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Roets E, Schuster K, Bickley S, Wartenberg M, Gonzato O, Fernandez N, Kasper B, Pilgermann K, Wilson R, Steeghs N, van der Graaf WTA, van Oortmerssen G, Husson O. Setting the international research agenda for sarcomas with patients and carers: results of phase II of the Sarcoma Patient Advocacy Global Network (SPAGN) priority setting partnership. BMC Cancer 2024; 24:962. [PMID: 39107697 PMCID: PMC11301941 DOI: 10.1186/s12885-024-12732-6] [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: 03/18/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Typically, researchers and clinicians determine the agenda in sarcoma research. However, patient involvement can have a meaningful impact on research. Therefore, the Patient-Powered Research Network (PPRN) of the Sarcoma Patient Advocacy Global Network (SPAGN) set up a Priority Setting Partnership (PSP). The primary objective of this partnership is to identify priorities for research and patient advocacy topics. METHODS In the first phase of this PSP, including 264 sarcoma patients and carers from all over the world, 23 research topics regarding sarcomas and 15 patient advocacy topics were identified using an online survey. In the second phase, participants were asked to fill in a top five and a top three of research and patient advocacy topics, respectively. Additionally, sociodemographic characteristics and sarcoma characteristics were collected. Social media channels, local national patient advocacy groups and the SPAGN website were used to distribute the survey. RESULTS In total, 671 patients (75%) and carers (25%) participated in this survey. The five highest ranked research topics were related to causes of sarcoma (43%), prognosis and risk of recurrence (40%), specific subtypes of sarcoma (33%), the role of immunotherapy, targeted therapy and combined therapy (30%), and hereditary aspects (30%). The three highest ranked patient advocacy topics were improving the diagnostic process of sarcoma (39%), access to tumor DNA analysis (37%) and establishing an international sarcoma registry (37%). CONCLUSIONS This sarcoma PSP has identified priorities for research and patient advocacy, offering guidance for researchers, assisting funding agencies with assessing project relevance and empowering patient advocates to represent the needs of patients and carers.
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Affiliation(s)
- E Roets
- Medical Oncology Department, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - K Schuster
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
| | - S Bickley
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
- Policy and Support, Sarcoma UK, 17/18 Angel Gate City Road, London, UK
| | - M Wartenberg
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
- German Sarcoma Foundation, National Center for Tumor Diseases, Heidelberg, Germany
| | - O Gonzato
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
- Fondazione Paola Gonzato-Rete Sarcoma ETS, Rome, Italy
| | - N Fernandez
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
| | - B Kasper
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
- German Sarcoma Foundation, National Center for Tumor Diseases, Heidelberg, Germany
- Sarcoma Unit, Mannheim University Medical Center, Heidelberg, Germany
| | - K Pilgermann
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
| | - R Wilson
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
- Sarcoma UK, 17/18 Angel Gate City Road, London, UK
| | - N Steeghs
- Medical Oncology Department, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - W T A van der Graaf
- Medical Oncology Department, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Medical Oncology Department, Erasmus Cancer Institute, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - G van Oortmerssen
- Sarcoma Patient Advocacy Global Network (SPAGN), Untergasse 36, D-61200, Wölfersheim, Germany
| | - O Husson
- Medical Oncology Department, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Medical Oncology Department, Erasmus Cancer Institute, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
- Surgical Oncology Department, Erasmus Cancer Institute, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
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Usher-Smith JA, Masson G, Godoy A, Burge SW, Kitt J, Farquhar F, Cartledge J, Kimuli M, Burbidge S, Crosbie PAJ, Eckert C, Hancock N, Iball GR, Rogerson S, Rossi SH, Smith A, Simmonds I, Wallace T, Ward M, Callister MEJ, Stewart GD. Acceptability of adding a non-contrast abdominal CT scan to screen for kidney cancer and other abdominal pathology within a community-based CT screening programme for lung cancer: A qualitative study. PLoS One 2024; 19:e0300313. [PMID: 38950010 PMCID: PMC11216619 DOI: 10.1371/journal.pone.0300313] [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: 07/25/2023] [Accepted: 02/27/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES The Yorkshire Kidney Screening Trial (YKST) is a feasibility study of adding non-contrast abdominal CT scanning to screen for kidney cancer and other abdominal malignancies to community-based CT screening for lung cancer within the Yorkshire Lung Screening Trial (YLST). This study explored the acceptability of the combined screening approach to participants and healthcare professionals (HCPs) involved in the trial. METHODS We conducted semi-structured interviews with eight HCPs and 25 participants returning for the second round of scanning within YLST, 20 who had taken up the offer of the additional abdominal CT scan and five who had declined. Transcripts were analysed using thematic analysis, guided by the Theoretical Framework of Acceptability. RESULTS Overall, combining the offer of a non-contrast abdominal CT scan alongside the low-dose thoracic CT was considered acceptable to participants, including those who had declined the abdominal scan. The offer of the additional scan made sense and fitted well within the process, and participants could see benefits in terms of efficiency, cost and convenience both for themselves as individuals and also more widely for the NHS. Almost all participants made an instant decision at the point of initial invitation based more on trust and emotions than the information provided. Despite this, there was a clear desire for more time to decide whether to accept the scan or not. HCPs also raised concerns about the burden on the study team and wider healthcare system arising from additional workload both within the screening process and downstream following findings on the abdominal CT scan. CONCLUSIONS Adding a non-contrast abdominal CT scan to community-based CT screening for lung cancer is acceptable to both participants and healthcare professionals. Giving potential participants prior notice and having clear pathways for downstream management of findings will be important if it is to be offered more widely.
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Affiliation(s)
- Juliet A. Usher-Smith
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Golnessa Masson
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Angela Godoy
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Sarah W. Burge
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Jessica Kitt
- Department of Surgery, University of Cambridge, Cambridge, United Kingdom
| | - Fiona Farquhar
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Jon Cartledge
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Michael Kimuli
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Simon Burbidge
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Philip A. J. Crosbie
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Claire Eckert
- Leeds Institute of Health Science, University of Leeds, Leeds, United Kingdom
| | - Neil Hancock
- Leeds Institute of Health Science, University of Leeds, Leeds, United Kingdom
| | - Gareth R. Iball
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
| | | | - Sabrina H. Rossi
- Department of Surgery, University of Cambridge, Cambridge, United Kingdom
| | - Andrew Smith
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Irene Simmonds
- Leeds Institute of Health Science, University of Leeds, Leeds, United Kingdom
| | - Tom Wallace
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Matthew Ward
- Leeds Institute of Health Science, University of Leeds, Leeds, United Kingdom
| | - Matthew E. J. Callister
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
- Leeds Institute of Health Science, University of Leeds, Leeds, United Kingdom
| | - Grant D. Stewart
- Department of Surgery, University of Cambridge, Cambridge, United Kingdom
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3
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Rossi SH, Harrison H, Usher-Smith JA, Stewart GD. Risk-stratified screening for the early detection of kidney cancer. Surgeon 2024; 22:e69-e78. [PMID: 37993323 DOI: 10.1016/j.surge.2023.10.010] [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: 09/27/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023]
Abstract
Earlier detection and screening for kidney cancer has been identified as a key research priority, however the low prevalence of the disease in unselected populations limits the cost-effectiveness of screening. Risk-stratified screening for kidney cancer may improve early detection by targeting high-risk individuals whilst limiting harms in low-risk individuals, potentially increasing the cost-effectiveness of screening. A number of models have been identified which estimate kidney cancer risk based on both phenotypic and genetic data, and while several of the former have been shown to identify individuals at high-risk of developing kidney cancer with reasonable accuracy, current evidence does not support including a genetic component. Combined screening for lung cancer and kidney cancer has been proposed, as the two malignancies share some common risk factors. A modelling study estimated that using lung cancer risk models (currently used for risk-stratified lung cancer screening) could capture 25% of patients with kidney cancer, which is only slightly lower than using the best performing kidney cancer-specific risk models based on phenotypic data (27%-33%). Additionally, risk-stratified screening for kidney cancer has been shown to be acceptable to the public. The following review summarises existing evidence regarding risk-stratified screening for kidney cancer, highlighting the risks and benefits, as well as exploring the management of potential harms and further research needs.
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Affiliation(s)
- Sabrina H Rossi
- Department of Surgery, University of Cambridge, Cambridge, UK.
| | - Hannah Harrison
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Juliet A Usher-Smith
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge, UK
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Yohannan B, Sridhar A, Kaur H, DeGolovine A, Maithel N. Screening for renal cell carcinoma in renal transplant recipients: a single-centre retrospective study. BMJ Open 2023; 13:e071658. [PMID: 37699639 PMCID: PMC10503370 DOI: 10.1136/bmjopen-2023-071658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVES The primary objective of our study was to evaluate the effectiveness of renal cell carcinoma (RCC) screening in renal transplant (RT) recipients. DESIGN Single-centre retrospective study. SETTING AND PARTICIPANTS 1998 RT recipients who underwent RT at Memorial Hermann Hospital (MHH) Texas Medical Center (TMC) between 1 January 1999 and 31 December 2019 were included and we identified 16 patients (0.8%) with RCC. An additional four patients with RCC who underwent RT elsewhere but received follow-up at MHH TMC were also included. Subject races included white (20%), black (50%), Hispanic (20%) and Asian (10%). OUTCOME MEASURES The RCC stage at diagnosis and outcomes were compared between patients who were screening versus those who were not. RESULTS We identified a total of 20 patients with post-RT RCC, 75% of whom were men. The median age at diagnosis was 56 years. RCC histologies included clear cell (75%), papillary (20%) and chromophobe (5%). Patients with post-RT RCC who had screening (n=12) underwent ultrasound or CT annually or every 2 years, whereas eight patients had no screening. All 12 patients who had screening had early-stage disease at diagnosis (stage I (n=11) or stage II (n=1)) and were cured by nephrectomy (n=10) or cryotherapy (n=2). In patients who had no screening, three (37.5%) had stage IV RCC at diagnosis and all of whom died of metastatic disease. There was a statistically significant difference in RCC-specific survival in patients who were screened (p=0.01) compared with those who were not screened. CONCLUSION All RT recipients who had RCC diagnosed based on screening had early-stage disease and there were no RCC-related deaths. Screening is an effective intervention in RT recipients to reduce RCC-related mortality.
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Affiliation(s)
- Binoy Yohannan
- Department of Hematology and Oncology, The University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Arthi Sridhar
- Department of Hematology and Oncology, The University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Harmanpreet Kaur
- Department of Internal Medicine, UT Southwestern Medical School, Dallas, Texas, USA
| | - Aleksandra DeGolovine
- Department of Renal Disease and Hypertension, The University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Neha Maithel
- Department of Hematology and Oncology, The University of Texas Health Sciences Center at Houston, Houston, Texas, USA
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Colomer‐Lahiguera S, Steimer M, Ellis U, Eicher M, Tompson M, Corbière T, Haase KR. Patient and public involvement in cancer research: A scoping review. Cancer Med 2023; 12:15530-15543. [PMID: 37329180 PMCID: PMC10417078 DOI: 10.1002/cam4.6200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/21/2023] [Accepted: 05/23/2023] [Indexed: 06/18/2023] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) in research emphasizes the importance of doing research with, rather than for people with lived health/illness experience(s). The purpose of this scoping review is to investigate the breadth and depth of scientific literature on PPI in cancer research and to identify how is PPI applied and reported in cancer research. METHODS We searched MEDLINE, Embase, CINAHL, and PsycInfo up to March 2022. All titles/abstracts and full-text results were screened by two reviewers. Data were analyzed and are presented in both narrative and tabular format. RESULTS We screened 22,009 titles/abstract, reviewed 375 full-text articles, of which 101 studies were included in this review. 66 papers applied PPI; 35 used co-design methodologies. PPI in cancer research in published research has increased steadily since 2015 and often includes those with a past diagnosis of cancer or relatives/informal caregivers. The most common applied methods were workshops or interviews. PPI was generally used at the level of consultation/advisor and occurred mainly in early stages of research. Costs related to PPI were mentioned in 25 papers and four papers described training provided for PPI. CONCLUSIONS Results of our review demonstrate the nature and extent of PPI expansion in cancer research. Researchers and research organizations entering the fray of PPI should consider planning and reporting elements such as the stage, level, and role type of PPI, as well as methods and strategies put in place to assure diversity. Furthermore, a thorough evaluation of whether all these elements meet the stated PPI purpose will help to grasp its impact on research outcomes. PATIENT OR PUBLIC CONTRIBUTION Two patients participated in the stakeholder consultation as part of the scoping review methodology, contributed to the discussion on refining the results, and critically reviewed the manuscript. Both are co-authors of this manuscript.
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Affiliation(s)
- Sara Colomer‐Lahiguera
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
| | - Matthieu Steimer
- Master of Advanced Studies in Public Health studentInstitute of Global Health, Geneva UniversityGenevaSwitzerland
| | - Ursula Ellis
- Woodward LibraryUniversity of British ColumbiaVancouverCanada
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
| | | | - Tourane Corbière
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
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Usher-Smith JA, Godoy A, Burge SW, Burbidge S, Cartledge J, Crosbie PAJ, Eckert C, Farquhar F, Hammond D, Hancock N, Iball GR, Kimuli M, Masson G, Neal RD, Rogerson S, Rossi SH, Sala E, Smith A, Sharp SJ, Simmonds I, Wallace T, Ward M, Callister MEJ, Stewart GD. The Yorkshire Kidney Screening Trial (YKST): protocol for a feasibility study of adding non-contrast abdominal CT scanning to screen for kidney cancer and other abdominal pathology within a trial of community-based CT screening for lung cancer. BMJ Open 2022; 12:e063018. [PMID: 36127097 PMCID: PMC9490622 DOI: 10.1136/bmjopen-2022-063018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Kidney cancer (renal cell cancer (RCC)) is the seventh most common cancer in the UK. As RCC is largely curable if detected at an early stage and most patients have no symptoms, there is international interest in evaluating a screening programme for RCC. The Yorkshire Kidney Screening Trial (YKST) will assess the feasibility of adding non-contrast abdominal CT scanning to screen for RCC and other abdominal pathology within the Yorkshire Lung Screening Trial (YLST), a randomised trial of community-based CT screening for lung cancer. METHODS AND ANALYSIS In YLST, ever-smokers aged 55-80 years registered with a general practice in Leeds have been randomised to a Lung Health Check assessment, including a thoracic low-dose CT (LDCT) for those at high risk of lung cancer, or routine care. YLST participants randomised to the Lung Health Check arm who attend for the second round of screening at 2 years without a history of RCC or abdominal CT scan within the previous 6 months will be invited to take part in YKST. We anticipate inviting 4700 participants. Those who consent will have an abdominal CT immediately following their YLST thoracic LDCT. A subset of participants and the healthcare workers involved will be invited to take part in a qualitative interview. Primary objectives are to quantify the uptake of the abdominal CT, assess the acceptability of the combined screening approach and pilot the majority of procedures for a subsequent randomised controlled trial of RCC screening within lung cancer screening. ETHICS AND DISSEMINATION YKST was approved by the North West-Preston Research Ethics Committee (21/NW/0021), and the Health Research Authority on 3 February 2021. Trial results will be disseminated at clinical meetings, in peer-reviewed journals and to policy-makers. Findings will be made available to participants via the study website (www.YKST.org). TRIAL REGISTRATION NUMBERS NCT05005195 and ISRCTN18055040.
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Affiliation(s)
- Juliet A Usher-Smith
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Angela Godoy
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - Sarah W Burge
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Simon Burbidge
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK, Leeds, UK
| | - Jon Cartledge
- Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK, Leeds, UK
| | - Philip A J Crosbie
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Claire Eckert
- Leeds Institiute of Health Sciences, University of Leeds, Leeds, UK
| | - Fiona Farquhar
- Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - David Hammond
- Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Neil Hancock
- Leeds Diagnosis & Screening Unit, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Gareth R Iball
- Department of Medical Physics & Engineering, Leeds teaching hospitals NHS Trust, Leeds, UK
| | - Michael Kimuli
- Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK, Leeds, UK
| | - Golnessa Masson
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Pitcairn Practice, Balmullo Surgery, Fife, UK
| | - Richard D Neal
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Suzanne Rogerson
- Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Sabrina H Rossi
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Radiology, Catholic University Sacro Cuore and Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Andrew Smith
- Upper Gastro-intestinal and Pancreas Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Irene Simmonds
- Leeds Institiute of Health Sciences, University of Leeds, Leeds, UK
| | - Tom Wallace
- Leeds Vascular Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Matthew Ward
- Leeds Institiute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge, UK
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Ossin DA, Carter EC, Cartwright R, Violette PD, Iyer S, Klein GT, Senapati S, Klaassen Z, Botros SM. Shared decision-making in urology and female pelvic floor medicine and reconstructive surgery. Nat Rev Urol 2022; 19:161-170. [PMID: 34931058 DOI: 10.1038/s41585-021-00551-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/09/2022]
Abstract
Shared decision-making (SDM) is a hallmark of patient-centred care that uses informed consent to help guide patients with making complex health-care decisions. In SDM, patients and providers work together to determine the best course of action based on both the current available evidence and the patient's values and preferences. SDM not only provides a framework for the legal and ethical obligations providers need to fulfil for informed consent, but also leads to improved knowledge of treatment options and satisfaction of decision-making for patients. Tools such as decision aids have been developed to support SDM for complex decisions. Several decision aids are available for use in the field of urology and female pelvic medicine and reconstructive surgery, but these decision aids are also associated with barriers to SDM implementation including patient, provider and systematic challenges. However, solutions to such barriers to SDM include continued development of SDM tools to improve patient engagement, expand training of providers in SDM communication models and a process to encourage implementation of SDM.
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Affiliation(s)
- David A Ossin
- Division of Urogynecology, Department of Urology, University of Texas Health San Antonio, Joe R & Theresa Long School of Medicine, San Antonio, TX, USA.
| | - Emily C Carter
- Department of Obstetrics and Gynaecology, Stoke Mandeville Hospital, Aylesbury, UK
| | - Rufus Cartwright
- Department of Urogynaecology, LNWH NHS Trust, London, UK & Department of Epidemiology & Biostatistics, Imperial College London, London, UK
| | - Philippe D Violette
- Department of Health Research Methods, Evidence and Impact (HEI) and Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Shilpa Iyer
- Department of Obstetrics and Gynecology, Section of Female Pelvic Medicine and Reconstructive Surgery, The University of Chicago, Chicago, IL, USA
| | - Geraldine T Klein
- Department of Urology Eisenhower Medical Associates, Rancho Mirage, CA, USA
| | - Sangeeta Senapati
- Department of Obstetrics and Gynecology, Northshore University HealthSystem, Evanston, IL, USA
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Zachary Klaassen
- Division of Urology, Department of Surgery, Augusta University-Medical College of Georgia, Augusta, GA, USA
| | - Sylvia M Botros
- Division of Urogynecology, Department of Urology, University of Texas Health San Antonio, Joe R & Theresa Long School of Medicine, San Antonio, TX, USA
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Cuthbert C, Nixon N, Vickers M, Samimi S, Rawson K, Ramjeesingh R, Karim S, Stein B, Laxdal G, Dundas L, Huband D, Daze E, Farrer C, Cheung WY. Top 10 research priorities for early-stage colorectal cancer: a Canadian patient-oriented priority-setting partnership. CMAJ Open 2022; 10:E278-E287. [PMID: 35351780 PMCID: PMC9259415 DOI: 10.9778/cmajo.20210046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Colorectal cancer, one of the most commonly diagnosed cancers, is now being detected earlier and treatments are improving, which means that patients are living longer. Partnering with Canadian clinicians, patients and researchers, we aimed to determine research priorities for those living with early-stage colorectal cancer in Canada. METHODS We followed the well-established priority-setting partnership outlined by the James Lind Alliance to identify and prioritize unanswered questions about early-stage (i.e., stages I-III) colorectal cancer. The study was conducted from September 2018 to September 2020. We surveyed patients, caregivers and clinicians from across Canada between June 2019 and December 2019. We categorized the responses using thematic analysis to generate a list of unique questions. We conducted an interim prioritization survey from April 2020 to July 2020, with patients, caregivers and clinicians, to determine a shorter list of questions, which was then reviewed at a final meeting (involving patients, caregivers and clinicians) in September 2020. At that meeting, we used a consensus-based process to determine the top 10 priorities. RESULTS For the initial survey, 370 responses were submitted by 185 individuals; of the 98 individuals who provided demographic information, 44 (45%) were patients, 16 (16%) were caregivers, 7 (7%) were members of an advocacy group, 26 (27%) were health care professionals and 5 (5%) were categorized as "other." The responses were refined to create a list of 66 unique unanswered questions. Twenty-five respondents answered the interim prioritization survey: 13 patients (52%), 2 caregivers (8%), 3 advocacy group members (12%) and 7 health care professionals (28%). This led to a list of the top 30 questions. The final consensus meeting involved 20 individuals (10 patients [50%], 3 caregivers [15%] and 7 health care professionals [35%]), who agreed to the top 10 research priorities. The priorities covered a range of topics, including screening, treatment, recurrence, management of adverse effects and decision-making. INTERPRETATION We determined the top research priorities for early-stage colorectal cancer using a collaborative partnership of stake-holders from across Canada. The priorities covered a broad range of topics that could be addressed by future research, including improved screening practices, the role of personalized medicine, the management of adverse effects of treatment, decision-making and prevention of recurrence.
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Affiliation(s)
- Colleen Cuthbert
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Nancy Nixon
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Michael Vickers
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Setareh Samimi
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Krista Rawson
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Ravi Ramjeesingh
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Safiya Karim
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Barry Stein
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Garry Laxdal
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Lorilee Dundas
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Diane Huband
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Emily Daze
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Christie Farrer
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Winson Y Cheung
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
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9
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Yan A, Hooyer K, Asan O, Flower M, Whittle J. Engaging veteran stakeholders to identify patient-centred research priorities for optimizing implementation of lung cancer screening. Health Expect 2021; 25:408-418. [PMID: 34890474 PMCID: PMC8849265 DOI: 10.1111/hex.13401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patient engagement in research agenda setting is increasingly being seen as a strategy to improve the responsiveness of healthcare to patient priorities. Implementation of low-dose computed tomography (LDCT) screening for lung cancer is suboptimal, suggesting that research is needed. OBJECTIVES This study aimed to describe an approach by which a Veteran patient group worked with other stakeholders to develop a research agenda for LDCT screening and to describe the research questions that they prioritized. METHODS We worked with Veterans organizations to identify 12 Veterans or family members at risk for or having experience with lung cancer to form a Patient Advisory Council (PAC). The PAC met repeatedly from June 2018 to December 2020, both independently and jointly, with stakeholders representing clinicians, health administrators and researchers to identify relevant research topics. The PAC prioritized these topics and then identified questions within these areas where research was needed using an iterative process. Finally, they ranked the importance of obtaining answers to these questions. RESULTS PAC members valued the co-learning generated by interactions with stakeholders, but emphasized the importance of facilitation to avoid stakeholders dominating the discussion. The PAC prioritized three broad research areas-(1) the impact of insurance on uptake of LDCT; (2) how best to inform Veterans about LDCT; and (3) follow-up and impact of screening results. Using these areas as guides, PAC members identified 20 specific questions, ranking as most important (1) innovative outreach methods, (2) the impact of screening on psychological health, and (3) the impact of outsourcing scans from VA to non-VA providers on completion of recommended follow-up of screening results. The latter two were not identified as high priority by the stakeholder group. CONCLUSIONS We present an approach that facilitates co-learning between Veteran patients and providers, researchers and health system administrators to increase patient confidence in their ability to contribute important information to a research agenda. The research questions prioritized by the Veterans who participated in this project illustrate that for this new screening technology, patients are concerned about the practical details of implementation (e.g., follow-up) and the technology's impact on quality of life. PATIENT OR PUBLIC CONTRIBUTION Veterans and Veteran advocates contributed to our research team throughout the entire research process, including conceiving and co-authoring this manuscript.
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Affiliation(s)
- Alice Yan
- Center for Advancing Population Science, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Katinka Hooyer
- Department of Family and Community Medicine, Center for Healthy Communities and Research, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Onur Asan
- School of Systems & Enterprises, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Mark Flower
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jeff Whittle
- Department of Medicine, Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin, USA
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10
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NCF1/2/4 Are Prognostic Biomarkers Related to the Immune Infiltration of Kidney Renal Clear Cell Carcinoma. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5954036. [PMID: 34708124 PMCID: PMC8545530 DOI: 10.1155/2021/5954036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/24/2021] [Indexed: 01/11/2023]
Abstract
Neutrophil cytoplasmic factor 1/2/4 (NCF1/2/4) belongs to the NADPH oxidase complex, which is a cytoplasmic component, and its polymorphism is the main factor related to autoimmune diseases, which is probably caused by the regulation of peroxide. They also play a role in tumor growth and metastasis. This research is aimed at evaluating the biological function and prognostic role of NCF1, NCF2, and NCF4 genes in kidney renal clear cell carcinoma (KIRC) by using multiple online bioinformatics website, including Oncomine, GEPIA, UALCAN, Kaplan-Meier Plotter, TIMER, TISIDB, cBioPortal, LinkedOmics, GeneMANIA, and DAVID databases. The mRNA levels of NCFs were higher in KIRC tissues than in normal tissues. The overexpression of NCFs was significantly correlated with advanced pathological grades and individual cancer stages in KIRC. Meanwhile, the expressions of NCFs played an important role in the tumorigenesis and progression of KIRC. Prognostic value analysis suggested that high transcription levels of NCF1/4 were associated with poor overall survival in KIRC patients. In addition, results from the LinkedOmics database showed that the KEGG pathway related to NCFs mainly focused on immune activation and immune regulation function. NCF genetic alterations, including copy number amplification, missense mutation, and deep deletion, could be found through the cBioPortal database. Further, NCF expression was significantly correlated with infiltration levels of various immune cells as well as immune signatures. Protein-protein interaction network and enrichment analysis of NCF1/2/4 in KIRC showed that NCF coexpressed genes mainly associated with diverse immune marker sets showed significance. Overall, these results indicated that NCFs could be prognostic biomarkers as well as effective targets for diagnosis in KIRC.
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Bhandari NR, Kamel MH, Kent EE, McAdam-Marx C, Ounpraseuth ST, Tilford JM, Payakachat N. Association of Health-Related Quality of Life with Overall Survival in Older Americans with Kidney Cancer: A Population-Based Cohort Study. Healthcare (Basel) 2021; 9:healthcare9101344. [PMID: 34683025 PMCID: PMC8544450 DOI: 10.3390/healthcare9101344] [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: 09/06/2021] [Revised: 10/01/2021] [Accepted: 10/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Our purpose was to evaluate associations between health-related quality of life (HRQoL) and overall survival (OS) in a population-based sample of kidney cancer (KC) patients in the US. Methods: We analyzed a longitudinal cohort (n = 188) using the Surveillance, Epidemiology, and End Results (SEER) database linked with the Medicare Health Outcomes Survey (MHOS; 1998–2014). We included KC patients aged ≥65 years, with a completed MHOS during baseline (pre-diagnosis) and another during follow-up (post-diagnosis). We reported HRQoL as physical component summary (PCS) and mental component summary (MCS) scores and OS as number of months from diagnosis to death/end-of-follow-up. Findings were reported as adjusted hazard ratios (aHRs (95% CI)) from Cox Proportional Hazard models. Results: The aHRs associated with a 3-point lower average (baseline and follow-up) or a 3-point within-patient decline (change) in HRQoL with OS were: (a) baseline: PCS (1.08 (1.01–1.16)) and MCS (1.09 (1.01–1.18)); (b) follow-up: PCS (1.21 (1.12–1.31)) and MCS (1.11 (1.04–1.19)); and (c) change: PCS (1.10 (1.02–1.18)) and MCS (1.02 (0.95–1.10)). Conclusions: Reduced HRQoL was associated with worse OS and this association was strongest for post-diagnosis PCS, followed by change in PCS and pre-diagnosis PCS. Findings highlight the prognostic value of HRQoL on OS, emphasize the importance of monitoring PCS in evaluating KC prognosis, and contribute additional evidence to support the implementation of patient-reported outcomes in clinical settings.
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Affiliation(s)
- Naleen Raj Bhandari
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72205, USA;
| | - Mohamed H. Kamel
- Department of Urology, University of Cincinnati, Cincinnati, OH 45221, USA;
- Department of Urology, Ain Shams University, Cairo 11566, Egypt
| | - Erin E. Kent
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27514, USA
| | - Carrie McAdam-Marx
- Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Songthip T. Ounpraseuth
- Department of Biostatistics, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72205, USA;
| | - J. Mick Tilford
- Department of Health Policy and Management, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72205, USA;
| | - Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72205, USA;
- Correspondence:
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12
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CUAJ E. Non-prostate Genitourinary Cancers, Tuesday, June 29, 2021. Can Urol Assoc J 2021; 15:S58-S62. [PMID: 34162470 DOI: 10.5489/cuaj.7398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Usher‐Smith JA, Harvey‐Kelly LLW, Rossi SH, Harrison H, Griffin SJ, Stewart GD. Acceptability and potential impact on uptake of using different risk stratification approaches to determine eligibility for screening: A population-based survey. Health Expect 2021; 24:341-351. [PMID: 33264472 PMCID: PMC8077132 DOI: 10.1111/hex.13175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/15/2020] [Accepted: 11/15/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Using risk stratification approaches to determine eligibility has the potential to improve efficiency of screening. OBJECTIVES To compare the public acceptability and potential impact on uptake of using different approaches to determine eligibility for screening. DESIGN An online population-based survey of 668 adults in the UK aged 45-79 including a series of scenarios in the context of a potential kidney cancer screening programme in which eligibility was determined by age, sex, age and sex combined, a simple risk score (age, sex, body mass index, smoking status), a complex risk score additionally incorporating family history and lifestyle, or a genetic risk score. OUTCOME MEASURES We used multi-level ordinal logistic regression to compare acceptability and potential uptake within individuals and multivariable ordinal logistic regression differences between individuals. RESULTS Using sex, age and sex, or the simple risk score were less acceptable than age (P < .0001). All approaches were less acceptable to women than men. Over 70% were comfortable waiting until they were older if the complex risk score or genetics indicated a low risk. If told they were high risk, 85% would be more likely to take up screening. Being told they were low risk had no overall influence on uptake. CONCLUSIONS Varying the starting age of screening based on estimated risk from models incorporating phenotypic or genetic risk factors would be acceptable to most individuals and may increase uptake. PATIENT OR PUBLIC CONTRIBUTION Two members of the public contributed to the development of the survey and have commented on this paper.
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Affiliation(s)
- Juliet A. Usher‐Smith
- The Primary Care UnitDepartment of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | | | - Sabrina H. Rossi
- Department of OncologyUniversity of Cambridge, Addenbrooke’s Hospital, Cambridge Biomedical CampusCambridgeUK
| | - Hannah Harrison
- The Primary Care UnitDepartment of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Simon J. Griffin
- The Primary Care UnitDepartment of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Grant D. Stewart
- Department of SurgeryUniversity of Cambridge, Addenbrooke’s Hospital, Cambridge Biomedical CampusCambridgeUK
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14
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Rossi SH, Klatte T, Usher-Smith JA, Fife K, Welsh SJ, Dabestani S, Bex A, Nicol D, Nathan P, Stewart GD, Wilson ECF. A Decision Analysis Evaluating Screening for Kidney Cancer Using Focused Renal Ultrasound. Eur Urol Focus 2021; 7:407-419. [PMID: 31530498 DOI: 10.1016/j.euf.2019.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/19/2019] [Accepted: 09/03/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Screening for renal cell carcinoma (RCC) has been identified as a key research priority; however, no randomised control trials have been performed. Value of information analysis can determine whether further research on this topic is of value. OBJECTIVE To determine (1) whether current evidence suggests that screening is potentially cost-effective and, if so, (2) in which age/sex groups, (3) identify evidence gaps, and (4) estimate the value of further research to close those gaps. DESIGN, SETTING, AND PARTICIPANTS A decision model was developed evaluating screening in asymptomatic individuals in the UK. A National Health Service perspective was adopted. INTERVENTION A single focused renal ultrasound scan compared with standard of care (no screening). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Expected lifetime costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER), discounted at 3.5% per annum. RESULTS AND LIMITATIONS Given a prevalence of RCC of 0.34% (0.18-0.54%), screening 60-yr-old men resulted in an ICER of £18 092/QALY (€22 843/QALY). Given a prevalence of RCC of 0.16% (0.08-0.25%), screening 60-yr-old women resulted in an ICER of £37327/QALY (€47 129/QALY). In the one-way sensitivity analysis, the ICER was <£30000/QALY as long as the prevalence of RCC was ≥0.25% for men and ≥0.2% for women at age 60yr. Given the willingness to pay a threshold of £30000/QALY (€37 878/QALY), the population-expected values of perfect information were £194 million (€244 million) and £97 million (€123 million) for 60-yr-old men and women, respectively. The expected value of perfect parameter information suggests that the prevalence of RCC and stage shift associated with screening are key research priorities. CONCLUSIONS Current evidence suggests that one-off screening of 60-yr-old men is potentially cost-effective and that further research into this topic would be of value to society. PATIENT SUMMARY Economic modelling suggests that screening 60-yr-old men for kidney cancer using ultrasound may be a good use of resources and that further research on this topic should be performed.
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Affiliation(s)
- Sabrina H Rossi
- Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK
| | - Tobias Klatte
- Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK; Department of Urology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Juliet A Usher-Smith
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kate Fife
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK
| | - Sarah J Welsh
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Saeed Dabestani
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Lund, Sweden
| | - Axel Bex
- The Royal Free London NHS Foundation Trust, Specialist Centre for Kidney Cancer, UK; Netherlands Cancer Institute, Division of Surgical Oncology, Department of Urology, Amsterdam, The Netherlands
| | - David Nicol
- Department of Urology, Royal Marsden Hospital, London, UK; Institute of Cancer Research, London, UK
| | - Paul Nathan
- Department of Oncology, Mount Vernon Cancer Centre, Northwood, UK
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
| | - Edward C F Wilson
- Cambridge Centre for Health Services Research, University of Cambridge Institute of Public Health, Forvie Site, Robinson Way, Cambridge, UK; Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK.
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15
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Usher-Smith J, Simmons RK, Rossi SH, Stewart GD. Current evidence on screening for renal cancer. Nat Rev Urol 2020; 17:637-642. [PMID: 32860009 PMCID: PMC7610655 DOI: 10.1038/s41585-020-0363-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2020] [Indexed: 02/07/2023]
Abstract
Renal cell carcinoma (RCC) incidence is increasing worldwide. A high proportion of individuals are asymptomatic at diagnosis, but RCC has a high mortality rate. These facts suggest that RCC meets some of the criteria for screening, and a new analysis shows that screening for RCC could potentially be cost-effective. Targeted screening of high-risk individuals is likely to be the most cost-effective strategy to maximize the benefits and reduce the harms of screening. However, the size of the benefit of earlier initiation of treatment and the overall cost-effectiveness of screening remains uncertain. The optimal screening modality and target population is also unclear, and uncertainties exist regarding the specification and implementation of a screening programme. Before moving to a fully powered trial of screening, future work should focus on the following: developing and validating accurate risk prediction models; developing non-invasive methods of early RCC detection; establishing the feasibility, public acceptability and potential uptake of screening; establishing the prevalence of RCC and stage distribution of RCC detected by screening; and evaluating the potential harms of screening, including the impact on quality of life, overdiagnosis and over-treatment.
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Affiliation(s)
- Juliet Usher-Smith
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Rebecca K Simmons
- Department of Public Health, Bartolins Allé 2, University of Aarhus, Aarhus C, Denmark
| | - Sabrina H Rossi
- Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
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16
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Ludwig C, Graham ID, Gifford W, Lavoie J, Stacey D. Partnering with frail or seriously ill patients in research: a systematic review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:52. [PMID: 32944284 PMCID: PMC7488581 DOI: 10.1186/s40900-020-00225-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/27/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND The expectation to include patients as partners in research has steadily gained momentum. The vulnerability of frail and/or seriously ill patients provides additional complexity and may deter researchers from welcoming individuals from this patient population onto their teams. The aim was to synthesize the evidence on the engagement of frail and/or seriously ill patients as research partners across the research cycle. METHODS A systematic review was conducted using PRISMA guidelines. A search strategy included MEDLINE®, EMBASE®, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO from database inception to April, 2019. Eligible studies were peer-reviewed qualitative, quantitative, and mixed methods research reporting on the engagement of frail and/or seriously ill patients as partners on research teams. The Mixed Methods Appraisal Tool was used to appraise study quality. Narrative analysis was conducted. RESULTS Of 8763 citations, 30 were included. Most studies included individuals with cancer on the research team (60%). Barriers included: lack of time and resources (50%), discontinuity in contribution (37%), and concerns for well-being (33%). Facilitators included: trust and mutual respect (60%), structural accessibility (57%), flexibility in timing and methods of engagement (43%), and attention to care and comfort, (33%). Perceived impacts for patients included: renewed personal sense of agency (37%) and emotional/peer support (37%). Impacts for researchers included sensitization to the lived experience of disease (57%) and an increased appreciation of the benefits of patient engagement (23%). Research design, execution, and outcomes, developed with patients, were deemed more suitable, relevant and reflective of patients' priorities. CONCLUSIONS There is emerging evidence to suggest that research partnerships with frail and/or seriously ill patients can be achieved successfully. Patients mostly report benefit from partnering with research teams. Frailty and/or serious illness do present legitimate concerns for their well-being but appear to be successfully mitigated when researchers ensure that the purpose of engagement is well-defined, the timing and methods of engagement are flexible, and the practical and emotional needs of patient partners are addressed throughout the process. SYSTEMATIC REVIEW REGISTRATION The systematic review protocol was registered with the International Prospective Register of Systematic Reviews PROSPERO (CRD42019127994).
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Affiliation(s)
- Claire Ludwig
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Ian D. Graham
- University of Ottawa, Faculty of Medicine, School of Epidemiology and Public Health, Ottawa, Ontario, Canada and Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
| | - Wendy Gifford
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Josee Lavoie
- Geriatric Psychiatry Program, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4 Canada
| | - Dawn Stacey
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
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17
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Bhandari NR, Ounpraseuth ST, Kamel MH, Kent EE, McAdam-Marx C, Tilford JM, Payakachat N. Changes in health-related quality of life outcomes in older patients with kidney cancer: A longitudinal cohort analysis with matched controls. Urol Oncol 2020; 38:852.e11-852.e20. [PMID: 32863123 DOI: 10.1016/j.urolonc.2020.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/21/2020] [Accepted: 08/05/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Current evidence regarding health-related quality of life (HRQoL) changes among patients with kidney cancer (KC) is limited. We characterized HRQoL changes from before (baseline) to after (follow-up) diagnosis of KC in older Americans relative to matched controls, and identified sociodemographic and clinical factors associated with HRQoL changes in older patients with KC. MATERIALS AND METHODS This longitudinal, population-based, retrospective cohort study used data from Surveillance, Epidemiology and End Results linked with Medicare Health Outcomes Survey, 1998-2013. Participants aged ≥65 years with baseline and follow-up survey data were identified. Those with primary KC (n = 186) were matched to adults without cancer (n = 558). HRQoL (physical component summary and mental component summary [MCS]) changes in KC patients were compared using generalized linear mixed-effects models to those of controls. Regression models were used to identify baseline factors associated with HRQoL changes. RESULTS The adjusted least squares mean (95% confidence interval) reduction in physical component summary from baseline to follow-up was greater in KC patients vs. controls (-4.1 [-5.6, -2.7] vs. -2.3 [-3.1, -1.4], P = 0.025). While the reduction in MCS was similar in both groups (-2.4 [-3.9, -0.8] vs. -1.5 [-2.4, -0.6], P = 0.338). Lower income and distant stage KC predicted greater declines in MCS among KC patients. CONCLUSION KC significantly affects overall general health in older patients, with sociodemographic factors and distant KC predicting greater reductions in HRQoL. Findings may help clinicians set patient expectations about their HRQoL post-diagnosis and increase clinician awareness of risk factors for HRQoL deterioration.
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Affiliation(s)
- Naleen Raj Bhandari
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR
| | | | - Mohamed H Kamel
- Department of Urology, UAMS, Little Rock, AR; Department of Urology, Ain Shams University, Cairo, Egypt
| | - Erin E Kent
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carrie McAdam-Marx
- Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE
| | - J Mick Tilford
- Department of Health Policy and Management, UAMS, Little Rock, AR
| | - Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR.
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18
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Lorenzon AR, Garcia D, Silva L, Oliveira CAD, Chehin MB, Marinho RM, Caetano JPJ, Vassena R, Motta ELAD. Research priorities in infertility and assisted reproductive technology treatments - a James Lind Alliance priority setting partnership with brazilian patients. JBRA Assist Reprod 2020; 24:265-272. [PMID: 32157860 PMCID: PMC7365546 DOI: 10.5935/1518-0557.20190077] [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] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To identify the main research interests of Brazilian patients in the field of infertility and assisted reproductive technology (ART) treatments. METHODS This prospective multicenter cross-sectional study was carried out in Brazil. Patients attending five fertility centers from the Huntington Group between October and December 2018 were invited to join the study, which consisted of answering an anonymous survey online. Two hundred and twenty-seven patients signed the informed consent form and were emailed the survey link. The survey was designed based on the James Lind Alliance Priority Setting Partnership protocol. In the area of infertility, patients were probed on issues such as somatic and psychological effects of treatment, prevention, assisted reproductive technology (medications and procedures), success rates, risks, and emotional aspects. RESULTS The response rate (RR) was 47.58% (108 patients; 88 women - RR 51.46% and 20 men - RR 35.71%). Patient mean age was 36.5 years (SD 4.6). The top ten research priorities listed were 1) short- and long-term side effects of treatment; 2) how to cope with infertility; 3) risks associated with ART; 4) success rates in ART; 5) impact of diet on ART and fertility; 6) healthy habits; 7) alternative therapies; 8) impact of exercise on fertility and ART success; 9) oocyte quality and ovarian reserve; and 10) genetic or inherited causes of infertility. CONCLUSION To better cater to the needs of patients and develop patient-centered care in the field of infertility and ART treatment, clinicians, healthcare providers, and the scientific community must identify patient concerns and priorities and make efforts to address them.
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Affiliation(s)
| | | | - Leticia Silva
- Huntington Medicina Reprodutiva, São Paulo, SP, Brazil
| | | | | | | | | | | | - Eduardo Leme Alves da Motta
- Huntington Medicina Reprodutiva, São Paulo, SP, Brazil.,Departamento de Ginecologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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19
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Levelink M, Voigt-Barbarowicz M, Brütt AL. Priorities of patients, caregivers and health-care professionals for health research - A systematic review. Health Expect 2020; 23:992-1006. [PMID: 32643854 PMCID: PMC7696132 DOI: 10.1111/hex.13090] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/30/2020] [Accepted: 05/03/2020] [Indexed: 12/21/2022] Open
Abstract
Background Based on subjective experience, patients can identify research priorities important for health services research. A systematic method for priority setting has been developed by the James Lind Alliance. Objective This article reviews the literature on the research priorities of patients, caregivers and health‐care professionals and presents the prioritized research themes and prioritization methods used. Search strategy Three electronic databases were searched on 22 May 2018. The search was not limited to any time period or language. Inclusion criteria The included studies reported the identification and prioritization of research priorities involving patients, relatives and caregivers. Each included paper addressed a specific ICD‐coded health problem, and at least one‐third of the sample involved in the prioritization process was affected by the health problem. Data extraction and synthesis The 10 top‐ranked research priorities were included in the thematic analysis. With an inductive approach, a system of identified themes and subthemes was developed from the research priorities. Each research priority was assigned to one research theme. Main results The priority lists of 34 publications involving 331 research priorities were included. Nine main themes represent the content of the research priorities. The most frequently represented main themes are ‘Treatment’, ‘Patients’ and ‘Health condition’. The distribution of the research priorities varied depending on the health conditions and prioritization methods. Discussion and conclusions This review provides a comprehensive overview of the overarching research themes in research priorities of affected individuals. The results can guide future patient‐oriented research.
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Affiliation(s)
- Michael Levelink
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Mona Voigt-Barbarowicz
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Anna Levke Brütt
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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20
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McAlpine K, Breau RH, Stacey D, Knee C, Jewett MAS, Violette PD, Richard PO, Cagiannos I, Morash C, Lavallée LT. Shared decision-making for the management of small renal masses: Development and acceptability testing of a novel patient decision aid. Can Urol Assoc J 2020; 14:385-391. [PMID: 32574143 DOI: 10.5489/cuaj.6575] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Shared decision-making incorporates patients' values and preferences to achieve high-quality decisions. The objective of this study was to develop an acceptable patient decision aid to facilitate shared decision-making for the management of small renal masses (SRMs). METHODS The International Patient Decision Aids Standards were used to guide an evidence-based development process. Management options included active surveillance, thermal ablation, partial nephrectomy, and radical nephrectomy. A literature review was performed to provide incidence rates for outcomes of each option. Once a prototype was complete, alpha-testing was performed using a 10-question survey to assess acceptability with patients, patient advocates, urologists, and methodological experts. The primary outcome was acceptability of the decision aid. RESULTS A novel patient decision aid was created to facilitate shared decision-making for the management of SRMs. Acceptability testing was performed with 20 patients, 10 urologists, two patient advocates, and one methodological expert. Responders indicated the decision aid was appropriate in length (82%, 27/33), well-balanced (82%, 27/33), and had language that was easy to follow (94%, 31/33). All patient responders felt the decision aid would have been helpful during their consultation and would recommend the decision aid for future patients (100%, 20/20). Most urologists reported they intend to use the decision aid (90%, 9/10). CONCLUSIONS A novel patient decision aid was created to facilitate shared decision-making for management of SRMs. This clinical tool was acceptable with patients, patient advocates, and urologists and is freely available at: https://decisionaid.ohri.ca/decaids.html.
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Affiliation(s)
| | - Rodney H Breau
- Division of Urology, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Dawn Stacey
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.,School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Christopher Knee
- Division of Urology, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Michael A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON, Canada
| | - Philippe D Violette
- Departments of Health Research Methods Evidence and Impact and Surgery, McMaster University, Hamilton, ON, Canada
| | - Patrick O Richard
- Division of Urology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Ilias Cagiannos
- Division of Urology, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Christopher Morash
- Division of Urology, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Luke T Lavallée
- Division of Urology, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
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21
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Mowforth OD, Davies BM, Goh S, O’Neill CP, Kotter MRN. Research Inefficiency in Degenerative Cervical Myelopathy: Findings of a Systematic Review on Research Activity Over the Past 20 Years. Global Spine J 2020; 10:476-485. [PMID: 32435569 PMCID: PMC7222686 DOI: 10.1177/2192568219847439] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
STUDY DESIGN Scoping review. OBJECTIVE To describe activity, themes and trends in degenerative cervical myelopathy (DCM) research over the past 20 years with a view to considering DCM research inefficiency. METHODS A systematic review of MEDLINE and Embase for "Cervical" AND "Myelopathy" was conducted following PRISMA guidelines. Full-text papers in English, exclusively studying DCM, published between January 1, 1995 and December 31, 2015 were considered eligible. Country of origin, number of papers published, number of patients studied, research theme, and year of publication were assessed. Comparison was made between developed and developing countries. RESULTS A total of 1485 papers and 4 117 051 patients were included. Japan published more papers (450) than any other country while the United States studied the greatest number of patients (3 674 737). Over 99.4% of papers and 78.6% of patients were from developed countries. The number of papers (r = 0.96, P < .001) and patients (r = 0.83 P < .001) studied each year increased significantly overall and for both developed (r = 0.93, P < .001; r = 0.81, P < .001) and developing countries (r = 0.90, P < .001; r = 0.87, P < .001). Surgery was the most prevalent theme (58.3% papers; 55.7% patients) for developed and developing countries. Research from developing countries showed greater thematic variability. CONCLUSIONS DCM research activity is increasing internationally, with surgery remaining the focus. Research output has predominantly been from developed countries; however, the rate of growth for developed and developing countries is comparable.
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Affiliation(s)
- Oliver D. Mowforth
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
- Joint first authors
| | - Benjamin M. Davies
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
- Joint first authors
| | - Samuel Goh
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - Cormac P. O’Neill
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - Mark R. N. Kotter
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
- Wellcome Trust and MRC Cambridge Stem Cell Institute, Anne McLaren Laboratory, University of Cambridge, United Kingdom
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22
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Obeid N, McVey G, Seale E, Preskow W, Norris ML. Cocreating research priorities for anorexia nervosa: The Canadian Eating Disorder Priority Setting Partnership. Int J Eat Disord 2020; 53:392-402. [PMID: 32011022 DOI: 10.1002/eat.23234] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The Canadian Eating Disorder Priority Setting Partnership was established to identify and prioritize the top 10 research priorities for females, 15 years or older, with anorexia nervosa, by incorporating equal input from those with lived experience, families, and healthcare professionals. METHOD This project, which closely followed the James Lind Alliance guidelines, solicited research priorities from the Canadian eating disorder community by means of a five-step process including use of a survey, response collation, literature checking, interim ranking survey, and in-person prioritization workshop. RESULTS The initial survey elicited 897 priorities from 147 individuals, with almost equal representation from all three stakeholder groups. From this, 603 responses aligned with the project objectives and were collapsed into 71 broader indicative questions. Based on available systematic reviews, 18 indicative questions were removed as they were considered answered by existing literature while 8 indicative questions were added from the recommendations of the reviews. In total, 61 indicative questions were ranked in an interim ranking survey, where 21 questions were prioritized as important by at least 20% of respondents. As a final step, 28 individuals from across Canada attended the prioritization workshop to coestablish the top 10 research priorities. DISCUSSION Top priorities were related to treatment gaps and the need for more surveillance data. This systematic methodology allowed for a transparent and collaborative approach to identifying current priorities from both the service user and provider perspective. Wide dissemination is anticipated to promote work that is of high relevance to patients, families, and clinicians.
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Affiliation(s)
- Nicole Obeid
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Gail McVey
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Emily Seale
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Wendy Preskow
- National Initiative for Eating Disorders, Toronto, Ontario, Canada
| | - Mark L Norris
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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23
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Kassouf W, Aprikian A, Saad F, Fleshner N, Alimohamed N, Breau RH, Brimo F, Chin J, Chung P, Cornacchia T, Devins F, Eapen L, Eigl B, Fairey A, Guttman D, Izard JP, Jacobsen N, Jeldres C, Kulkarni G, Lalani AK, Lodde M, Lukka H, Moore R, Morash C, North S, Northam T, Ong M, Power N, Rendon R, Purves R, Shayegan B, Smith R, So A, Sridhar SS, Zlotta A, Siemens DR, Black PC. Continuing towards optimization of bladder cancer care in Canada: Summary of the third Bladder Cancer Canada-Canadian Urological Association-Canadian Urologic Oncology Group (BCC-CUA-CUOG) bladder cancer quality of care consensus meeting. Can Urol Assoc J 2020; 14:E115-E125. [PMID: 32453694 DOI: 10.5489/cuaj.6378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Wassim Kassouf
- Departments of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Armen Aprikian
- Departments of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Fred Saad
- Division of Urology, Université de Montréal, Montreal, QC, Canada
| | - Neil Fleshner
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada
| | - Nimira Alimohamed
- Division of Medical Oncology, University of Calgary, Calgary, AB, Canada
| | - Rodney H Breau
- Divisions of Urology, University of Ottawa, Ottawa, ON, Canada
| | - Fadi Brimo
- Department of Pathology, McGill University Health Centre, Montreal, QC, Canada
| | - Joe Chin
- Division of Urology, Western University, London, ON, Canada
| | - Peter Chung
- Department of Radiation Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Ferg Devins
- Patient representative, Bladder Cancer Canada
| | - Libni Eapen
- Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada
| | | | - Adrian Fairey
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | | | - Jason P Izard
- Departments of Urology and Oncology, Queen's University, Kingston, ON, Canada
| | - Niels Jacobsen
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | - Claudio Jeldres
- Division of Urology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Girish Kulkarni
- Department of Surgical Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada
| | - Aly-Khan Lalani
- Division of Medical Oncology, McMaster University, Hamilton, ON, Canada
| | - Michele Lodde
- Department of Urology, Université Laval, Quebec City, QC, Canada
| | - Himu Lukka
- Division of Medical Oncology, McMaster University, Hamilton, ON, Canada
| | - Ron Moore
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | - Chris Morash
- Divisions of Urology, University of Ottawa, Ottawa, ON, Canada
| | - Scott North
- Division of Medical Oncology, University of Alberta, Edmonton, AB, Canada
| | | | - Michael Ong
- Division of Medical Oncology, University of Ottawa, Ottawa, ON, Canada
| | - Nick Power
- Division of Urology, Western University, London, ON, Canada
| | - Ricardo Rendon
- Division of Urology, Dalhousie University, Halifax, NS, Canada
| | | | - Bobby Shayegan
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Randy Smith
- Patient representative, Bladder Cancer Canada
| | - Alan So
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Srikala S Sridhar
- Department of Medical Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada
| | - Alex Zlotta
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada
| | - D Robert Siemens
- Departments of Urology and Oncology, Queen's University, Kingston, ON, Canada
| | - Peter C Black
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
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Priorities for Cancer Research From the Viewpoints of Cancer Nurses and Cancer Patients: A Mixed-Method Systematic Review. Cancer Nurs 2020; 43:238-256. [PMID: 31895171 DOI: 10.1097/ncc.0000000000000776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Setting priorities in oncology is a useful way to produce a robust set of research questions that researchers can address. OBJECTIVE The aim of this review was to describe cancer nurses and patients' main research priorities and describe their development over time. METHODS A mixed-method systematic review was conducted for the period from 2000 to 2018 through a search of multiple databases. The methodological quality of the studies included was assessed using the Mixed-Methods Appraisal Tool, and the process of setting the health research priorities was assessed using Viergever's tool. Each study's top research priorities were extracted and summarized in categories. RESULTS Fifteen studies were included: 13 addressed nurses' research priorities, and 2 focused on those of patients. The majority were Delphi and quantitative studies that were conducted in the United States and United Kingdom. The quality criteria score and the quality of the process were considered sufficiently good. The most important research priorities were categorized as disease control and management, patient-related issues, and professional dimensions and issues. Management of symptoms and pain, education, information, and communication were research priorities always present in the articles during the study period. CONCLUSION Priorities change over time and depend on several factors; however, some have remained consistent for the last 18 years. Although there is increasing emphasis on including patients in establishing research priorities that inform cancer care, this involvement is still lacking. IMPLICATIONS FOR PRACTICE Future studies should describe the primary cancer research priorities of nurses in collaboration with patients.
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25
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Staley K, Crowe S, Crocker JC, Madden M, Greenhalgh T. What happens after James Lind Alliance Priority Setting Partnerships? A qualitative study of contexts, processes and impacts. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:41. [PMID: 32670611 PMCID: PMC7353437 DOI: 10.1186/s40900-020-00210-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/04/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND The James Lind Alliance (JLA) supports priority setting partnerships (PSPs) in which patients, carers and health professionals collaborate to identify a Top 10 list of research priorities. Few studies have examined how partnerships plan for the post-prioritisation phase, or how context and post-PSP processes influence the fortunes of priorities. This evaluation aimed to explore these questions. METHODS We selected a diverse sample of 20 interviewees who had knowledge of 25 PSPs. Thirteen interviewees had led a PSP, either from a university, patient organisation or charity. Three were patients who had taken part in a PSP workshop. Four others, three researchers and one funder, had worked with JLA PSP priorities to develop research proposals. We analysed the data thematically, exploring how success was understood and achieved. RESULTS The JLA PSPs had different histories, funding sources, goals and stakeholders. Whilst their focus was on generating priority research topics, PSPs' wider impacts included enhanced status and greater confidence for individuals, as well as relationship-building and network strengthening for the organisations involved. To follow through on a Top 10, additional work was needed to refine broad priority topics into research questions and match them with appropriate funding sources. Commitment to post-PSP action from partners appeared to increase the chance that priority topics would be followed through to funded studies. Academic publications could alert researchers to a PSP's outputs, but not all PSPs had the capacity to produce them. A Top 10 list potentially influences funding decisions through direct funding, themed calls or as a prompt in open calls. Influence on funders appears to depend on alignment between a priority and the funder's remit, culture and values. CONCLUSION The history and context of a JLA PSP have a major influence on its impact. Our findings suggest that there is no universal formula for success, but that greater resource and attention should be given to what happens after prioritisation. Further research is needed on what works best in what circumstances. Overall, we conclude that a wider cultural change in the research world is needed for JLA PSPs to achieve their goal of shaping the research agenda.
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Affiliation(s)
| | | | - Joanna C. Crocker
- Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG UK
| | - Mary Madden
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - Trisha Greenhalgh
- Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG UK
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26
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McAlpine K, Lewis KB, Trevena LJ, Stacey D. What Is the Effectiveness of Patient Decision Aids for Cancer-Related Decisions? A Systematic Review Subanalysis. JCO Clin Cancer Inform 2019; 2:1-13. [PMID: 30652610 DOI: 10.1200/cci.17.00148] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To determine the effectiveness of patient decision aids when used with patients who face cancer-related decisions. PATIENTS AND METHODS Two reviewers independently screened the 105 trials in the original 2017 Cochrane review to identify eligible trials of patient decision aids across the cancer continuum. Primary outcomes were attributes of the choice and decision-making process. Secondary outcomes were patient behavior and health system effects. A meta-analysis was conducted for similar outcome measures. RESULTS Forty-six trials evaluated patient decision aids for cancer care, including 27 on screening decisions (59%), 12 on treatments (26%), four on genetic testing (9%), and three on prevention (6%). Common decisions were aboutprostate cancer screening (30%), colorectal cancer screening (22%), breast cancer treatment (13%), and prostate cancer treatment (9%). Compared with the control groups (usual care or alternative interventions), the patient decision aid group improved the match between the chosen option and the features that mattered most to the patient as demonstrated by improved knowledge (weighted mean difference, 12.88 of 100; 95% CI, 9.87 to 15.89; 24 trials), accurate risk perception (risk ratio [RR], 1.77; 95% CI, 1.22 to 2.56; six trials), and value-choice agreement (RR, 2.76; 95% CI, 1.57 to 4.84; nine trials). Compared with controls, the patient decision aid group improved the decision-making process with decreased decisional conflict (weighted mean difference, -9.56 of 100; 95% CI, -13.90 to -5.23; 12 trials), reduced clinician-controlled decision making (RR, 0.57; 95% CI, 0.41 to 0.79; eight trials), and fewer patients being indecisive (RR, 0.59; 95% CI, 0.45 to 0.78; nine trials). CONCLUSION Patient decision aids improve the attributes of the choice made and decision-making process for patients who face cancer-related decisions.
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Affiliation(s)
- Kristen McAlpine
- Kristen McAlpine, Krystina B. Lewis, and Dawn Stacey, University of Ottawa; Dawn Stacey, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; and Lyndal J. Trevena, University of Sydney, Sydney, New South Wales, Australia
| | - Krystina B Lewis
- Kristen McAlpine, Krystina B. Lewis, and Dawn Stacey, University of Ottawa; Dawn Stacey, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; and Lyndal J. Trevena, University of Sydney, Sydney, New South Wales, Australia
| | - Lyndal J Trevena
- Kristen McAlpine, Krystina B. Lewis, and Dawn Stacey, University of Ottawa; Dawn Stacey, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; and Lyndal J. Trevena, University of Sydney, Sydney, New South Wales, Australia
| | - Dawn Stacey
- Kristen McAlpine, Krystina B. Lewis, and Dawn Stacey, University of Ottawa; Dawn Stacey, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; and Lyndal J. Trevena, University of Sydney, Sydney, New South Wales, Australia
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McAlpine K, Breau RH, Stacey D, Knee C, Jewett MAS, Cagiannos I, Morash C, Lavallée LT. Development and acceptability testing of a patient decision aid for individuals with localized renal masses considering surgical removal with partial or radical nephrectomy. Urol Oncol 2019; 37:811.e1-811.e7. [PMID: 31540831 DOI: 10.1016/j.urolonc.2019.08.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/08/2019] [Accepted: 08/19/2019] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Patient decision aids are structured clinical tools that facilitate shared decision-making. In urology, the decision between partial and radical nephrectomy for a renal mass can be difficult. We sought to develop and evaluate a decision aid for patients with a localized renal mass considering surgery. This paper describes the development process and acceptability testing of our patient decision aid. MATERIAL AND METHODS A decision aid was systematically created using the International Patient Decision Aids Standards. Review of the literature identified evidence regarding patient-important outcomes of partial and radical nephrectomy. A mixed methods survey was designed to assess acceptability of the decision aid. Kidney cancer survivors, patient advocates, methodological experts, and urologists were recruited to evaluate the decision aid. The primary outcome was the acceptability of the decision aid reported by survey responders. RESULTS An evidence-based decision aid was created. Included benefits were overall survival, cancer-free survival, and length of hospital stay. Included harms were postoperative bleeding, urine leak, stage 3 renal failure, renal replacement therapy, and flank bulge. The decision aid met the International Patient Decision Aids Standards defining (6 of 6), certification (6 of 6), and quality criteria (21 of 23). Results of acceptability testing were highly favorable. Responders (n = 22) reported the decision aid had acceptable language (91%), an appropriate length (82%), and presented balanced options (91%). Nine of 11 urologists (82%) reported intended use with future patients. CONCLUSIONS A novel, evidence-based decision aid was created for patients with renal masses considering surgery. The decision aid is available at https://decisionaid.ohri.ca/AZsumm.php?ID=1913. A separate decision aid addressing the management of small renal masses is currently under development.
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Affiliation(s)
| | - Rodney H Breau
- Division of Urology, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Dawn Stacey
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada; School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Christopher Knee
- Division of Urology, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Michael A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON, Canada
| | - Ilias Cagiannos
- Division of Urology, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Christopher Morash
- Division of Urology, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Luke T Lavallée
- Division of Urology, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
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Nygaard A, Halvorsrud L, Linnerud S, Grov EK, Bergland A. The James Lind Alliance process approach: scoping review. BMJ Open 2019; 9:e027473. [PMID: 31473612 PMCID: PMC6720333 DOI: 10.1136/bmjopen-2018-027473] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 07/11/2019] [Accepted: 07/16/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To summarise study descriptions of the James Lind Alliance (JLA) approach to the priority setting partnership (PSP) process and how this process is used to identify uncertainties and to develop lists of top 10 priorities. DESIGN Scoping review. DATA SOURCES The Embase, Medline (Ovid), PubMed, CINAHL and the Cochrane Library as of October 2018. STUDY SELECTION All studies reporting the use of JLA process steps and the development of a list of top 10 priorities, with adult participants aged 18 years. DATA EXTRACTION A data extraction sheet was created to collect demographic details, study aims, sample and patient group details, PSP details (eg, stakeholders), lists of top 10 priorities, descriptions of JLA facilitator roles and the PSP stages followed. Individual and comparative appraisals were discussed among the scoping review authors until agreement was reached. RESULTS Database searches yielded 431 potentially relevant studies published in 2010-2018, of which 37 met the inclusion criteria. JLA process participants were patients, carers and clinicians, aged 18 years, who had experience with the study-relevant diagnoses. All studies reported having a steering group, although partners and stakeholders were described differently across studies. The number of JLA PSP process steps varied from four to eight. Uncertainties were typically collected via an online survey hosted on, or linked to, the PSP website. The number of submitted uncertainties varied across studies, from 323 submitted by 58 participants to 8227 submitted by 2587 participants. CONCLUSIONS JLA-based PSP makes a useful contribution to identifying research questions. Through this process, patients, carers and clinicians work together to identify and prioritise unanswered uncertainties. However, representation of those with different health conditions depends on their having the capacity and resources to participate. No studies reported difficulties in developing their top 10 priorities.
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Affiliation(s)
- Agnete Nygaard
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Center for Development of Institutional and Home Care, Lørenskog, Akershus
| | - Liv Halvorsrud
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Siv Linnerud
- Center for Development of Institutional and Home Care, Lørenskog, Akershus
| | - Ellen Karine Grov
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Astrid Bergland
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Jones JM, Bhatt J, Avery J, Laupacis A, Cowan K, Basappa NS, Basiuk J, Canil C, Al-Asaaed S, Heng DY, Wood L, Stacey D, Kollmannsberger C, Jewett MA. Setting Research Priorities for Kidney Cancer. Eur Urol 2017; 72:861-864. [DOI: 10.1016/j.eururo.2017.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/06/2017] [Indexed: 12/14/2022]
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