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Attai DJ, Katz MS, Streja E, Hsiung JT, Marroquin MV, Zavaleta BA, Nekhlyudov L. Patient preferences and comfort for cancer survivorship models of care: results of an online survey. J Cancer Surviv 2023; 17:1327-1337. [PMID: 35113306 DOI: 10.1007/s11764-022-01177-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/21/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE Workforce shortages will impact oncologists' ability to provide both active and survivorship care. While primary care provider (PCP) or survivorship clinic transition has been emphasized, there is little evidence regarding patient comfort. METHODS We developed an online survey in partnership with patient advocates to assess survivors' comfort with PCP or survivorship clinic care and distributed the survey to online, cancer-specific patient communities from June to August 2020. Descriptive and logistic regression analyses were conducted. RESULTS A total of 975 surveys were complete. Most respondents were women (91%) and had private insurance (65%). Thirty-six cancer types were reported. Ninety-three percent had a PCP. Twenty-four percent were comfortable seeing a PCP for survivorship care. Higher odds of comfort were seen among respondents who were Black or had stage 0 cancer; female sex was associated with lower odds. Fifty-five percent were comfortable with a survivorship clinic. Higher odds of comfort were seen with lymphoma or ovarian cancer, > 15 years from diagnosis, and non-US government insurance. Lower odds were seen with melanoma, advanced stage, Medicaid insurance, and one late effect. Preference for PCP care was 87% for general health, 32% for recurrence monitoring, and 37% for late effect management. CONCLUSIONS One quarter of cancer survivors were comfortable with PCP-led survivorship care and about half with a survivorship clinic. Most preferred oncologist care for recurrence monitoring and late-effect management. IMPLICATIONS FOR CANCER SURVIVORS Patient preference and comfort should be considered when developing survivorship care models. Future efforts should focus on facilitating patient-centered transitions to non-oncologist care.
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Affiliation(s)
- Deanna J Attai
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- UCLA Health Burbank Breast Care, 191 S. Buena Vista #415, Burbank, CA, 91505, USA.
| | - Matthew S Katz
- Department of Radiation Medicine, Lowell General Hospital, Lowell, MA, USA
| | - Elani Streja
- Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Jui-Ting Hsiung
- Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | | | - Beverly A Zavaleta
- Department of Medicine, Valley Baptist Medical Center - Brownsville, Brownsville, TX, USA
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Social Media and Cardiovascular Health: Implications for Women. Curr Atheroscler Rep 2022; 24:901-913. [PMID: 36441421 PMCID: PMC10017051 DOI: 10.1007/s11883-022-01069-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) is the leading cause of mortality in adult women in the USA, yet CVD is underrecognized in women. Disparities in care are further pronounced in women of racial/ethnic minority backgrounds. In this review, we discuss the role of social media (SoMe) as a tool to (i) promote women's cardiovascular (CV) health and (ii) address and potentially reduce gaps in care, particularly in general cardiology (targeting atherosclerotic cardiovascular disease), cardio-oncology, and cardio-obstetrics. We also briefly discuss women's CV health as a common, although not unique, focus of women in cardiology on SoMe. RECENT FINDINGS Studies have suggested the utility of social media to help advance subspecialties of cardiology. Leaders within general cardiology, cardio-oncology, and cardio-obstetrics have curated social media strategies to advance their respective fields and call attention to cardiovascular health disparities in female populations and racial/ethnic minorities. In addition to these types of uses, women in cardiology also frequently use SoMe to encourage a career in cardiology and to share experiences, challenges, and resources for support and career advancement as healthcare professionals; men in cardiology and especially those who are allies for sex and racial/ethnic minorities also use SoMe for these means. Herein, we highlight the role and myriad applications of social media in the promotion of women's cardiovascular health. We discuss five primary roles of social media: increasing public awareness, disseminating medical literature in a rapid and accessible fashion, facilitating professional networking, serving as a platform for medical conferences, and empowering patients. These core strategies are discussed through the lens of general cardiology, cardio-oncology, and cardio-obstetrics. We also demonstrate how these applications can be leveraged to increase representation of women in cardiology, also supporting an increased focus on women's cardiovascular health.
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Teplinsky E, Ponce SB, Drake EK, Garcia AM, Loeb S, van Londen GJ, Teoh D, Thompson M, Schapira L. Online Medical Misinformation in Cancer: Distinguishing Fact From Fiction. JCO Oncol Pract 2022; 18:584-589. [PMID: 35357887 PMCID: PMC9377685 DOI: 10.1200/op.21.00764] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
It is without question that the Internet has democratized access to medical information, with estimates that 70% of the American population use it as a resource, particularly for cancer-related information. Such unfettered access to information has led to an increase in health misinformation. Fortunately, the data indicate that health care professionals remain among the most trusted information resources. Therefore, understanding how the Internet has changed engagement with health information and facilitated the spread of misinformation is an important task and challenge for cancer clinicians. In this review, we perform a meta-synthesis of qualitative data and point toward empirical evidence that characterizes misinformation in medicine, specifically in oncology. We present this as a call to action for all clinicians to become more active in ongoing efforts to combat misinformation in oncology.
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Affiliation(s)
- Eleonora Teplinsky
- Valley-Mount Sinai Comprehensive Cancer Care; Valley Health System, Paramus, NJ
| | - Sara Beltrán Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Emily K Drake
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anna Meredith Garcia
- Section of Medical Oncology, Dagupan Doctors Villaflor Memorial Hospital, Dagupan City, Philippines
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
| | - G J van Londen
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Deanna Teoh
- Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | | | - Lidia Schapira
- Stanford Cancer Institute, Stanford University, Palo Alto, CA
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Anampa-Guzmán A, Freeman-Daily J, Fisch M, Lou E, Pennell NA, Painter CA, Sparacio D, Lewis MA, Karmo M, Anderson PF, Graff SL. The Rise of the Expert Patient in Cancer: From Backseat Passenger to Co-navigator. JCO Oncol Pract 2022; 18:578-583. [PMID: 35344398 PMCID: PMC9377686 DOI: 10.1200/op.21.00763] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Patients who have cancer have leveraged the Internet to gain a better understanding of their disease and connect across geographic boundaries with others facing the same challenges. Online cancer communities have developed into resources that highlight new research and evolving care pathways. Combined with increasing health literacy and social media, they have enabled some patients to become experts in their cancer. This combination of empowerment and expertise describes the new "e-patients." METHODS We reviewed the literature to identify key areas where expert e-patients have directly participated in advancing cancer medicine, as well as opportunities available to those who wish to become more involved in research advocacy. RESULTS E-patients are widely acknowledged as key stakeholders in oncology by clinicians, researchers, cancer centers, government agencies, and nonprofits. Their input is vital for informing cancer care delivery, developing and launching research initiatives, creating care guidelines and pathways, and formulating policy. CONCLUSION Expert e-patients play an expanded role in their own care and in larger conversations regarding practice, research, and policy. Clinicians can engage e-patients as partners in cancer care as we work together towards improving health care access and outcomes for people with cancer.
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Affiliation(s)
- Andrea Anampa-Guzmán
- San Fernando Medical School, Faculty of Medicine, Universidad Nacional Mayor de San Marcos. Lima, Peru.,Lymphoma Section, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | - Michael Fisch
- Department of General Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Emil Lou
- Masonic Cancer Center, Minneapolis, MN
| | | | | | | | | | | | - Patricia F Anderson
- Virtual Projects Advisory Committee, and Emerging Technologies Informationist, Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI
| | - Stephanie L Graff
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI
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Ponce SB, M Barry M, S Dizon D, S Katz M, Murphy M, Teplinsky E, Tinianov S, J Attai D, Markham MJ. Netiquette for social media engagement for oncology professionals. Future Oncol 2022; 18:1133-1141. [PMID: 35109663 PMCID: PMC9344460 DOI: 10.2217/fon-2021-1366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/07/2021] [Indexed: 12/16/2022] Open
Abstract
Social media growth has revolutionized health care, facilitating user-friendly, rapid and global sharing of content. Within oncology, this allows for new frontiers in communication for cancer patients, caregivers and healthcare providers. As more physicians engage in online spaces, it is imperative that there are resources to assist in establishing a professional presence on social media. This article describes how to create a social media identity, best practices for engaging both in patient and caregiver spaces and professional communities, and how to address antagonistic and inappropriate behavior on social media with the goal of helping physicians develop an engaging, productive and enjoyable experience online.
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Affiliation(s)
- Sara Beltrán Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Maura M Barry
- Division of Hematology & Oncology, The University of Vermont Larner College of Medicine, Burlington, VT 05405, USA
| | - Don S Dizon
- Brown University & Lifespan Cancer Institute, Providence, RI 02903, USA
| | - Matthew S Katz
- Radiation Oncology Associates, PA, Lowell, MA 01854, USA
| | - Martina Murphy
- Division of Hematology & Oncology, University of Florida, Gainesville, FL 32610, USA
| | | | - Stacey Tinianov
- Breast Science Advocacy Core UCSF, Advocates for Collaborative Education, San Francisco, CA 94143, USA
| | - Deanna J Attai
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
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Seid M, Bridgeland D, Bridgeland A, Hartley DM. A collaborative learning health system agent-based model: Computational and face validity. Learn Health Syst 2021; 5:e10261. [PMID: 34277939 PMCID: PMC8278449 DOI: 10.1002/lrh2.10261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/21/2021] [Accepted: 01/30/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Improving the healthcare system is a major public health challenge. Collaborative learning health systems (CLHS) - network organizations that allow all healthcare stakeholders to collaborate at scale - are a promising response. However, we know little about CLHS mechanisms of actions, nor how to optimize CLHS performance. Agent-based models (ABM) have been used to study a variety of complex systems. We translate the conceptual underpinnings of a CLHS to a computational model and demonstrate initial computational and face validity. METHODS CLHSs are organized to allow stakeholders (patients and families, clinicians, researchers) to collaborate, at scale, in the production and distribution of information, knowledge, and know-how for improvement. We build up a CLHS ABM from a population of patient- and doctor-agents, assign them characteristics, and set them into interaction, resulting in engagement, information, and knowledge to facilitate optimal treatment selection. To assess computational and face validity, we vary a single parameter - the degree to which patients influence other patients - and trace its effects on patient engagement, shared knowledge, and outcomes. RESULTS The CLHS ABM, developed in Python and using the open-source modeling framework Mesa, is delivered as a web application. The model is simulated on a cloud server and the user interface is a web browser using Python and Plotly Dash. Holding all other parameters steady, when patient influence increases, the overall patient population activation increases, leading to an increase in shared knowledge, and higher median patient outcomes. CONCLUSIONS We present the first theoretically-derived computational model of CLHSs, demonstrating initial computational and face validity. These preliminary results suggest that modeling CLHSs using an ABM is feasible and potentially valid. A well-developed and validated computational model of the health system may have profound effects on understanding mechanisms of action, potential intervention targets, and ultimately translation to improved outcomes.
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Affiliation(s)
- Michael Seid
- Division of Pulmonary MedicineCincinnati Children's HospitalCincinnatiOhioUSA
- James M. Anderson Center for Health Systems ExcellenceCincinnati Children's HospitalCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati, College of MedicineCincinnatiOhioUSA
| | | | | | - David M. Hartley
- James M. Anderson Center for Health Systems ExcellenceCincinnati Children's HospitalCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati, College of MedicineCincinnatiOhioUSA
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Papautsky EL, Patterson ES. Patients Are Knowledge Workers in the Clinical Information Space. Appl Clin Inform 2021; 12:133-140. [PMID: 33626585 DOI: 10.1055/s-0041-1723022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Limited research exists on patient knowledge/cognition or "getting inside patients' heads." Because patients possess unique and privileged knowledge, clinicians need this information to make patient-centered and coordinated treatment planning decisions. To achieve patient-centered care, we characterize patient knowledge and contributions to the clinical information space. METHODS AND OBJECTIVES In a theoretical overview, we explore the relevance of patient knowledge to care provision, apply historical perspectives of knowledge acquisition to patient knowledge, propose a representation of patient knowledge types across the continuum of care, and include illustrative vignettes about Mr. Jones. We highlight how the field of human factors (a core competency of health informatics) provides a perspective and methods for eliciting and characterizing patient knowledge. CONCLUSION Patients play a vital role in the clinical information space by possessing and sharing unique knowledge relevant to the clinical picture. Without a patient's contributions, the clinical picture of the patient is incomplete. A human factors perspective informs patient-centered care and health information technology solutions to support clinical information sharing.
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Affiliation(s)
- Elizabeth Lerner Papautsky
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Emily S Patterson
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, United States
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