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Guadamuz JS, Wang X, Royce TJ, Calip GS. Sociodemographic Inequities in Telemedicine Use Among US Patients Initiating Treatment in Community Cancer Centers During the Ongoing COVID-19 Pandemic, 2020-2022. JCO Oncol Pract 2023; 19:1206-1214. [PMID: 37748113 PMCID: PMC10732501 DOI: 10.1200/op.23.00144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/07/2023] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
PURPOSE Although telemedicine was seen as a way to improve cancer care during the coronavirus disease (COVID-19) pandemic, there is limited information regarding inequities in its uptake. This study assessed sociodemographic factors associated with telemedicine use among patients initiating treatment for 20 common cancers. METHODS This retrospective cohort study used deidentified electronic health record-derived patient data from a nationwide network of community cancer practices, linked to area-level Census information. We included adults (age 18 years and older) who initiated first-line systemic cancer treatment between March 2020 and December 2022 (follow-up through March 2023). Exposures include race/ethnicity, insurance status, and area-level social determinants of health (eg, block group socioeconomic status [SES]). The outcome was telemedicine use within 90 days after treatment initiation. Associations were examined using logistic regression models adjusted for age, sex, performance status, stage, and cancer type. RESULTS This study included 36,993 patients (48.6% women; median age, 69 years), of whom 15.1% used telemedicine services. Black (12.2%; odds ratio [OR], 0.78 [95% CI, 0.70 to 0.88]) and uninsured (9.2%; OR, 0.59 [95% CI, 0.48 to 0.73]) patients were less likely to use telemedicine services than their White and well-insured counterparts (14.5% and 15.0%, respectively). Patients in rural (9.7%; OR, 0.54 [95% CI, 0.46 to 0.57]), suburban (11.8%; OR, 0.67 [95% CI, 0.61 to 0.74]), and low SES areas (9.9%; OR, 0.39 [95% CI, 0.35 to 0.43]) were less also likely to use telemedicine than their counterparts in urban (16.6%) or high SES (21.6%) areas. CONCLUSION Nearly one sixth of patients initiating cancer treatment during the pandemic used telemedicine, but there were substantial inequities. The proliferation of telemedicine may perpetuate cancer care inequities if marginalized populations do not have equitable access.
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Affiliation(s)
- Jenny S. Guadamuz
- Flatiron Health, New York, NY
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley, CA
- School of Pharmacy, University of Southern California, Los Angeles, CA
| | | | - Trevor J. Royce
- Flatiron Health, New York, NY
- Wake Forest School of Medicine, Winston-Salem, NC
| | - Gregory S. Calip
- Flatiron Health, New York, NY
- School of Pharmacy, University of Southern California, Los Angeles, CA
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Goyal G, Lau KW, Wang X, Davidoff AJ, Huntington SF, Jamy O, Calip G, Shah H, Stephens DM, Miksad R, Parikh RB, Takvorian S, Neparidze N, Seymour EK. The COVID-19 Pandemic and In-Person Visit Rate Disruptions Among Patients With Hematologic Neoplasms in the US in 2020 to 2021. JAMA Netw Open 2023; 6:e2316642. [PMID: 37273206 PMCID: PMC10242428 DOI: 10.1001/jamanetworkopen.2023.16642] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Importance The COVID-19 pandemic has led to a reduction in routine in-person medical care; however, it is unknown whether there have been any changes in visit rates among patients with hematologic neoplasms. Objective To examine associations between the COVID-19 pandemic and in-person visits and telemedicine use among patients undergoing active treatment for hematologic neoplasms. Design, Setting, and Participants Data for this retrospective observational cohort study were obtained from a nationwide electronic health record-derived, deidentified database. Data for patients with hematologic neoplasms who had received at least 1 systemic line of therapy between March 1, 2016, and February 28, 2021, were included. Treatments were categorized into 3 types: oral therapy, outpatient infusions, and inpatient infusions. The data cutoff date was April 30, 2021, when study analyses were conducted. Main Outcomes and Measures Monthly visit rates were calculated as the number of documented visits (telemedicine or in-person) per active patient per 30-day period. We used time-series forecasting methods on prepandemic data (March 2016 to February 2020) to estimate expected rates between March 1, 2020, and February 28, 2021 (if the pandemic had not occurred). Results This study included data for 24 261 patients, with a median age of 68 years (IQR, 60-75 years). A total of 6737 patients received oral therapy, 15 314 received outpatient infusions, and 8316 received inpatient infusions. More than half of patients were men (14 370 [58%]) and non-Hispanic White (16 309 [66%]). Early pandemic months (March to May 2020) demonstrated a significant 21% reduction (95% prediction interval [PI], 12%-27%) in in-person visit rates averaged across oral therapy and outpatient infusions. Reductions in in-person visit rates were also significant for all treatment types for multiple myeloma (oral therapy: 29% reduction; 95% PI, 21%-36%; P = .001; outpatient infusions: 11% reduction; 95% PI, 4%-17%; P = .002; inpatient infusions: 55% reduction; 95% PI, 27%-67%; P = .005), for oral therapy for chronic lymphocytic leukemia (28% reduction; 95% PI, 12%-39%; P = .003), and for outpatient infusions for mantle cell lymphoma (38% reduction; 95% PI, 6%-54%; P = .003) and chronic lymphocytic leukemia (20% reduction; 95% PI, 6%-31%; P = .002). Telemedicine visit rates were highest for patients receiving oral therapy, with greater use in the early pandemic months and a subsequent decrease in later months. Conclusions and Relevance In this cohort study of patients with hematologic neoplasms, documented in-person visit rates for those receiving oral therapy and outpatient infusions significantly decreased during the early pandemic months but returned to close to projected rates in the later half of 2020. There were no statistically significant reductions in the overall in-person visit rate for patients receiving inpatient infusions. There was higher telemedicine use in the early pandemic months, followed by a decline, but use was persistent in the later half of 2020. Further studies are needed to ascertain associations between the COVID-19 pandemic and subsequent cancer outcomes and the evolution of telemedicine use for care delivery.
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Affiliation(s)
- Gaurav Goyal
- Division of Hematology-Oncology, University of Alabama at Birmingham
| | - Krystal W Lau
- Flatiron Health, Inc, New York, New York
- Now with Palantir Technologies, New York, New York
| | | | | | - Scott F Huntington
- Section of Hematology, Yale University School of Medicine, New Haven, Connecticut
| | - Omer Jamy
- Division of Hematology-Oncology, University of Alabama at Birmingham
| | | | - Harsh Shah
- Huntsman Cancer Center, University of Utah, Salt Lake City
| | | | - Rebecca Miksad
- Flatiron Health, Inc, New York, New York
- Boston Medical Center, Boston University, Boston, Massachusetts
| | - Ravi B Parikh
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Samuel Takvorian
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Natalia Neparidze
- Section of Hematology, Yale University School of Medicine, New Haven, Connecticut
| | - Erlene K Seymour
- Flatiron Health, Inc, New York, New York
- Now with BeiGene, Ridgefield Park, New Jersey
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Muacevic A, Adler JR, Wang K, Lewis GD. The Effects of the COVID-19 Pandemic on Cancer Staging in Patients Diagnosed With Head and Neck Cancer. Cureus 2023; 15:e34190. [PMID: 36843727 PMCID: PMC9951633 DOI: 10.7759/cureus.34190] [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] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
Purpose The healthcare system across the world was forced to implement new policies, guidelines, and procedures due to the coronavirus disease 2019 (COVID-19) pandemic, which led many patients to make an impossible choice about their health. For various reasons, many patients chose to remain at home and delay any interaction at medical facilities to protect themselves or others from the virus. Patients managing chronic diseases faced unprecedented challenges during this period, and the long-term effects on these patient populations remain unclear. Oncology patients, specifically those diagnosed with head and neck cancers, require prompt diagnosis and initiation of treatment for better outcomes. While the overall impact of how the pandemic has affected oncology patients is unknown, this retrospective study examined how the staging of head and neck tumors at our institution has been impacted since the beginning of the pandemic. Methods Available patient data (from August 1, 2019, through June 28, 2021) were collected from medical records and compared to determine statistical significance. Patients were categorized into a Pre-pandemic group, Pandemic group, and Vaccine-approved group, and patient and treatment characteristics were analyzed to look for patterns. The pre-pandemic period was defined as the period from August 1, 2019, to March 16, 2020, the pandemic period was defined as the period from March 17, 2020, to December 31, 2020, and the vaccine-approved period was defined as the period from January 1, 2021, to June 28, 2021. Results Fisher's exact tests were used to compare tumor, node, metastasis (TNM) staging distributions between the three groups. In the Pre-pandemic group, out of 67 patients, 33 patients (55.0%) were diagnosed with a T stage of 0-2 and 27 patients (45.0%) were diagnosed with a T stage of 3-4. In the Pandemic and Vaccine-approved groups, out of 139 patients, 50 patients (39.1%) were diagnosed with a T stage of 0-2 and 78 patients (60.9%) were diagnosed with a T stage of 3-4; these differences were statistically significant (P-value = 0.0426). The Pre-pandemic group had 25 patients (41.7%) diagnosed with a group stage of 0-2 and 35 patients (58.3%) diagnosed with a group stage of 3-4. The Pandemic and Vaccine-approved groups had 36 patients (28.1%) diagnosed with a group stage of 0-2 and 92 patients (71.9%) diagnosed with a group stage of 3-4; these results trended to statistically significant (P-value = 0.0688). Conclusions Our findings suggest that there have been a higher number of patients with head and neck cancer diagnosed with a T stage of 3 or 4 since the start of the COVID-19 pandemic. The effects of the COVID-19 pandemic are ongoing and will need further evaluation to determine the overall effects on oncology patients. Increased morbidity and mortality rates may be a potential result in the years to come.
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Calip GS, Cohen A, Rohrer R, Wang X, Wang X, Webster A, Wu A, Griffith SD, Showalter TN, Miksad RA. Telemedicine use among patients with metastatic breast cancer during the COVID-19 pandemic: Differences by race, age, and region. Pharmacoepidemiol Drug Saf 2023; 32:66-72. [PMID: 36111444 PMCID: PMC10091805 DOI: 10.1002/pds.5541] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE Our objective was to describe differences in telemedicine use among women with metastatic breast cancer (mBC) by race, age, and geographic region. METHODS This was a retrospective cohort study of women with recurrent or de novo mBC treated in US community cancer practices that initiated a new line of therapy between March 2020 and February 2021. Multivariable modified Poisson regression models were used to calculate adjusted rate ratios (RR) and robust 95% confidence intervals (CI) associated with telemedicine visits within 90 days of therapy initiation. RESULTS Overall, among 3412 women with mBC, 751 (22%) patients had telemedicine visits following therapy initiation, with lower risks observed among older women (<50 years: 24%; 50-64 years: 22%; 65-74 years: 21%; ≥75 years: 20%). Greater telemedicine use was observed among Asian women (35%) compared to White (21%), Black (18%), and Hispanic (21%) women. Fewer telemedicine visits occurred in Southern (12%) and Midwestern (17%) states versus Northeastern (37%) or Western (36%) states. In multivariable models, women ages ≥75 years had significantly lower risks of telemedicine visits (RR = 0.76, 95% CI 0.62-0.95) compared to ages <50 years. Compared to patients in Northeastern states, women in Midwestern (RR = 0.46, 95% CI 0.37-0.57) and Southern (RR = 0.31, 95% CI 0.26-0.37) states had significantly lower risks of telemedicine visits; but not women in Western states (RR = 0.96, 95% CI 0.83-1.12). No statistically significant differences in telemedicine use were found between racial groups in overall multivariable models. CONCLUSIONS In this study of community cancer practices, older mBC patients and those living in Southern and Midwestern states were less likely to have telemedicine visits. Preferences for communication and delivery of care may have implications for measurement of exposures and endpoints in pharmacoepidemiologic studies of cancer patients.
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Affiliation(s)
- Gregory S Calip
- Flatiron Health, New York, New York, USA.,University of Illinois Chicago College of Pharmacy, Chicago, Illinois, USA
| | - Aaron Cohen
- Flatiron Health, New York, New York, USA.,New York University School of Medicine, New York, New York, USA
| | | | | | | | | | - Amy Wu
- Flatiron Health, New York, New York, USA
| | | | - Timothy N Showalter
- Flatiron Health, New York, New York, USA.,University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Rebecca A Miksad
- Flatiron Health, New York, New York, USA.,Boston Medical Center, Boston, Massachusetts, USA
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Mullangi S, Aviki EM, Chen Y, Robson M, Hershman DL. Factors Associated With Cancer Treatment Delay Among Patients Diagnosed With COVID-19. JAMA Netw Open 2022; 5:e2224296. [PMID: 35900758 PMCID: PMC9335143 DOI: 10.1001/jamanetworkopen.2022.24296] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE The COVID-19 pandemic led to disruptions in delivery of cancer treatments; factors associated with treatment delay among patients with cancer who contract COVID-19 need further characterization. OBJECTIVE To assess the associations of patient factors, social determinants of health, severity of COVID-19, and timing of COVID-19 diagnosis with the risk of treatment delay. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted from March 2020 through July 2021 at 60 academic and community medical practices in the United States. Participants included patients with any cancer diagnosis who were scheduled for treatment and contracted COVID-19. Data were analyzed in February 2022. EXPOSURE Positive test result for SARS-CoV-2. MAIN OUTCOMES AND MEASURES The main outcomes were treatment delay, defined as more than 14 days between the date originally planned for treatment and the date of initiation of therapy, or discontinuation of therapy. Multivariable analyses were used to assess outcomes. RESULTS A total of 3028 patients (1470 patients [49%] aged ≥65 years; 1741 [58%] women) were included in the registry. With 962 of 2103 patients (46%) experiencing anticancer drug delay or discontinuation, delays were higher among Black patients compared with White patients (odds ratio [OR], 1.87; 95% CI, 1.40-2.51), Hispanic or Latino patients compared with non-Hispanic or Latino patients (OR, 1.91; 95% CI, 1.34-2.72), patients with 2 or more comorbidities compared with patients with 0 to 1 (OR, 1.23; 95% CI, 1.00-1.53), patients with metastatic disease rather than locoregional disease (OR, 1.63; 95% CI, 1.29-2.05), and patients who experienced COVID-19 complications compared with those who did not (OR, 1.52; 95% CI, 1.24-1.86). Residing in an area with a higher proportion of residents reporting Hispanic or Latino ethnicity (OR, 0.76; 95% CI, 0.60-0.95) and contracting COVID-19 later in the pandemic, compared with those who were infected in March to June 2020, (eg, January to March 2021: OR, 0.38; 95% CI, 0.26-0.53) were associated with lower likelihood of drug therapy delay. A total of 95 of 202 patients (47%) experienced delay or discontinuation of radiation treatment, with having 2 or more comorbidities associated with delay (OR, 2.69; 95% CI, 1.20-6.20). Higher local-area median household income was associated with lower likelihood of radiation treatment delay (OR, 0.41; 95% CI, 0.17-0.94). There were 89 of 125 patients (71%) who experienced surgical treatment delay, and delays were higher among patients in the South compared with those in the Midwest (OR, 9.66; 95% CI, 2.14-52.3). Interestingly, patients with 2 or more comorbidities, compared with those with 0 to 1, experienced lower likelihoods of surgical treatment delay (OR, 0.26; 95% CI, 0.07-0.88). CONCLUSIONS AND RELEVANCE Our findings suggest that individual patient factors, social determinants of health, and COVID-19 severity and diagnosis date were associated with exacerbated health disparities during the pandemic in regards to cancer treatment delay.
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Affiliation(s)
- Samyukta Mullangi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Emeline M. Aviki
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yuan Chen
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark Robson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Dawn L. Hershman
- Department of Medicine, Columbia University Medical Center, New York, New York
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Valverde PA, Kennedy Sheldon L, Gentry S, Dwyer AJ, Saavedra Ferrer EL, Wightman PD. Flexibility, adaptation, and roles of patient navigators in oncology during COVID-19. Cancer 2022; 128 Suppl 13:2610-2622. [PMID: 35699607 DOI: 10.1002/cncr.33962] [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] [Received: 03/04/2021] [Revised: 08/10/2021] [Accepted: 09/07/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The impact of COVID-19 on cancer care during the first 6 months of the pandemic has been significant. The National Navigation Roundtable Workforce Development Task Group conducted a national survey to highlight the role of patient navigators (PNs). METHODS An anonymous online survey captured how cancer care navigation changed during 2 phases: 1) March 13 to May 31, 2020; and 2) June 1 to September 4, 2020. Differences between the 2 time periods for categorical variables were assessed using χ2 tests, and 1-way analyses of variance were used for ordinal variables. RESULTS Almost one-half of PNs expected changes in duties (49%) during phase 1. By phase 2, PNs showed greater confidence in retaining PN work (P < .001) and reduced changes to duties (P < .01). PNs reported new training on COVID-19 and telehealth during phase 1 (64% and 27%, respectively) and phase 2 (54% and 19%, respectively). Significant decreases in service delays were identified by phase 2 for cancer screening (P < .001), preventive care (P < .001), medical treatment (P < .01), cancer treatment (P < .001), and cancer survivorship services (P < .01). PNs reported that the top patient issues were COVID-19 concerns, medical care disruptions, and finances, and there were decreases in medical care disruptions (P < .01) during phase 2. PNs addressed myths related to mask use, COVID-19 spread, disbelief, risk, clinical changes, transmission prevention, and finances/politics. CONCLUSIONS The PN role demonstrated resiliency and adaptability. Both clinical and nonclinical oncology PNs identified key patient needs and can provide connections with patient populations that have been economically and socially marginalized, which is necessary to build trust throughout the pandemic.
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Affiliation(s)
- Patricia A Valverde
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado
| | - Lisa Kennedy Sheldon
- Clinical and Scientific Affairs, Oncology Nursing Society, Pittsburgh, Pennsylvania
| | - Sharon Gentry
- Academy of Oncology Nurse and Patient Navigators, Cranbury, New Jersey
| | - Andrea J Dwyer
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado
| | - Elba L Saavedra Ferrer
- Center for Collaborative Research and Community Engagement, College of Education and Human Sciences, University of New Mexico, Albuquerque, New Mexico
| | - Patrick D Wightman
- Arizona Health Sciences-Center for Population Health Sciences, University of Arizona, Tucson, Arizona
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Press DJ, Shariff-Marco S, Lichtensztajn DY, Lauderdale D, Murphy AB, Inamdar PP, DeRouen MC, Hamilton AS, Yang J, Lin K, Hedeker D, Haiman CA, Cheng I, Gomez SL. Contributions of Social Factors to Disparities in Prostate Cancer Risk Profiles among Black Men and Non-Hispanic White Men with Prostate Cancer in California. Cancer Epidemiol Biomarkers Prev 2022; 31:404-412. [PMID: 34853020 PMCID: PMC8825684 DOI: 10.1158/1055-9965.epi-21-0697] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/20/2021] [Accepted: 11/22/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Black men are more likely than Non-Hispanic White (NHW) men to be diagnosed with high-risk prostate cancer. We examined the extent to which social factors were associated with differences in prostate cancer risk profiles between Black men and NHW men [using a modification to the original D'Amico risk groups based on prostate specific antigen (PSA), Gleason score (GS), and TNM stage (stage)], based on individual and combined clinicopathologic characteristics. METHODS We conducted a cross-sectional population-based study of 23,555 Black men and 146,889 NHW men diagnosed with prostate cancer in the California Cancer Registry from 2004 to 2017. We conducted multivariable logistic regression to examine the association of year of diagnosis, block group-level neighborhood socioeconomic status (nSES), marital status, and insurance type on differences in prostate cancer risk profiles between Black and NHW men. RESULTS High PSA (>20 ng/mL), GS, stage, individually and combined prostate cancer risk profiles were more common among Black men versus NHW men. In fully adjusted models, relative to NHW men, we observed a persistent 67% increased odds of high PSA among Black men. nSES was the factor most strongly associated with racial disparity in high PSA, accounting for 25% of the difference. Marital status was the factor that was second most associated with a racial disparity. CONCLUSIONS nSES was the factor most strongly associated with racial disparities in high PSA prostate cancer. IMPACT The influence of nSES on racial disparities in PSA, GS, stage, and prostate cancer risk profiles warrants further consideration.
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Affiliation(s)
- David J Press
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois.
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago Illinois
- The Center for Health Information Partnerships (CHiP), Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Salma Shariff-Marco
- Greater Bay Area Cancer Registry, Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Daphne Y Lichtensztajn
- Greater Bay Area Cancer Registry, Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Diane Lauderdale
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Adam B Murphy
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Pushkar P Inamdar
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Mindy C DeRouen
- Greater Bay Area Cancer Registry, Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California
| | - Juan Yang
- Greater Bay Area Cancer Registry, Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Katherine Lin
- Greater Bay Area Cancer Registry, Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California
| | - Iona Cheng
- Greater Bay Area Cancer Registry, Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Scarlett Lin Gomez
- Greater Bay Area Cancer Registry, Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, San Francisco, California
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Bosserman LD. Enhancing JCO Oncology Practice's Cancer Care Delivery and Quality Improvement Mission With Equity and Value Components. JCO Oncol Pract 2021; 17:258-260. [PMID: 33974830 DOI: 10.1200/op.21.00232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Linda D Bosserman
- Department of Medical Oncology and Hematology, City of Hope, Duarte, CA
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