'Sullivan MJ, Twomey M, O'Leary MJ, Cahill MR, O'Riordan A, Joyce CM, Moloney G, Flavin A, M Bambury R, Murray D, Bennett K, Mullooly M, O'Reilly S. Dealing with digital paralysis: Surviving a cyberattack in a National Cancer center. J Cancer Policy 2024; 39:100466. [PMID: 38176467 DOI: 10.1016/j.jcpo.2023.100466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/26/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION Cyberattacks represent a growing threat for healthcare delivery globally. We assess the impact and implications of a cyberattack on a cancer center in Ireland. METHODS On May 14th 2021 (day 0) Cork University Hospital (CUH) Cancer Center was involved in the first national healthcare ransomware attack in Ireland. Contingency plans were only present in laboratory services who had previously experienced information technology (IT) failures. No hospital cyberattack emergency plan was in place. Departmental logs of activity for 120 days after the attack were reviewed and compared with historical activity records. Daily sample deficits (routine daily number of samples analyzed - number of samples analyzed during cyberattack) were calculated. Categorical variables are reported as median and range. Qualitative data were collected via reflective essays and interviews with key stakeholders from affected departments in CUH. RESULTS On day 0, all IT systems were shut down. Radiotherapy (RT) treatment and cancer surgeries stopped, outpatient activity fell by 50%. hematology, biochemistry and radiology capacity fell by 90% (daily sample deficit (DSD) 2700 samples), 75% (DSD 2250 samples), and 90% (100% mammography/PET scan) respectively. Histopathology reporting times doubled (7 to 15 days). Radiotherapy (RT) was interrupted for 113 patients in CUH. The median treatment gap duration was six days for category 1 patients and 10 for the remaining patients. Partner organizations paused all IT links with CUH. Outsourcing of radiology and radiotherapy commenced, alternative communication networks and national conference calls in RT and Clinical Trials were established. By day 28 Email communication was restored. By day 210 reporting and data storage backlogs were cleared and over 2000 computers were checked/replaced. CONCLUSION Cyberattacks have rapid, profound and protracted impacts. While laboratory and diagnostic deficits were readily quantified, the impact of disrupted/delayed care on patient outcomes is less readily quantifiable. Cyberawareness and cyberattack plans need to be embedded in healthcare. POLICY SUMMARY Cyberattacks pose significant challenges for healthcare systems, impacting patient care, clinical outcomes, and staff wellbeing. This study provides a comprehensive review of the impact of the Conti ransomware attack on cancer services in Cork University Hospital (CUH), the first cyberattack on a national health service. Our study highlights the widespread disruption caused by a cyberattack including shutdown of information technology (IT) services, marked reduction in outpatient activity, temporary cessation of essential services such as radiation therapy. We provide a framework for other institutions for mitigating the impact of a cyberattack, underscoring the need for a cyberpreparedness plan similar to those made for natural disasters and the profound legacy of a cyberattack on patient care.
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Affiliation(s)
- Rachel J Keogh
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland.
| | - Harry Harvey
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Claire Brady
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland
| | - Edel Hassett
- Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland
| | - Seán J Costelloe
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork, Ireland
| | - Martin J O'Sullivan
- Department of Breast Surgery, Cork University Hospital, Ireland; University College Cork, College Road, University College Cork, Ireland
| | - Maria Twomey
- Department of Radiology, Cork University Hospital, Ireland
| | - Mary Jane O'Leary
- Palliative Medicine, Marymount University Hospital and Hospice, Cork, Ireland; Palliative Medicine, Cork University Hospital, Ireland
| | - Mary R Cahill
- Department of Haematology, Cork University Hospital, Ireland
| | | | - Caroline M Joyce
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork, Ireland; INFANT Centre, University College Cork, Ireland; Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, University College Cork, Ireland
| | - Ger Moloney
- Information and Communication Technology (ICT) Department, Cork University Hospital, Ireland
| | - Aileen Flavin
- Bon Secours Radiotherapy Cork in Partnership with UPMC Hillman Cancer Centre, Cork, Ireland
| | - Richard M Bambury
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland; Cancer Research @UCC, University College Cork, Cork, Ireland
| | | | - Kathleen Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences Dublin, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences Dublin, Ireland
| | - Seamus O'Reilly
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland; Cancer Research @UCC, University College Cork, Cork, Ireland
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Cummins MR, Soni H, Ivanova J, Ong T, Barrera J, Wilczewski H, Welch B, Bunnell BE. Narrative review of telemedicine applications in decentralized research. J Clin Transl Sci 2024; 8:e30. [PMID: 38384915 PMCID: PMC10880018 DOI: 10.1017/cts.2024.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 12/04/2023] [Accepted: 01/05/2024] [Indexed: 02/23/2024] Open
Abstract
Telemedicine enables critical human communication and interaction between researchers and participants in decentralized research studies. There is a need to better understand the overall scope of telemedicine applications in clinical research as the basis for further research. This narrative, nonsystematic review of the literature sought to review and discuss applications of telemedicine, in the form of synchronous videoconferencing, in clinical research. We searched PubMed to identify relevant literature published between January 1, 2013, and June 30, 2023. Two independent screeners assessed titles and abstracts for inclusion, followed by single-reviewer full-text screening, and we organized the literature into core themes through consensus discussion. We screened 1044 publications for inclusion. Forty-eight publications met our inclusion and exclusion criteria. We identified six core themes to serve as the structure for the narrative review: infrastructure and training, recruitment, informed consent, assessment, monitoring, and engagement. Telemedicine applications span all stages of clinical research from initial planning and recruitment to informed consent and data collection. While the evidence base for using telemedicine in clinical research is not well-developed, existing evidence suggests that telemedicine is a potentially powerful tool in clinical research.
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Affiliation(s)
- Mollie R. Cummins
- University of Utah, College of Nursing, Salt Lake City, UT, USA
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
| | - Hiral Soni
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
| | | | - Triton Ong
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
| | - Janelle Barrera
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
| | | | - Brandon Welch
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
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Silverio-Murillo A, Hoehn-Velasco L, Balmori de la Miyar J, Méndez Méndez JS. The COVID-19 pandemic and non-COVID-19 healthcare utilization in Mexico. Public Health 2024; 226:99-106. [PMID: 38042128 DOI: 10.1016/j.puhe.2023.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/15/2023] [Accepted: 10/24/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVES This study aimed to analyze the effects of the COVID-19 pandemic on non-COVID-19 healthcare utilization in Mexico, including oral health, mental health, communicable disease visits, health checkups, chronic degenerative disease visits, postpartum care, prenatal care, and family planning visits. STUDY DESIGN This was a retrospective ecological analysis during the COVID-19 pandemic. During the pandemic, the Mexican government recommended non-essential consultations be suspended or rescheduled to accommodate the new demand for healthcare services from COVID-19 patients. METHODS This study uses administrative data from Mexico's Ministry of Health from January 2017 to December 2022. These data cover 14,299 consultation units and 775 hospitals from the 32 Mexican States, all of which are public institutions. A difference-in-differences strategy and an event study specification are used to study the impacts of the pandemic on non-COVID-19 healthcare utilization. RESULTS The findings reveal a decrease in the utilization of all healthcare services: oral health (69%), mental health (27%), communicable diseases (46%), chronic degenerative diseases (36%), health checkups (62%), family planning (45%), prenatal care (36%), and postpartum care (44%). Furthermore, the event study indicates that most services follow a U-shaped trend, although only mental health services clearly return to prepandemic levels. The remainder of services remain below prepandemic levels at the end of 2022. CONCLUSIONS The 2020 pandemic had detrimental effects on non-COVID-19 healthcare utilization. The healthcare interruptions will likely impact short- and long-term morbidity and mortality. Programs intended to remediate these negative consequences may be of interest to public health policymakers.
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Affiliation(s)
| | - L Hoehn-Velasco
- Andrew Young School of Policy Studies, Georgia State University, USA.
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6
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Ballatore Z, Goudas A, Bozzi F, Lucarelli A, Burattini M, Ricci G, Savino F, Berardi R. A single experience in the conduction of clinical trial during COronaVIrusDisease-2019 pandemic. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2023; 4:793-800. [PMID: 37970207 PMCID: PMC10645463 DOI: 10.37349/etat.2023.00168] [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: 01/16/2023] [Accepted: 04/24/2023] [Indexed: 11/17/2023] Open
Abstract
Aim From the start of the pandemic, several aspects of healthcare policies changed, not least the clinical trials management from recruiting capabilities to the protocol compliance in terms of schedule of procedures, follow-up visits, staff constraints and monitoring. This study aims to assess the impact of the COronaVIrusDisease-2019 (COVID-19) pandemic in the conduction of clinical trials at the site of clinical oncology, Ancona (Italy), to identify the strengths and weaknesses upfront the past emergency, and to select better strategies for future similar situations. Methods Data from February to July of the years 2019, 2020 and 2021 were collected and three practical parameters of the trial unit were investigated: milestones, performance, and impact. Results The trials mean numbers were 18, 24, and 23, in 2019, 2020, and 2021 respectively. The pre-Site Initiation Visit (PRE-SIV) rate grew from 66.6% in 2019 to 95.5% in 2021 with a deflection in 2020. Protocol deviations were 40 in the period February-July 2019, in the same period of 2020 the number of deviations increased due to COVID related ones, then there was a significant total decrease in February-July 2021. In 2020 and 2021, all the investigator meetings were online. Conclusions The growing number of remote Site Initiation Visit (SIV) and meetings over the last 3 years suggests the feasibility of the on-line processes. The significant reduction in protocol deviations during 2021 is probably due to an under check of data during a pandemic. But that is also a possible key indicator of the coping strategy made out by clinical oncology to guarantee the continuity of care in clinical trials and to offer new opportunities of cancer care in a bad scenario such as a pandemic one.
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Affiliation(s)
- Zelmira Ballatore
- Department of Medical Oncology, AOU della Marche, 60126 Ancona, Italy
| | - Amalia Goudas
- Department of Medical Oncology, AOU della Marche, 60126 Ancona, Italy
| | - Francesco Bozzi
- Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy
| | | | - Michela Burattini
- Department of Medical Oncology, AOU della Marche, 60126 Ancona, Italy
| | - Giulia Ricci
- Department of Medical Oncology, AOU della Marche, 60126 Ancona, Italy
| | - Francesco Savino
- Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Rossana Berardi
- Department of Medical Oncology, AOU della Marche, 60126 Ancona, Italy
- Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy
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7
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Sun G, Dizon DS, Szczepanek CM, Petrylak DP, Sparks DB, Tangen C, Lara P“LN, Thompson IM, Blanke CD. Crisis of the Clinical Trials Staff Attrition After the COVID-19 Pandemic. JCO Oncol Pract 2023; 19:533-535. [PMID: 37285550 PMCID: PMC10424897 DOI: 10.1200/op.23.00152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/21/2023] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
A survey of clinical research professionals @SWOG indicate that 80% of clinical trial offices are understaffed. Addressing this is critical so progress for people with cancer continues. Read more about lessons learned in the #COVID19 pandemic and how it informs a path forward.
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Affiliation(s)
- Grace Sun
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Don S. Dizon
- Warren Alpert Medical School of Brown University, Providence, RI
- Lifespan Cancer Institute and Legorreta Cancer Center at Brown University, Providence, RI
| | | | | | | | | | | | | | - Charles David Blanke
- SWOG Cancer Research Network, San Antonio, TX
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
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Harvey H, Carroll H, Murphy V, Ballot J, O'Grady M, O'Hare D, Lawler G, Bennett E, Connolly M, Noone E, Kelly MG, Bazin A, Daly A, Mulroe E, McDermott R, O'Reilly S. The Impact of a National Cyberattack Affecting Clinical Trials: The Cancer Trials Ireland Experience. JCO Clin Cancer Inform 2023; 7:e2200149. [PMID: 37053539 PMCID: PMC10281450 DOI: 10.1200/cci.22.00149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/18/2022] [Accepted: 02/22/2023] [Indexed: 04/15/2023] Open
Abstract
PURPOSE Cyberattacks are increasing in health care and cause immediate disruption to patient care, have a lasting impact, and compromise scientific integrity of affected clinical trials. On the May 14, 2021, the Irish health service was the victim of a nationwide ransomware attack. Patient care was disrupted across 4,000 locations, including 18 cancer clinical trials units associated with Cancer Trials Ireland (CTI). This report analyses the impact of the cyberattack on the organization and proposes steps to mitigate the impact of future cyberattacks. METHODS A questionnaire was distributed to the units within the CTI group; this examined key performance indicators for a period of 4 weeks before, during, and after the attack, and was supplemented by minutes of weekly conference call with CTI units to facilitate information sharing, accelerate mitigation, and support affected units. A total of 10 responses were returned, from three private and seven public hospitals. RESULTS The effect of the attack on referrals and enrollment to trials was marked, resulting in a drop of 85% in referrals and 55% in recruitment before recovery. Radiology, radiotherapy, and laboratory systems are heavily reliant on information technology systems. Access to all was affected. Lack of preparedness was highlighted as a significant issue. Of the sites surveyed, two had a preparedness plan in place before the attack, both of these being private institutions. Of the eight institutions where no plan was in place, three now have or are putting a plan in place, whereas no plan is in place at the five remaining sites. CONCLUSION The cyberattack had a dramatic and sustained impact on trial conduct and accrual. Increased cybermaturity needs to be embedded in clinical trial logistics and the units conducting them.
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Affiliation(s)
- Harry Harvey
- UCC Cancer Trials Group, Cork University Hospital, Cork, Ireland
| | - Hailey Carroll
- UCC Cancer Trials Group, Cork University Hospital, Cork, Ireland
| | | | - Jo Ballot
- St Vincents University Hospital, Dublin, Ireland
| | | | - Debra O'Hare
- UCC Cancer Trials Group, Cork University Hospital, Cork, Ireland
| | - Gavin Lawler
- Irish Research Radiation Oncology Group, Dublin, Ireland
| | - Erica Bennett
- Bon Secours Radiotherapy Centre in association with UPMC Hillman Cancer Center, Cork, Ireland
| | | | - Emma Noone
- St Lukes Radiation Oncology Trials Unit, Dublin, Ireland
| | | | | | | | | | | | - Seamus O'Reilly
- UCC Cancer Trials Group, Cork University Hospital, Cork, Ireland
- Cancer Trials Ireland, Dublin, Ireland
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Waich A, Barahona-Correa JE, Figueredo MDC, Rondón-Sepúlveda MA, Ruiz AJ, Castellanos JC, Hidalgo-Martínez P. Sleep Quality, Insomnia, and Perceived Stress among Colombian Healthcare Workers during the COVID-19 Pandemic. Sleep Sci 2023; 16:44-50. [PMID: 37151765 PMCID: PMC10157824 DOI: 10.1055/s-0043-1767756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/21/2022] [Indexed: 05/09/2023] Open
Abstract
Objective The COVID-19 pandemic has imposed a great burden on healthcare workers worldwide. The aim of the present study was to assess sleep quality, insomnia, and perceived stress in healthcare workers of a high complexity hospital located in Bogota, Colombia. Methods Cross-sectional study in which 1,155 healthcare workers at the Hospital Universitario San Ignacio in Bogotá, Colombia were included, between September and October 2020. Using an online-based survey, self-reported variables were assessed including demographics, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and 10 item Perceived Stress Scale (PSS-10). Associations between these variables were evaluated. Results Fifty percent of the respondents were between 31 and 45 years old, and 76 percent were women. Most of the surveyed were the nursing staff. Poor sleep quality, insomnia, and high perceived stress was found in 74.9, 12.4, and 13.2%, respectively. Poor sleep quality was predominantly found in females, in the 31 to 45 years old group and in married personnel. Also, poor sleep quality was found in relation to a moderate to high perceived risk of COVID-19 infection by the family of the workers surveyed. Discussion Poor sleep quality, moderate rates of insomnia, and perceived stress were found among healthcare workers committed to COVID-19 infected patients in Colombia. The identification of workers at greater risk and the implementation of targeted interventions are called upon as the results.
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Affiliation(s)
- Alan Waich
- Pontificia Universidad Javeriana, Sleep Disorders Research Group, Bogota, Colombia
- Address for correspondence Alan Waich
| | - Julián Esteban Barahona-Correa
- Pontificia Universidad Javeriana, Sleep Disorders Research Group, Bogota, Colombia
- Pontificia Universidad Javeriana, Department of Internal Medicine, Bogota, Colombia
| | - Maria del Carmen Figueredo
- Pontificia Universidad Javeriana, Sleep Disorders Research Group, Bogota, Colombia
- Pontificia Universidad Javeriana, Department of Internal Medicine, Bogota, Colombia
| | - Martín Alonso Rondón-Sepúlveda
- Pontificia Universidad Javeriana, Sleep Disorders Research Group, Bogota, Colombia
- Pontificia Universidad Javeriana, Department of Epidemiology and Biostatistics, Bogota, Colombia
| | - Alvaro J. Ruiz
- Pontificia Universidad Javeriana, Sleep Disorders Research Group, Bogota, Colombia
- Pontificia Universidad Javeriana, Department of Internal Medicine, Bogota, Colombia
- Pontificia Universidad Javeriana, Department of Epidemiology and Biostatistics, Bogota, Colombia
| | - Julio Cesar Castellanos
- Pontificia Universidad Javeriana, Sleep Disorders Research Group, Bogota, Colombia
- Hospital Universitario San Ignacio, Bogota, Colombia
| | - Patricia Hidalgo-Martínez
- Pontificia Universidad Javeriana, Sleep Disorders Research Group, Bogota, Colombia
- Pontificia Universidad Javeriana, Department of Internal Medicine, Bogota, Colombia
- Hospital Universitario San Ignacio, Sleep Medicine Clinic, Division of Pulmonology, Bogota, Colombia
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Cooper L, Jose N. Despite negative perceptions of clinical trial conduct during the coronavirus disease 2019 (COVID-19) pandemic, are decentralized clinical trial methods here to stay? ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:159. [PMID: 36923074 PMCID: PMC10009564 DOI: 10.21037/atm-23-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Affiliation(s)
- Lisa Cooper
- Department of Health Informatics, School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Nadina Jose
- Department of Health Informatics, School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA
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Thomas EE, Kelly JT, Taylor ML, Mendis R, Banbury A, Haydon H, Catto J, Der Vartanian C, Smith AC, Caffery LJ. Telehealth adoption in cancer clinical trials: An Australian perspective. Asia Pac J Clin Oncol 2022. [DOI: 10.1111/ajco.13899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/08/2022] [Accepted: 10/22/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Emma E. Thomas
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Jaimon T. Kelly
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Monica L. Taylor
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Roshni Mendis
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Annie Banbury
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Helen Haydon
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | | | | | - Anthony C. Smith
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
- Centre for Innovative Medical Technology University of Southern Denmark Odense Denmark
| | - Liam J. Caffery
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
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12
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Zhu Y, Sun Y, Jin Y, Tao T, Yi L, Li X. Impact of the COVID-19 pandemic on clinical trials: a cross-sectional questionnaire study in China. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1154. [PMID: 36467359 PMCID: PMC9708462 DOI: 10.21037/atm-22-777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022]
Abstract
Background The number of Chinese clinical trials has continued to grow throughout the coronavirus disease 2019 (COVID-19) pandemic, but we know little about clinical trial team members' perceptions and attitudes toward the impacts of the pandemic. This study aimed to assess the impact of the COVID-19 pandemic on clinical trials in China from the perspective of research staff to provide a deeper understanding and some recommendations for the ongoing and upcoming clinical trials during the pandemic. Methods A nationwide cross-sectional questionnaire was distributed to respondents throughout mainland China between September 2021 and October 2021. The participants assessed the impact of the COVID-19 pandemic on clinical trials based on a 5-point Likert-type scale, and exploratory factor analysis (EFA) was used to confirm the factor structure. Descriptive statistical analysis and the Mann-Whitney test were used to discover the differences between different groups. Results A total of 2,393 questionnaires from 272 hospitals were collected in mainland China. Factor analysis resulted in 4 factors, with a cumulative explained variance of 64.93%, as follows: subject enrollment, patient care, study supplies and data management, and research milestones and quality management. The research team members, predominantly represented by clinical research coordinators (CRCs), basically agreed with all but 3 preset scenarios of the impact of COVID-19 on clinical trials. Most respondents did not agree that the pandemic was associated with more serious adverse events (SAEs), missed reports of safety events, or any increase of unscheduled unblinding. In addition, significant differences were revealed in different age, gender, and role groups of respondents based on their views on the impact of the pandemic. Conclusions The current pandemic situation has had a negative impact on clinical trials, especially in terms of subject recruitment and protocol compliance, yet research team members feel confident that some of the effective measures proposed in the study can moderate the negative impact.
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Affiliation(s)
- Yanhong Zhu
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Yanjun Sun
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yan Jin
- Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Tiantian Tao
- Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Ling Yi
- Department of Drug Clinical Trials Institution, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Li
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China.,Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, Nanjing, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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13
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Jalali R, Nogueira-Rodrigues A, Das A, Sirohi B, Panda PK. Drug Development in Low- and Middle-Income Countries: Opportunity or Exploitation? Am Soc Clin Oncol Educ Book 2022; 42:1-8. [PMID: 35658520 DOI: 10.1200/edbk_10033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Low- and middle-income countries (LMICs) represent a diverse group of regions with varied cancer presentation. Drug development and accessibility across these regions have primarily been dependent on the trials initiated and conducted across high-income countries. Representation of LMIC regions in these trials in terms of study population has been minimal, leading to inequitable distribution of optimal and affordable cancer care. In spite of many challenges, LMICs have now increasingly been able to contribute to anticancer drug development. The opportunities present in LMICs must be explored and used in conjunction with due collaborative efforts from high-income countries, health care planners, and regulatory agencies. Global drug development trials should not only factor in suitable representation of LMICs but also design studies with pragmatic objectives and endpoints so that the trial results lead to equitable and affordable cancer care. Strengthening collaboration between cancer researchers from LMICs and high-income countries and empowering the local investigator with adequate resources will help remove current disparities.
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Affiliation(s)
- Rakesh Jalali
- Neuro-Oncology Cancer Management Team, Apollo Proton Cancer Centre, Taramani, Chennai, India
| | - Angelica Nogueira-Rodrigues
- Federal University of Minas Gerais, DOM Oncologia, Grupo Oncoclínicas, EVA Brazilian Group of Gynecologic Cancer, LACOG, Porto Alegre, Brazil
| | - Arunangshu Das
- Department of Oncology, Square Hospitals Ltd, Dhaka, Bangladesh
| | - Bhawna Sirohi
- Department of Medical Oncology, Apollo Proton Cancer Centre, Taramani, Chennai, India
| | - Pankaj Kumar Panda
- Clinical Research Secretariat, Apollo Proton Cancer Centre, Taramani, Chennai, India
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14
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O’Reilly S, Murphy V, Mulroe E, Tucker L, Carragher F, Marron J, Shannon AM, Rogan K, Connolly RM, Hennessy BT, McDermott RS. The SARS-CoV-2 Pandemic and Cancer Trials Ireland: Impact, Resolution and Legacy. Cancers (Basel) 2022; 14:2247. [PMID: 35565375 PMCID: PMC9101172 DOI: 10.3390/cancers14092247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cancer Trials Ireland (CTI) is the national cooperative group in Ireland. The SARS-CoV-2 pandemic led to significant ongoing disruptive change in healthcare from March 2020 to the present day. Its impact and legacy on a national clinical trials organisation was assessed. METHODS A review was conducted of prospectively acquired communications, team logs and time sheets, trial activation, closure and accrual, for the period 2019 to September 2021. An online survey of the impact of the pandemic on clinical investigators and of clinical trials units was performed. A National Cancer Retreat was organised on 21 May 2021 to identify and address pandemic related disruption and develop adaptive strategies. RESULTS In the weeks after the pandemic was declared, remote working was initiated by all central office staff. Nationally, clinical trial accrual fell by 54% compared to the same period in 2019, radiotherapy trial accrual by 90%, and translational studies by 36%. Staff reassignment of research nurse staff occurred in 60% of units, trial monitoring was reduced in 42%, and trial initiations fell by 67%. Extreme fluctuations in monitoring hours were noted paralleling lockdown measures. Significant impact on all clinical trials units was noted including staff reassignments, reduced access to diagnostic imaging and reduced institutional supports. Remote clinic visits and remote monitoring was widely adopted. The National Cancer Retreat identified flexibility in trial conduct, staff recruitment and retention, the need for harmonisation of processes, and research staff support in the context of remote working as priorities. CONCLUSION The pandemic has had a significant ongoing negative impact on cancer clinical trial activity in Ireland. Adaptive strategies including trial flexibility, expanded telehealth and remote monitoring, harmonisation of processes and staff support have been identified as priorities to ameliorate this impact, and develop a more sustainable clinical trial ecosystem.
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Affiliation(s)
- Seamus O’Reilly
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
- Department of Medical Oncology, Cork University Hospital and Cancer Research @ UCC University College Cork, T12 DCA4 Cork, Ireland;
| | - Verena Murphy
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
| | - Eibhlin Mulroe
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
| | - Lisa Tucker
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
| | - Fiona Carragher
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
| | - Jacinta Marron
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
| | - Aoife M. Shannon
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
| | - Ken Rogan
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
| | - Roisin M. Connolly
- Department of Medical Oncology, Cork University Hospital and Cancer Research @ UCC University College Cork, T12 DCA4 Cork, Ireland;
| | - Bryan T. Hennessy
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
| | - Ray S. McDermott
- Cancer Trials Ireland, D02 VN51 Dublin, Ireland; (V.M.); (E.M.); (L.T.); (F.C.); (J.M.); (A.M.S.); (K.R.); (B.T.H.); (R.S.M.)
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15
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Alpuim Costa D, Nobre JGG, Fernandes JP, Batista MV, Simas A, Sales C, Gouveia H, Ribeiro LA, Coelho A, Brito M, Inácio M, Cruz A, Mariano M, Savva-Bordalo J, Fernandes R, Oliveira A, Chaves A, Fontes-Sousa M, Sampaio-Alves M, Martins-Branco D, Afonso N. Impact of the COVID-19 Pandemic on Breast Cancer Management in Portugal: A Cross-Sectional Survey-Based Study of Medical Oncologists. Oncol Ther 2022; 10:225-240. [PMID: 35312952 PMCID: PMC8935098 DOI: 10.1007/s40487-022-00191-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Cancer care providers have faced many challenges in delivering safe care for patients during the COVID-19 pandemic. This cross-sectional survey-based study investigated the impact of the pandemic on clinical practices of Portuguese medical oncologists caring for patients with breast cancer. METHODS An anonymous online survey comprising 42 questions gathered information regarding COVID-19 testing, treatment in (neo)adjuvant and metastatic settings, and other aspects of breast cancer management. Practices before and during the pandemic were compared, and potential differences in outcomes according to respondents' regions, case volumes, and practice type were explored. RESULTS Of 129 respondents, 108 worked in the public health system, giving a representative national picture of the impact of the COVID-19 pandemic on breast cancer management. Seventy-one percent of respondents reported a reduction in visits for new cases of breast cancer, and there was a shift towards increased use of telemedicine. Clinical decision-making was largely unaffected in the most aggressive indications (i.e., triple-negative, HER2-positive, visceral crisis). The use of neoadjuvant therapy increased when access to surgery was difficult, whereas dose-dense regimens decreased, and cyclin-dependent kinase 4/6 inhibitor treatment decreased for less aggressive disease and increased for more aggressive disease. The use of oral formulations and metronomic chemotherapy regimens increased, and clinical trial participation decreased. Some differences by respondents' region and case volume were noted. CONCLUSION Medical oncologists in Portugal implemented many changes during the COVID-19 pandemic, most of which were logical and reasonable responses to the current healthcare emergency; however, the true impact on patient outcomes remains unknown.
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Affiliation(s)
- Diogo Alpuim Costa
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal. .,NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Campo dos Mártires da Pátria 130, 1169-056, Lisbon, Portugal.
| | | | - João Paulo Fernandes
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal
| | - Marta Vaz Batista
- Medical Oncology Department, Hospital Prof. Doutor Fernando Fonseca (HFF), IC19, 2720-276, Amadora, Portugal
| | - Ana Simas
- Medical Oncology Department, Hospital de Santa Luzia (HSL), Unidade Local Saúde Alto Minho (ULSAM), Estr. de Santa Luzia 50 4900, Viana do Castelo, Portugal
| | - Carolina Sales
- Medical Oncology Department, Hospital Dr. Nélio Mendonça, Hospital Central Do Funchal (HCF), Av. Luís de Camões 6180, 9000-177, Funchal, Madeira, Portugal
| | - Helena Gouveia
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Leonor Abreu Ribeiro
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal.,Medical Oncology Department, Hospital de Santa Maria (HSM), Centro Hospitalar Universitário de Lisboa Norte (CHULN), Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal
| | - Andreia Coelho
- Medical Oncology Department, Hospital de Santo Espírito da Ilha Terceira (HSEIT), Canada do Briado, Canada do Briado, 9700-049, Terceira, Azores, Portugal
| | - Margarida Brito
- Medical Oncology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), E.P.E., Rua Prof. Lima Basto, Lisbon, Portugal.,Medical Oncology Department, Hospital de São Bernardo (HSB), Centro Hospitalar de Setúbal (CHS), Rua Camilo Castelo Branco, Aptd. 140, Setúbal, Portugal
| | - Mariana Inácio
- Medical Oncology Department, Hospital Do Espírito Santo de Évora (HESE), Largo do Sr. da Pobreza, 7000-811, Évora, Portugal
| | - André Cruz
- Medical Oncology Department, Hospital Particular Do Algarve-Gambelas, Grupo HPA Saúde, Urbanização Casal de Gambelas, Lote 2, 8005-226, Faro, Portugal
| | - Mónica Mariano
- Medical Oncology Department, Instituto Português de Oncologia de Coimbra Francisco Gentil (IPOCFG), E.P.E., Av. Prof. Dr. Bissaya Barreto 98, 3000-075, Coimbra, Portugal
| | - Joana Savva-Bordalo
- Medical Oncology Department, Instituto Português de Oncologia Do Porto Francisco Gentil (IPOPFG), E.P.E., Rua Dr. António Bernardino de Almeida, 4200-072, Oporto, Portugal
| | | | - André Oliveira
- Medical Oncology Department, Hospital Do Divino Espírito Santo (HDES), Av. D. Manuel I, 9500-370, Ponta Delgada, Azores, Portugal
| | - Andreia Chaves
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal.,Medical Oncology Department, Hospital Prof. Doutor Fernando Fonseca (HFF), IC19, 2720-276, Amadora, Portugal
| | - Mário Fontes-Sousa
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal.,Medical Oncology Department, Hospital de São Bernardo (HSB), Centro Hospitalar de Setúbal (CHS), Rua Camilo Castelo Branco, Aptd. 140, Setúbal, Portugal.,Medical Oncology Department, Hospital de São Francisco Xavier (HSFX), Centro Hospitalar de Lisboa Ocidental (CHLO), Estr. Forte do Alto Duque, 1449-005, Lisbon, Portugal
| | - Mafalda Sampaio-Alves
- Faculdade de Medicina, Universidade Do Porto (FMUP), Alameda Prof. Hernâni Monteiro, 4200-319, Oporto, Portugal.,PTSurg-Portuguese Surgical Research Collaborative, Lisbon, Portugal
| | - Diogo Martins-Branco
- Academic Trials Promoting Team, Institut Jules Bordet, l'Université Libre de Bruxelles (ULB), Av. Franklin Roosevelt 50, 1050, Brussels, Belgium
| | - Noémia Afonso
- Medical Oncology Department, Centro Hospitalar Vila Nova de Gaia/Espinho (CHVNG/E), R. Conceição Fernandes S/N, 4434-502, Vila Nova de Gaia, Portugal
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16
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Bhatia RK, Lichter KE, Gurram L, MacDuffie E, Lombe D, Sarria GR, Grover S. Gynecologic radiation therapy in low and middle income countries during the COVID-19 pandemic. Int J Gynecol Cancer 2022; 32:446-450. [PMID: 35256435 PMCID: PMC9997715 DOI: 10.1136/ijgc-2021-003039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/14/2021] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic has forever affected healthcare and posed an incredible challenge to our society to care for our sick. Patients with cancer were found early on to have higher rates of complications with COVID-19. Radiation therapy is an integral part of treatment for many types of gynecologic cancer and adaptation on its utilization during the pandemic varied across the globe. In this review, we detail certain guidelines for the use of radiation in gynecologic cancers during the pandemic as well as real world accounts of how different countries adapted to these guidelines or created their own based on individualized resources, staffing, government restrictions, and societal norms. Critically, this review demonstrates the breadth of fractionation schemes and technologies used when resources were limited but highlights the importance of long term follow-up for many of our patients during this time.
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Affiliation(s)
- Rohini K Bhatia
- Department of Radiation Oncology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Katie E Lichter
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California, USA
| | - Lavanya Gurram
- Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Emily MacDuffie
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, Bonn, Nordrhein-Westfalen, Germany
| | - Surbhi Grover
- Department of Radiation Oncology, Botswana-University of Pennsylvania Partnership, Philadelphia, Pennsylvania, USA
- University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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17
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Mansilla C, Herrera CA, Boeira L, Yearwood A, Lopez AS, Colunga-Lozano LE, Brocard E, Villacres T, Vélez M, Di Paolantonio G, Reveiz L. Characterising COVID-19 empirical research production in Latin America and the Caribbean: A scoping review. PLoS One 2022; 17:e0263981. [PMID: 35171957 PMCID: PMC8849471 DOI: 10.1371/journal.pone.0263981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/01/2022] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The Coronavirus Disease 2019 (COVID19) pandemic has struck Latin America and the Caribbean (LAC) particularly hard. One of the crucial areas in the international community's response relates to accelerating research and knowledge sharing. The aim of this article is to map and characterise the existing empirical research related to COVID-19 in LAC countries and contribute to identify opportunities for strengthening future research. METHODS In this scoping review, articles published between December 2019 and 11 November 2020 were selected if they included an empirical component (explicit scientific methods to collect and analyse primary data), LAC population was researched, and the research was about the COVID-19 pandemic, regardless of publication status or language. MEDLINE, EMBASE, LILACS, Scielo, CENTRAL and Epistemonikos were searched. All titles and abstracts, and full texts were screened by two independent reviewers. Data from included studies was extracted by one reviewer and checked by a second independent reviewer. RESULTS 14,406 records were found. After removing duplicates, 5,458 titles and abstracts were screened, of which 2,323 full texts were revised to finally include 1,626 empirical studies. The largest portion of research came from people/population of Brazil (54.6%), Mexico (19.1%), Colombia (11.2%), Argentina (10.4%), Peru (10.3%) and Chile (10%), while Caribbean countries concentrated 15.3%. The methodologies most used were cross-sectional studies (34.7%), simulation models (17.5%) and randomized controlled trials (RCTs) (13.6%). Using a modified version of WHO's COVID-19 Coordinated Global Research Roadmap classification, 54.2% were epidemiological studies, followed by clinical management (22.3%) and candidate therapeutics (12.2%). Government and public funds support were reported in 19.2% of studies, followed by universities or research centres (9%), but 47.5% did not include any funding statement. CONCLUSION During the first part of the COVID-19 pandemic, LAC countries have contributed to the global research effort primarily with epidemiological studies, with little participation on vaccines research, meaning that this type of knowledge would be imported from elsewhere. Research agendas could be further coordinated aiming to enhance shared self-sufficiency regarding knowledge needs in the region.
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Affiliation(s)
- Cristián Mansilla
- McMaster Health Forum and Health Policy PhD Program, McMaster University, Hamilton, Canada
| | - Cristian A. Herrera
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- The World Bank Group, Washington, DC, United States of America
| | | | | | - Analia S. Lopez
- Instituto Universitario CEMIC (IUC), Buenos Aires, Argentina
| | - Luis E. Colunga-Lozano
- Department of Clinical Medicine, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | | | | | - Marcela Vélez
- Faculty of Medicine, Universidad de Antioquia, Medellin, Colombia
| | | | - Ludovic Reveiz
- Incident Management Systems for COVID-19 and Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, United States of America
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18
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Van Hemelrijck M, Lewison G, Fox L, Vanderpuye VD, Murillo R, Booth CM, Canfell K, Pramesh CS, Sullivan R, Mukherij D. Global cancer research in the era of COVID-19: a bibliometric analysis. Ecancermedicalscience 2021; 15:1264. [PMID: 34567249 PMCID: PMC8426029 DOI: 10.3332/ecancer.2021.1264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Indexed: 12/23/2022] Open
Abstract
Background Patients with cancer across the world have been impacted by the COVID-19 pandemic due to increased risk of infection and disruption to cancer diagnosis and treatment. Widening of healthcare disparities is expected as the gap between health systems with and without adequate resources to mitigate the pandemic become more apparent. We undertook a bibliometric analysis of research related to cancer and COVID-19 to understand (1) the type of research that has been conducted (e.g. patients, services and systems) and (2) whether the pandemic has impacted the state of global cancer research as measured by research outputs to date. Methods An existing filter for cancer research consisting of title words and the names of specialist cancer journals was used to identify cancer and COVID-19 related articles and reviews in the Web of Science (©Clarivate Analytics) between January 2019 and February 2021. Results One thousand five hundred and forty-five publications were identified. The majority (57%) were reviews, opinion pieces or concerned with modelling impact of delays to diagnosis and treatment. The main research domains focused on managing or estimating COVID-19 risk to cancer patients accounting for 384 papers (25%). High Income countries contributed the largest volume (n = 1,115; 72%), compared to Upper Middle (n = 302; 20%), Lower Middle (n = 122; 8%) and Low Income countries (n = 2.4; 0.2%). No evidence of a reduction in global cancer research output was observed in 2020. Conclusions We observed a shift in research focus rather than a decline in absolute output. However, there is variation based on national income and collaborations are minimal. There has been a focus on pan-cancer studies rather than cancer site-specific studies. Strengthening global multidisciplinary research partnerships with teams from diverse backgrounds with regard to gender, clinical expertise and resource setting is essential to prevent the widening of cancer inequalities.
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Affiliation(s)
- Mieke Van Hemelrijck
- King's College London, Faculty of Life Sciences and Medicine, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), London SE1 9RT, UK
| | - Grant Lewison
- King's College London, Faculty of Life Sciences and Medicine, Institute of Cancer Policy, London SE1 9RT, UK
| | - Louis Fox
- King's College London, Faculty of Life Sciences and Medicine, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), London SE1 9RT, UK
| | - Verna Dnk Vanderpuye
- National Center for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, PO Box KB369, Accra, Ghana
| | | | | | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - C S Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India
| | - Richard Sullivan
- King's College London, Faculty of Life Sciences and Medicine, Institute of Cancer Policy, London SE1 9RT, UK
| | - Deborah Mukherij
- Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
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