1
|
Mobley EM, Moke DJ, Milam J, Ochoa‐Dominguez CY, Stal J, Mitchell H, Aminzadeh N, Bolshakova M, Mailhot Vega RB, Dinalo J, Motala A, Hempel S. Disparities in pediatric cancer survivorship care: A systematic review. Cancer Med 2023; 12:18281-18305. [PMID: 37551113 PMCID: PMC10524017 DOI: 10.1002/cam4.6426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Childhood cancer survivors (CCS) experience many long-term health problems that can be mitigated with recommended survivorship care. However, many CCS do not have access to survivorship care nor receive recommended survivorship care. We reviewed the empirical evidence of disparities in survivorship care for CCS. METHODS This systematic review searched PubMed, CINAHL, and PsycINFO for studies on survivorship care for CCS (PROSPERO: CRD42021227965) and abstracted the reported presence or absence of disparities in care. We screened 7945 citations, and of those, we reviewed 2760 publications at full text. RESULTS A total of 22 studies reported in 61 publications met inclusion criteria. Potential disparities by cancer treatment (N = 14), diagnosis (N = 13), sex (N = 13), and current age (N = 13) were frequently studied. There was high quality of evidence (QOE) of survivorship care disparities associated with non-White race, Hispanic ethnicity, and being uninsured. Moderate QOE demonstrated disparities among CCS who were unemployed and older. Lower QOE was found for disparities based on cancer diagnosis, cancer treatment, age at diagnosis, time since diagnosis, sex, insurance type, income, educational attainment, and geographic area. CONCLUSIONS We found strong empirical evidence of disparities in survivorship care for CCS associated with race, ethnicity, and insurance status. Multiple other disparate groups, such as those by employment, income, insurance type, education, cancer diagnosis, age at diagnosis, time since diagnosis, cancer treatment, geographic area, sex, and self-identified gender warrant further investigation. Prospective, multilevel research is needed to examine the role of other patient characteristics as potential disparities hindering adequate survivorship care in CCS.
Collapse
Affiliation(s)
- Erin M. Mobley
- Department of Surgery, College of MedicineUniversity of FloridaJacksonvilleFloridaUSA
| | - Diana J. Moke
- Department of Hematology, Oncology, and Blood and Marrow TransplantationChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
- Department of Pediatrics, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Southern California Center for Young Adult Cancer Survivorship ResearchLos Angeles and IrvineCaliforniaUSA
| | - Joel Milam
- Southern California Center for Young Adult Cancer Survivorship ResearchLos Angeles and IrvineCaliforniaUSA
- Department of Epidemiology and Biostatistics, Program in Public HealthUniversity of California IrvineIrvineCaliforniaUSA
| | - Carol Y. Ochoa‐Dominguez
- Department of Radiation Medicine and Applied Sciences, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Julia Stal
- Southern California Center for Young Adult Cancer Survivorship ResearchLos Angeles and IrvineCaliforniaUSA
- Department of Preventive Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Halle Mitchell
- Department of Surgery, College of MedicineUniversity of FloridaJacksonvilleFloridaUSA
| | - Naghmeh Aminzadeh
- Southern California Evidence Review Center, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Maria Bolshakova
- Southern California Evidence Review Center, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Raymond B. Mailhot Vega
- Department of Radiation Oncology, College of MedicineUniversity of FloridaJacksonvilleFloridaUSA
| | - Jennifer Dinalo
- Southern California Evidence Review Center, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Aneesa Motala
- Southern California Evidence Review Center, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Susanne Hempel
- Southern California Evidence Review Center, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| |
Collapse
|
2
|
Hempel S, Bolshakova M, Turner BJ, Dinalo J, Rose D, Motala A, Fu N, Clemesha CG, Rubenstein L, Stockdale S. Evidence-Based Quality Improvement: a Scoping Review of the Literature. J Gen Intern Med 2022; 37:4257-4267. [PMID: 36175760 PMCID: PMC9708973 DOI: 10.1007/s11606-022-07602-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Quality improvement (QI) initiatives often reflect approaches based on anecdotal evidence, but it is unclear how initiatives can best incorporate scientific literature and methods into the QI process. Review of studies of QI initiatives that aim to systematically incorporate evidence review (termed evidence-based quality improvement (EBQI)) may provide a basis for further methodological development. METHODS In this scoping review (registration: https://osf.io/hr5bj ) of EBQI, we searched the databases PubMed, CINAHL, and SCOPUS. The review addressed three central questions: How is EBQI defined? How is evidence used to inform evidence-informed QI initiatives? What is the effectiveness of EBQI? RESULTS We identified 211 publications meeting inclusion criteria. In total, 170 publications explicitly used the term "EBQI." Published definitions emphasized relying on evidence throughout the QI process. We reviewed a subset of 67 evaluations of QI initiatives in primary care, including both studies that used the term "EBQI" with those that described an evidence-based initiative without using EBQI terminology. The most frequently reported EBQI components included use of evidence to identify previously tested effective QI interventions; engaging stakeholders; iterative intervention development; partnering with frontline clinicians; and data-driven evaluation of the QI intervention. Effectiveness estimates were positive but varied in size in ten studies that provided data on patient health outcomes. CONCLUSIONS EBQI is a promising strategy for integrating relevant prior scientific findings and methods systematically in the QI process, from the initial developmental phase of the IQ initiative through to its evaluation. Future QI researchers and practitioners can use these findings as the basis for further development of QI initiatives.
Collapse
Affiliation(s)
- Susanne Hempel
- Southern California Evidence Review Center, University of Southern California, Los Angeles, CA, USA.,Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, USA.,RAND Health, RAND Corporation, Santa Monica, CA, USA
| | - Maria Bolshakova
- Southern California Evidence Review Center, University of Southern California, Los Angeles, CA, USA
| | - Barbara J Turner
- Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, USA
| | | | - Danielle Rose
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Aneesa Motala
- Southern California Evidence Review Center, University of Southern California, Los Angeles, CA, USA.,Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, USA.,RAND Health, RAND Corporation, Santa Monica, CA, USA
| | - Ning Fu
- Southern California Evidence Review Center, University of Southern California, Los Angeles, CA, USA. .,School of Economics, Shanghai University of Finance and Economics, Shanghai, China.
| | | | | | - Susan Stockdale
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| |
Collapse
|
3
|
Schneberk T, Bolshakova M, Sloan K, Chang E, Stal J, Dinalo J, Jimenez E, Motala A, Hempel S. Quality Indicators for High-Need Patients: a Systematic Review. J Gen Intern Med 2022; 37:3147-3161. [PMID: 35260956 PMCID: PMC9485370 DOI: 10.1007/s11606-022-07454-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/03/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Healthcare systems are increasingly implementing programs for high-need patients, who often have multiple chronic conditions and complex social situations. Little, however, is known about quality indicators that might guide healthcare organizations and providers in improving care for high-need patients. We sought to conduct a systematic review to identify potential quality indicators for high-need patients. METHODS This systematic review (CRD42020215917) searched PubMed, CINAHL, and EMBASE; guideline clearing houses ECRI and GIN; and Google scholar. We included publications suggesting, evaluating, and utilizing indicators to assess quality of care for high-need patients. Critical appraisal of the indicators addressed the development process, endorsement and adoption, and characteristics, such as feasibility. We standardized indicators by patient population subgroups to facilitate comparisons across different indicator groups. RESULTS The search identified 6964 citations. Of these, 1382 publications were obtained as full text, and 53 studies met inclusion criteria. We identified over 1700 quality indicators across studies. Quality indicator characteristics varied widely. The scope of the selected indicators ranged from detailed criterion (e.g., "annual eye exam") to very broad categories (e.g., "care coordination"). Some publications suggested disease condition-specific indicators (e.g., diabetes), some used condition-independent criteria (e.g., "documentation of the medication list in the medical record available to all care agencies"), and some publications used a mixture of indicator types. DISCUSSION We identified and evaluated existing quality indicators for a complex, heterogeneous patient group. Although some quality indicators were not disease-specific, we found very few that accounted for social determinants of health and behavioral factors. More research is needed to develop quality indicators that address patient risk factors.
Collapse
Affiliation(s)
- Todd Schneberk
- Gehr Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, GNH 1011, 1200 N State Street Rm 1011, Los Angeles, CA, 90033, USA.
| | - Maria Bolshakova
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kylie Sloan
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Evelyn Chang
- VA Greater Los Angeles Healthcare System, Sepulveda, CA, USA
| | - Julia Stal
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer Dinalo
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Elvira Jimenez
- VA Greater Los Angeles Healthcare System, Sepulveda, CA, USA
| | - Aneesa Motala
- Gehr Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, GNH 1011, 1200 N State Street Rm 1011, Los Angeles, CA, 90033, USA
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Susanne Hempel
- Gehr Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, GNH 1011, 1200 N State Street Rm 1011, Los Angeles, CA, 90033, USA
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
4
|
Lau C, Rivas M, Dinalo J, King K, Duddalwar V. Scoping Review of Targeted Ultrasound Contrast Agents in the Detection of Angiogenesis. J Ultrasound Med 2020; 39:19-28. [PMID: 31237009 DOI: 10.1002/jum.15072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 05/16/2019] [Accepted: 05/22/2019] [Indexed: 06/09/2023]
Abstract
A systematic search was conducted to categorize targeted ultrasound contrast agents (UCAs) used in cancer-related angiogenesis detection. We identified 15 unique contrast agents from 2008 to March 2018. Most primary research articles studied UCAs targeted to vascular endothelial growth factor receptor or αv β3 -integrin. Breast cancer and colon cancer are the most common neoplastic processes in which these agents were studied. BR55 (Bracco Research SA, Geneva, Switzerland), a vascular endothelial growth factor receptor-targeting UCA, is the first targeted UCA that has completed phase 0 trials. Our review identifies a gap in the literature regarding the application of targeted UCAs in cancer models beyond breast and colon cancers and identifies other promising UCAs.
Collapse
Affiliation(s)
- Christopher Lau
- Department of Radiology, Keck School of Medicine, California, Los Angeles, USA
| | - Marielena Rivas
- Department of Radiology, Keck School of Medicine, California, Los Angeles, USA
| | - Jennifer Dinalo
- Norris Medical Library, Keck School of Medicine, California, Los Angeles, USA
| | - Kevin King
- Department of Radiology, Keck School of Medicine, California, Los Angeles, USA
| | - Vinay Duddalwar
- Department of Radiology, Keck School of Medicine, California, Los Angeles, USA
| |
Collapse
|