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Mohan P, Lemoine J, Trotter C, Rakova I, Billings P, Peacock S, Kao C, Wang Y, Xia F, Eng CM, Benn P. Clinical experience with non-invasive prenatal screening for single-gene disorders. Ultrasound Obstet Gynecol 2022; 59:33-39. [PMID: 34358384 PMCID: PMC9302116 DOI: 10.1002/uog.23756] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [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: 05/30/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To assess the performance of a non-invasive prenatal screening test (NIPT) for a panel of dominant single-gene disorders (SGD) with a combined population incidence of 1 in 600. METHODS Cell-free fetal DNA isolated from maternal plasma samples accessioned from 14 April 2017 to 27 November 2019 was analyzed by next-generation sequencing, targeting 30 genes, to look for pathogenic or likely pathogenic variants implicated in 25 dominant conditions. The conditions included Noonan spectrum disorders, skeletal disorders, craniosynostosis syndromes, Cornelia de Lange syndrome, Alagille syndrome, tuberous sclerosis, epileptic encephalopathy, SYNGAP1-related intellectual disability, CHARGE syndrome, Sotos syndrome and Rett syndrome. NIPT-SGD was made available as a clinical service to women with a singleton pregnancy at ≥ 9 weeks' gestation, with testing on maternal and paternal genomic DNA to assist in interpretation. A minimum of 4.5% fetal fraction was required for test interpretation. Variants identified in the mother were deemed inconclusive with respect to fetal carrier status. Confirmatory prenatal or postnatal diagnostic testing was recommended for all screen-positive patients and follow-up information was requested. The screen-positive rates with respect to the clinical indication for testing were evaluated. RESULTS A NIPT-SGD result was available for 2208 women, of which 125 (5.7%) were positive. Elevated test-positive rates were observed for referrals with a family history of a disorder on the panel (20/132 (15.2%)) or a primary indication of fetal long-bone abnormality (60/178 (33.7%)), fetal craniofacial abnormality (6/21 (28.6%)), fetal lymphatic abnormality (20/150 (13.3%)) or major fetal cardiac defect (4/31 (12.9%)). For paternal age ≥ 40 years as a sole risk factor, the test-positive rate was 2/912 (0.2%). Of the 125 positive cases, follow-up information was available for 67 (53.6%), with none classified as false-positive. No false-negative cases were identified. CONCLUSIONS NIPT can assist in the early detection of a set of SGD, particularly when either abnormal ultrasound findings or a family history is present. Additional clinical studies are needed to evaluate the optimal design of the gene panel, define target populations and assess patient acceptability. NIPT-SGD offers a safe and early prenatal screening option. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
| | | | | | | | | | | | | | - Y. Wang
- Baylor GeneticsHoustonTXUSA
- Baylor College of MedicineHoustonTXUSA
| | - F. Xia
- Baylor GeneticsHoustonTXUSA
- Baylor College of MedicineHoustonTXUSA
| | - C. M. Eng
- Baylor GeneticsHoustonTXUSA
- Baylor College of MedicineHoustonTXUSA
| | - P. Benn
- Department of Genetics and Genome SciencesUniversity of Connecticut Health CenterFarmingtonCTUSA
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Peacock S, Briggs D, Barnardo M, Battle R, Brookes P, Callaghan C, Clark B, Collins C, Day S, Diaz Burlinson N, Dunn P, Fernando R, Fuggle S, Harmer A, Kallon D, Keegan D, Key T, Lawson E, Lloyd S, Martin J, McCaughan J, Middleton D, Partheniou F, Poles A, Rees T, Sage D, Santos-Nunez E, Shaw O, Willicombe M, Worthington J. BSHI/BTS guidance on crossmatching before deceased donor kidney transplantation. Int J Immunogenet 2021; 49:22-29. [PMID: 34555264 PMCID: PMC9292213 DOI: 10.1111/iji.12558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022]
Abstract
All UK H&I laboratories and transplant units operate under a single national kidney offering policy, but there have been variations in approach regarding when to undertake the pre‐transplant crossmatch test. In order to minimize cold ischaemia times for deceased donor kidney transplantation we sought to find ways to be able to report a crossmatch result as early as possible in the donation process. A panel of experts in transplant surgery, nephrology, specialist nursing in organ donation and H&I (all relevant UK laboratories represented) assessed evidence and opinion concerning five factors that relate to the effectiveness of the crossmatch process, as follows: when the result should be ready for reporting; what level of donor HLA typing is needed; crossmatch sample type and availability; fairness and equity; risks and patient safety. Guidelines aimed at improving practice based on these issues are presented, and we expect that following these will allow H&I laboratories to contribute to reducing CIT in deceased donor kidney transplantation.
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Affiliation(s)
- S Peacock
- Tissue Typing Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - D Briggs
- H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK
| | - M Barnardo
- Clinical Transplant Immunology, Churchill Hospital, Oxford, UK
| | - R Battle
- H&I Laboratory, SNBTS, Edinburgh, UK
| | - P Brookes
- H&I Laboratory, Harefield Hospital, Harefield, UK
| | - C Callaghan
- Department of Nephrology and Transplantation, Guy's Hospital, London, UK
| | - B Clark
- H&I Laboratory, Leeds Teaching Hospitals NHS Trust, UK
| | - C Collins
- H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK
| | - S Day
- H&I Laboratory, Southmead Hospital, Bristol, UK
| | - N Diaz Burlinson
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
| | - P Dunn
- Transplant Laboratory, Leicester General Hospital, Leicester, UK
| | - R Fernando
- H&I Laboratory, The Anthony Nolan Laboratories, Royal Free Hospital, UK
| | - S Fuggle
- Organ Donation & Transplantation, NHSBT, Stoke Gifford, Bristol, UK
| | - A Harmer
- H&I Laboratory, NHSBT Barnsley Centre, Barnsley, UK
| | - D Kallon
- H & I Laboratory, Royal London Hospital, London, UK
| | - D Keegan
- Department of H&I, Beaumont Hospital, Dublin, UK
| | - T Key
- H&I Laboratory, NHSBT Barnsley Centre, Barnsley, UK
| | - E Lawson
- Organ Donation and Transplantation, NHSBT, Birmingham, UK
| | - S Lloyd
- Welsh Transplantation & Immunogenetics Laboratory, Cardiff, UK
| | - J Martin
- H&I Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - J McCaughan
- H&I Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - D Middleton
- H&I Laboratory, Liverpool Foundation Trust, Liverpool, UK
| | - F Partheniou
- H&I Laboratory, Liverpool Foundation Trust, Liverpool, UK
| | - A Poles
- H&I Laboratory, University Hospitals Plymouth, Plymouth, UK.,H&I Laboratory, NHSBT Filton, Bristol, UK
| | - T Rees
- Welsh Transplantation & Immunogenetics Laboratory, Cardiff, UK
| | - D Sage
- H&I Laboratory, NHSBT Tooting Centre, London, UK
| | - E Santos-Nunez
- H&I Laboratory, Imperial College Healthcare NHS Trust, London, UK
| | - O Shaw
- H&I Laboratory, Viapath, Guys & St Thomas, London, UK
| | - M Willicombe
- Department of Immunology and Inflammation, Imperial College London, UK
| | - J Worthington
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
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3
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Beca JM, Dai WF, Pataky RE, Tran D, Dvorani E, Isaranuwatchai W, Peacock S, Alvi R, Cheung WY, Earle CC, Gavura S, Chan KKW. Real-world Safety of Bevacizumab with First-line Combination Chemotherapy in Patients with Metastatic Colorectal Cancer: Population-based Retrospective Cohort Studies in Three Canadian Provinces. Clin Oncol (R Coll Radiol) 2021; 34:e7-e17. [PMID: 34456106 DOI: 10.1016/j.clon.2021.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 07/16/2021] [Accepted: 08/12/2021] [Indexed: 11/03/2022]
Abstract
AIMS To examine the real-world safety of adding bevacizumab to first-line irinotecan-based chemotherapy for patients with metastatic colorectal cancer (mCRC). MATERIALS AND METHODS Patients diagnosed with CRC in three Canadian provinces (Ontario, Saskatchewan and British Columbia) who received publicly funded bevacizumab and/or irinotecan from 2000 to 2016 were identified from cancer registries. Propensity score 1:1 matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to contemporaneous and historical controls, adjusting for baseline demographic and clinical characteristics. Safety end points evaluated during first-line treatment plus 30 days included mortality within 30 days and all-cause-, chemotherapy- and bevacizumab-related hospitalisations. Chemotherapy- and bevacizumab-related visits were defined as hospitalisations for specific conditions commonly associated with chemotherapy (e.g. infections) or bevacizumab (e.g. arteriovenous thromboembolism) using most responsible diagnosis codes. In PSM and IPTW-weighted cohorts, we assessed event frequencies using odds ratios from logistic regressions and event rate ratios using negative binomial regression models. The results from each province and comparison were pooled using random-effects meta-analysis. RESULTS We identified 16 250 mCRC patients who received first-line irinotecan-based treatment. In PSM cohorts, bevacizumab was associated with fewer deaths within 30 days of treatment compared with contemporaneous (pooled odds ratio = 0.62; 95% confidence interval 0.50-0.75) and historical controls (pooled odds ratio = 0.73; 95% confidence interval 0.58-0.93). Hospitalisations were more frequent among patients treated with bevacizumab compared with historical controls but similar to contemporaneous controls. As patients receiving bevacizumab were exposed to a longer average treatment duration, across their full treatment duration, patients receiving bevacizumab had significantly lower rates of hospitalisations (contemporaneous pooled rate ratio = 0.56; 95% confidence interval 0.47-0.67; historical pooled rate ratio = 0.73; 95% confidence interval 0.56-0.95). Similar trends were observed for chemotherapy- and bevacizumab-related hospitalisations and in IPTW-weighted cohorts. DISCUSSION We did not observe any increase in rates of hospitalisation or death within 30 days of treatment among mCRC patients treated with bevacizumab plus chemotherapy versus chemotherapy alone; these findings should be interpreted with caution due to the risk of residual confounding.
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Affiliation(s)
- J M Beca
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada; Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada.
| | - W F Dai
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - R E Pataky
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada; BC Cancer, Vancouver, British Columbia, Canada
| | - D Tran
- Saskatchewan Cancer Agency, Saskatoon, Saskatchewan, Canada
| | - E Dvorani
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - W Isaranuwatchai
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada; St. Michael's Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - S Peacock
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada; BC Cancer, Vancouver, British Columbia, Canada; Simon Fraser University, Burnaby, British Columbia, Canada
| | - R Alvi
- Saskatchewan Cancer Agency, Saskatoon, Saskatchewan, Canada
| | - W Y Cheung
- Cancer Control Alberta, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - C C Earle
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - S Gavura
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - K K W Chan
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada; Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada; Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
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4
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Hoheneder R, Fitz E, Bischof RH, Russmayer H, Ferrero P, Peacock S, Sauer M. Efficient conversion of hemicellulose sugars from spent sulfite liquor into optically pure L-lactic acid by Enterococcus mundtii. Bioresour Technol 2021; 333:125215. [PMID: 33964599 DOI: 10.1016/j.biortech.2021.125215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/03/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
Spent sulfite liquor (SSL), a waste stream from wood pulp production, has great potential as carbon source for future industrial fermentations. In the present study, SSL was separated into a hemicellulose derived sugar syrup (HDSS) and a lignosulfonic fraction by simulated moving bed chromatography. The recovery of SSL sugars in the HDSS was 89% and the fermentation inhibitors furfural, 5-hydroxymethylfurfural and acetic acid were removed by 98.7%, 60.5% and 75.5%, respectively. The obtained sugars have been converted to L-lactic acid, a building block for bioplastics, by fermentation with the lactic acid bacterium Enterococcus mundtii DSM4838. Batch fermentations on HDSS produced up to 56.3 g/L L-lactic acid. Simultaneous conversion of pentose and hexose sugars during fed-batch fermentation of wildtype E. mundtii led to 87.9 g/L optically pure (>99%) L-lactic acid, with maximum productivities of 3.25 g/L.h and yields approaching 1.00 g/g during feeding phase from HDSS as carbon source.
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Affiliation(s)
- R Hoheneder
- Department of Wood Chemistry & Biotechnology, Wood Kplus - Kompetenzzentrum Holz GmbH, c/o Muthgasse 18, 1190 Vienna, Austria; Institute of Microbiology and Microbial Biotechnology, Department of Biotechnology, BOKU-University of Natural Resources and Life Sciences, Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - E Fitz
- Department of Wood Chemistry & Biotechnology, Wood Kplus - Kompetenzzentrum Holz, c/o Werkstraße 2, 4860 Lenzing, Austria
| | - R H Bischof
- Lenzing Aktiengesellschaft, Werkstraße 2, 4860 Lenzing, Austria
| | - H Russmayer
- Institute of Microbiology and Microbial Biotechnology, Department of Biotechnology, BOKU-University of Natural Resources and Life Sciences, Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - P Ferrero
- Amalgamated Research LLC, 2531 Orchard Drive East, Twin Falls, ID 83301, United States
| | - S Peacock
- Amalgamated Research LLC, 2531 Orchard Drive East, Twin Falls, ID 83301, United States
| | - M Sauer
- Institute of Microbiology and Microbial Biotechnology, Department of Biotechnology, BOKU-University of Natural Resources and Life Sciences, Vienna, Muthgasse 18, 1190 Vienna, Austria.
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5
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Bentley C, Sundquist S, Dancey J, Peacock S. Barriers to conducting cancer trials in Canada: an analysis of key informant interviews. ACTA ACUST UNITED AC 2020; 27:e307-e312. [PMID: 32669937 DOI: 10.3747/co.27.5707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background In Canada, there is growing evidence that oncology clinical trials units (ctus) and programs face serious financial challenges. Investment in cancer research in Canada has declined almost 20% in the 5 years since its peak in 2011, and the costs of conducting leading-edge trials are rising. Clinical trials units must therefore be strategic about which studies they open. We interviewed Canadian health care professionals responsible for running cancer trials programs to identify the barriers to sustainability that they face. Methods One-on-one telephone interviews were conducted with clinicians and clinical research professionals at oncology ctus in Canada. We asked for their perspectives about the barriers to conducting trials at their institutions, in their provinces, and nationwide. Interviews were digitally recorded, transcribed, anonymized, and coded in the NVivo software application (version 11: QSR International, Melbourne, Australia). The initial coding structure was informed by the interview script, with new concepts drawn out and coded during analysis, using a constant comparative approach. Results Between June 2017 and November 2018, 25 interviews were conducted. Key barriers that participants identified were■ insufficient stable funding to support trials infrastructure and retain staff;■ the need to adopt strict cost-recovery policies, leading to fewer academic trials in portfolios; and■ an overreliance on industry to fund clinical research in Canada. Conclusions Funding uncertainties have led ctus to increasingly rely on industry sponsorship and more stringent feasibility thresholds to remain solvent. Retaining skilled trials staff can create efficiencies in opening and running studies, with spillover effects of more trials being open to patients. More academic studies are needed to curb industry's influence.
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Affiliation(s)
- C Bentley
- Canadian Centre for Applied Research in Cancer Control, Vancouver, BC.,Department of Cancer Control Research, BC Cancer, Vancouver, BC
| | - S Sundquist
- Canadian Cancer Clinical Trials Network, Toronto, ON.,Ontario Institute for Cancer Research, Toronto, ON
| | - J Dancey
- Canadian Cancer Clinical Trials Network, Toronto, ON.,Ontario Institute for Cancer Research, Toronto, ON.,Department of Oncology, School of Medicine, Queens University, Kingston, ON.,Canadian Cancer Trials Group, Kingston, ON
| | - S Peacock
- Canadian Centre for Applied Research in Cancer Control, Vancouver, BC.,Department of Cancer Control Research, BC Cancer, Vancouver, BC.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
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6
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Cottrell L, Duggleby W, Ploeg J, McAiney C, Peacock S, Ghosh S, Holroyd-Leduc JM, Nekolaichuk C, Forbes D, Paragg J, Swindle J. Using focus groups to explore caregiver transitions and needs after placement of family members living with dementia in 24-hour care homes. Aging Ment Health 2020; 24:227-232. [PMID: 30588823 DOI: 10.1080/13607863.2018.1531369] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Family caregivers (defined broadly as family and friends) of persons with dementia are challenged to cope with myriad stressors and changes that occur along the dementia trajectory. The purpose of this study was to explore the transitions experienced by caregivers of persons with dementia after their relative relocated to a 24-hour care home.Method: Qualitative thematic and conversational analysis were used: themes were co-created and modes of speech and syntactical patterns analysed to expose discourses related to caregiving after placement in 24-hour care homes.Results: Four main themes were co-constructed from the data analysis: living with loss, relinquishing, redefining the caregiving role, and rediscovering and recreating a new self.Discussion: Caregiving continues after placement of family members with dementia in 24-hour care homes. Caregivers are at-risk group and require ongoing support throughout the caregiving journey. Study participants reported that navigation skills such as relationship building, communication, and advocacy were particularly salient to the post-placement period, when navigating the complex health care environment was a significant obstacle. Ultimately, findings from these focus groups will be used to inform an online intervention to support caregivers of a family member with dementia residing in a 24-hour care home.
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Affiliation(s)
- L Cottrell
- Faculty of Nursing, The University of Alberta, Edmonton, Canada
| | - W Duggleby
- Faculty of Nursing, The University of Alberta, Edmonton, Canada
| | - J Ploeg
- School of Nursing, McMaster University, Hamilton, Canada
| | - C McAiney
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - S Peacock
- College of Nursing, University of Saskatchewan, Saskatchewan, Canada
| | - S Ghosh
- Department of Medical Oncology/Department of Mathematical & Statistical Sciences, The University of Alberta, Edmonton, Canada
| | - J M Holroyd-Leduc
- Department of Medicine & Community Health Sciences, University of Calgary, Alberta, Canada
| | - C Nekolaichuk
- Faculty of Medicine & Dentistry, The University of Alberta, Edmonton, Canada
| | - D Forbes
- Faculty of Nursing, The University of Alberta, Edmonton, Canada
| | - J Paragg
- Faculty of Nursing, The University of Alberta, Edmonton, Canada
| | - J Swindle
- Faculty of Nursing, The University of Alberta, Edmonton, Canada
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7
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Peacock S, Chan KKW. Special supplement on Canadian cancer costing research. ACTA ACUST UNITED AC 2019; 26:85-86. [PMID: 31043806 DOI: 10.3747/co.26.5057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As we approach the 10th anniversary of the Canadian Centre for Applied Research in Cancer Control (arcc) [...]
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Affiliation(s)
- S Peacock
- Canadian Centre for Applied Research in Cancer Control, Vancouver, BC, and Toronto, ON
| | - K K W Chan
- Canadian Centre for Applied Research in Cancer Control, Vancouver, BC, and Toronto, ON
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Glover R, Al-Haboubi M, Petticrew M, Peacock S. Reviewing the use of turnaround time in rapid identification and antibiotic susceptibility testing. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Glover
- London School of Hygiene and Tropical Medicine, London, UK
| | - M Al-Haboubi
- London School of Hygiene and Tropical Medicine, London, UK
| | - M Petticrew
- London School of Hygiene and Tropical Medicine, London, UK
| | - S Peacock
- London School of Hygiene and Tropical Medicine, London, UK
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Cressman S, Peacock S, Tremblay A, Ho C, Tammemagi M, Lam S. P3.11-03 Implementing Lung Cancer Screening in Canada: Evidence on Adherence and Budget Impact from the Pan-Canadian Early Detection Study. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Magani F, Bray E, Peacock S, Zhao N, Burnstein K. Integrated system-level analyses of androgen receptor variant networks to identify novel prostate cancer-relevant genes that serve as prognostic biomarkers. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx361.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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11
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Duggleby W, Ploeg J, McAiney C, Ghosh S, Peacock S, Fisher K. MY TOOLS 4 CARE: AN ONLINE INTERVENTION SUPPORTING CAREGIVERS OF OLDER PERSONS WITH DEMENTIA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- W. Duggleby
- Unversity of Alberta, Edmonton, Ontario, Canada,
| | - J. Ploeg
- McMaster University, Hamilton, Ontario, Canada,
| | | | - S. Ghosh
- Faculty of Medicine and Dentistry University of Alberta, Edmonton, Alberta, Canada,
| | - S. Peacock
- College of Nursing University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - K. Fisher
- McMaster University, Hamilton, Ontario, Canada,
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12
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Norman R, Viney R, Aaronson NK, Brazier JE, Cella D, Costa DSJ, Fayers PM, Kemmler G, Peacock S, Pickard AS, Rowen D, Street DJ, Velikova G, Young TA, King MT. Erratum to: Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format. Qual Life Res 2016; 25:2401. [PMID: 27060090 DOI: 10.1007/s11136-016-1289-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- R Norman
- School of Public Health, Curtin University, Perth, Australia. .,Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia.
| | - R Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia
| | - N K Aaronson
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J E Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D S J Costa
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - G Kemmler
- Innsbruck Medical University, Innsbruck, Austria
| | - S Peacock
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,Canadian Centre for Applied Research in Cancer Control (ARCC), Vancouver, Canada.,British Columbia Cancer Agency, Vancouver, Canada
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D J Street
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, Australia
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.,St James's Hospital, Leeds, UK
| | - T A Young
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - M T King
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia.,Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
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13
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Norman R, Viney R, Aaronson NK, Brazier JE, Cella D, Costa DSJ, Fayers PM, Kemmler G, Peacock S, Pickard AS, Rowen D, Street DJ, Velikova G, Young TA, King MT. Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format. Qual Life Res 2015; 25:637-49. [PMID: 26342928 DOI: 10.1007/s11136-015-1115-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess the feasibility of using a discrete choice experiment (DCE) to value health states within the QLU-C10D, a utility instrument derived from the QLQ-C30, and to assess clarity, difficulty, and respondent preference between two presentation formats. METHODS We ran a DCE valuation task in an online panel (N = 430). Respondents answered 16 choice pairs; in half of these, differences between dimensions were highlighted, and in the remainder, common dimensions were described in text and differing attributes were tabulated. To simplify the cognitive task, only four of the QLU-C10D's ten dimensions differed per choice set. We assessed difficulty and clarity of the valuation task with Likert-type scales, and respondents were asked which format they preferred. We analysed the DCE data by format with a conditional logit model and used Chi-squared tests to compare other responses by format. Semi-structured telephone interviews (N = 8) explored respondents' cognitive approaches to the valuation task. RESULTS Four hundred and forty-nine individuals were recruited, 430 completed at least one choice set, and 422/449 (94 %) completed all 16 choice sets. Interviews revealed that respondents found ten domains difficult but manageable, many adopting simplifying heuristics. Results for clarity and difficulty were identical between formats, but the "highlight" format was preferred by 68 % of respondents. Conditional logit parameter estimates were monotonic within domains, suggesting respondents were able to complete the DCE sensibly, yielding valid results. CONCLUSION A DCE valuation task in which only four of the QLU-C10D's ten dimensions differed in any choice set is feasible for deriving utility weights for the QLU-C10D.
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Affiliation(s)
- R Norman
- School of Public Health, Curtin University, Perth, Australia. .,Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia.
| | - R Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia
| | - N K Aaronson
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J E Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D S J Costa
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - G Kemmler
- Innsbruck Medical University, Innsbruck, Austria
| | - S Peacock
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,Canadian Centre for Applied Research in Cancer Control (ARCC), Vancouver, Canada.,British Columbia Cancer Agency, Vancouver, Canada
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D J Street
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, Australia
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.,St James's Hospital, Leeds, UK
| | - T A Young
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - M T King
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia.,Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
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Maxfield SJ, Taylor CJ, Kosmoliaptsis V, Broecker V, Watson CJE, Bradley JA, Peacock S. Transfer of HLA-Specific Allosensitization From a Highly Sensitized Deceased Organ Donor to the Recipients of Each Kidney. Am J Transplant 2015; 15:2501-6. [PMID: 25932715 DOI: 10.1111/ajt.13300] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/05/2015] [Accepted: 02/26/2015] [Indexed: 01/25/2023]
Abstract
We report for the first time the adoptive transfer of donor HLA-specific allosensitization in two recipients following kidney transplantation from a highly sensitized donor. Kidneys from a donation after circulatory death donor were transplanted into two nontransfused, HLA-specific antibody negative males receiving their first transplant. Antibody screening 7 days after transplant showed high level de novo IgG HLA class I- and class II-specific antibodies in both recipients, with largely overlapping antibody profiles but no antibodies to donor HLA. The unusually rapid appearance of de novo alloantibodies in immunosuppressed nonsensitized recipients and absence of donor HLA-specific antibody prompted testing of stored donor serum that revealed high antibody levels with specificities very similar to those seen in both recipients, but in addition the presence of strong antibodies to each recipient HLA. Alloantibody levels gradually declined but were still detectable at 3 months. These findings suggest that alloreactive passenger B cells/plasma cells within the kidneys of highly sensitized donors may give rise to rapid development of posttransplant de novo HLA-specific alloantibodies. While the clinical significance of this phenomenon is uncertain it provides one explanation for the appearance of de novo HLA-specific antibodies directed against third party but not donor HLA.
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Affiliation(s)
- S J Maxfield
- Histocompatibility and Immunogenetics Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - C J Taylor
- Histocompatibility and Immunogenetics Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - V Kosmoliaptsis
- Department of Surgery, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - V Broecker
- Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - C J E Watson
- Department of Surgery, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - J A Bradley
- Department of Surgery, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - S Peacock
- Histocompatibility and Immunogenetics Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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15
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Ogilvie G, Krajden M, Ehlen T, Martin R, Smith L, Peacock S, Stuart GCE, Franco EL, Coldman AJ. O10.1 Age Specific Round 1 Results of a Cervical Cancer Screening Trial: HPV FOCAL. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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16
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Davidson JA, Cromwell I, Ellard SL, Lohrisch C, Gelmon KA, Shenkier T, Villa D, Lim H, Sun S, Taylor S, Taylor M, Czerkawski B, Hayes M, Ionescu DN, Yoshizawa C, Chao C, Peacock S, Chia SK. A prospective clinical utility and pharmacoeconomic study of the impact of the 21-gene Recurrence Score® assay in oestrogen receptor positive node negative breast cancer. Eur J Cancer 2013; 49:2469-75. [PMID: 23611660 DOI: 10.1016/j.ejca.2013.03.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/02/2013] [Accepted: 03/05/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The primary purpose of this study was to measure the impact of the 21-gene Recurrence Score® result on systemic treatment recommendations and to perform a prospective health economic analysis in stage I-II, node-negative, oestrogen receptor positive (ER+) breast cancer. METHODS Consenting patients with ER+ node negative invasive breast cancer and their treating medial oncologists were asked to complete questionnaires about treatment preferences, level of confidence in those preferences and a decisional conflict scale (patients only) after a discussion of their diagnosis and risk without knowledge of the Recurrence Score. At a subsequent visit, the assay result and final treatment recommendations were discussed prior to both parties completing a second set of questionnaires. A Markov health state transition model was constructed, simulating the costs and outcomes experienced by a hypothetical 'assay naïve' population and an 'assay informed' population. RESULTS One hundred and fifty-six patients across two cancer centres were enrolled. Of the 150 for whom successful assay results were obtained, physicians changed their chemotherapy recommendations in 45 cases (30%; 95% confidence interval (CI) 22.8-38.0%); either to add (10%; 95% CI 5.7-16.0%) or omit (20%; 95% CI 13.9-27.3%) adjuvant chemotherapy. There was an overall significant improvement in physician confidence post-assay (p<0.001). Patient decisional conflict also significantly decreased following the assay (p<0.001). The simulation model found an incremental cost-effectiveness ratio of Canadian Dollars (CAD) $6630/quality-adjusted life years (QALY). CONCLUSION Within the context of a publicly funded health care system, the Recurrence Score assay significantly affects adjuvant treatment recommendations and is cost effective in ER+ node negative breast cancer.
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Affiliation(s)
- J A Davidson
- Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada
| | - I Cromwell
- Canadian Centre for Applied Research in Cancer Control, British Columbia Cancer Research Centre, Vancouver, Canada
| | | | - C Lohrisch
- Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada
| | - K A Gelmon
- Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada
| | - T Shenkier
- Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada
| | - D Villa
- Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada
| | - H Lim
- Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada
| | - S Sun
- Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada
| | - S Taylor
- Medical Oncology, BCCA, Kelowna, Canada
| | - M Taylor
- Medical Oncology, BCCA, Kelowna, Canada
| | | | - M Hayes
- Pathology, BCCA, Vancouver, Canada
| | | | | | - C Chao
- Genomic Health Inc., Redwood City, CA, USA
| | - S Peacock
- Canadian Centre for Applied Research in Cancer Control, British Columbia Cancer Research Centre, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - S K Chia
- Medical Oncology, British Columbia Cancer Agency (BCCA), Vancouver, Canada.
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Abstract
BACKGROUND The increasing cost of cancer drugs underscores the importance of economic analyses. Although guidelines for abstract reporting of randomized controlled studies and phase i trials are available, similar recommendations for conference abstracts of economic analyses are lacking. Our objectives were to identify items considered to be essential in abstracts of economic analyses;to evaluate the quality of abstracts submitted to the American Society of Clinical Oncology (asco), the American Society of Hematology (ash), and the International Society for Pharmacoeconomics and Outcomes Research (ispor) meetings; andto propose guidelines for future abstract reporting at conferences. METHODS Health economic experts were surveyed and asked to rate each of 24 possible abstract elements on a 5-point Likert scale. A scoring system for abstract quality was devised based on elements with an average expert rating of 3.5 or greater. Abstracts for economic analyses from asco, ash, and ispor meetings were reviewed and assigned a quality score. RESULTS Of 99 experts, 50 (51%) responded to the survey (average age: 53 years; 78% men; 54% from the United States, 28% from Europe, 18% from Canada). In total, 216 abstracts were reviewed: asco, 53%; ash, 14%; and ispor, 33%. The median quality score was 75, but notable deficiencies were observed. Cost perspective was reported in only 61% of abstracts, and time horizon was described in only 47%. Abstracts from recent years demonstrated better quality scores. We also observed disparities in quality scores for various cancer sites (p = 0.005). CONCLUSIONS The quality of conference abstracts for economic analyses in oncology has room for improvement. Abstracts may be enhanced using the guidelines derived from our survey of experts.
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Affiliation(s)
- M Y Ho
- Division of Medical Oncology, BC Cancer Agency, Vancouver, BC
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Limmathurotsakul D, Turner E, Lim C, Day N, Cooper B, Peacock S. Defining the true accuracy of diagnostic tests when the gold standard is imperfect using web-based application. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Limmathurotsakul D, Wuthiekanun V, Kanoksil M, deStavola B, Day N, Peacock S. A matched case-control study identifies activities of daily living associated with acquisition of melioidosis in northeast Thailand. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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20
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Loiselle CR, Eby PR, Kim JN, Calhoun KE, Allison KH, Gadi VK, Peacock S, Storer B, Mankoff DA, Partridge SC, Lehman CD. Can preoperative dynamic contrast-enhanced breast MRI predict extensive occult axillary lymph node metastases in patients with positive sentinel node biopsy? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Villa D, Hedden L, Peacock S, Kennecke HF. Cost-effectiveness analysis of the addition of bevacizumab to first-line chemotherapy in metastatic colorectal cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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22
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Ho MY, Chan KK, Cheung MC, Peacock S, Cheung WY. Improving the quality of abstracts for economic analyses (EA) in oncology. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e16546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Lehman C, Lehman C, Silbergeld J, Silbergeld J, DeMartini W, DeMartini W, Eby P, Eby P, Gutierrez R, Gutierrez R, Peacock S, Peacock S, Javid S, Javid S. MRI Detection of Otherwise Occult Malignancies in Women Recently Diagnosed with Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-4017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective. Breast Magnetic Resonance Imaging (MRI) is recommended as a screening test for women at high risk for breast cancer but its role as a diagnostic tool for women recently diagnosed with breast cancer is not universally accepted. We report outcomes in a center that routinely uses breast MRI to evaluate extent of disease in patients recently diagnosed with breast cancer.Material and Methods. Between 1/1/2003 and 4/30/2007, 592 patients with recently diagnosed breast cancer underwent bilateral breast MRI to assess extent of disease. All had undergone mammography prior to breast MRI. Twenty-two were excluded because they were either lost to follow up (n=7) or had a mastectomy or lumpectomy (n=15) where correlation of pathology to the study lesion was not possible or incomplete. 570 patients comprised the analysis set. Patient age, index tumor characteristics (histologic subtype, grade, ER/PR status, HER2 status and presence of angiolymphatic invasion), axillary lymph node status, and pathologic stage were recorded in addition to mammographic breast density. All MR exams were coded following the American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS) breast MRI lexicon. Biopsy rates, positive predictive values of biopsy, and overall yield of detecting an occult cancer in the ipsilateral or contralateral breast were calculated and compared using Chi-square test across patient age, mammographic breast density, index tumor type, receptor status and presence or absence of lymph node metastases.Results. The distribution of tumor histologies was typical of that seen in the U.S. during the study period, with 61% having invasive ductal index cancers, 21% pure ductal carcinoma in situ, 19% invasive lobular or other invasive cancers and 67% being node negative at time of diagnosis. Additional biopsy was recommended for 152/570 (27%) patients found to have one or more suspicious lesions on MRI distinct from the index cancer, based upon mammographic, sonographic, or clinical exam measurements. Of the 152 women who underwent biopsy, 67 women had additional cancers diagnosed, for a positive predictive value of 44% (67/152). Overall, 12% (67/570) of women had otherwise occult cancers diagnosed by MRI alone: 8% of women had additional sites or greater extent of ipsilateral disease and 4% of women had unsuspected contralateral cancer detected by MRI alone. No significant differences were found in the probability of detecting an occult cancer based on patient age, breast density, index tumor characteristics, or lymph node status.Conclusion. The 12% added cancer yield of MRI in detecting additional ipsilateral or contralateral malignancies in a clinical population of women recently diagnosed with breast cancer is significantly higher than the added cancer yield of MRI screening among women at high risk for breast cancer. The positive predictive value of MRI in this clinical setting is also high, with 44% of women who undergo additional tissue sampling being diagnosed with otherwise occult cancer. The probability of finding additional malignancy does not vary significantly with patient age, breast density, or index cancer characteristics.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4017.
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Affiliation(s)
| | | | | | | | | | | | - P. Eby
- 1University of Washington, WA,
| | - P. Eby
- 2Seattle Cancer Care Alliance, WA,
| | | | | | | | | | - S. Javid
- 2Seattle Cancer Care Alliance, WA,
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Loiselle C, Eby P, Peacock S, Kim J, Lehman C. A Dynamic Contrast Enhanced MRI Kinetic Parameter Indicating Lymph Node Extracapsular Extension. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Yatsenko SA, Kruer MC, Bader PI, Corzo D, Schuette J, Keegan CE, Nowakowska B, Peacock S, Cai WW, Peiffer DA, Gunderson KL, Ou Z, Chinault AC, Cheung SW. Identification of critical regions for clinical features of distal 10q deletion syndrome. Clin Genet 2009; 76:54-62. [PMID: 19558528 DOI: 10.1111/j.1399-0004.2008.01115.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Array comparative genomic hybridization studies were performed to further characterize cytogenetic abnormalities found originally by karyotype and fluorescence in situ hybridization in five clinical cases of distal 10q deletions, including several with complex cytogenetic rearrangements and one with a partial male-to-female sex-reversal phenotype. These results have enabled us to narrow the previously proposed critical regions for the craniofacial, urogenital, and neuropsychiatric disease-related manifestations associated with distal 10q deletion syndrome. Furthermore, we propose that haploinsufficiency of the DOCK1 gene may play a crucial role in the pathogenesis of the 10q deletion syndrome. We hypothesize that alteration of DOCK1 and/or other genes involved in regulation and signaling of multiple pathways can explain the wide range of phenotypic variability between patients with similar or identical cytogenetic abnormalities.
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Affiliation(s)
- S A Yatsenko
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
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Loiselle C, Eby P, Peacock S, Lehman C, Kim J. Dynamic Contrast Enhanced MRI Kinetics and Invasive Breast Cancer: A Potential Prognostic Marker for Radiation Therapy. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zelefsky JR, Taylor CJ, Srinivasan M, Peacock S, Goodman RS, Key T, Watson PG, Cunningham ET. HLA-DR17 and Mooren's ulcer in South India. Br J Ophthalmol 2008; 92:179-81. [DOI: 10.1136/bjo.2007.127050] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lehman C, Gatsonis C, Kuhl C, Hendrick E, Pisano E, Hanna L, Peacock S, Smazal S, Maki D, Schnall M. Factors influencing performance of MRI in newly diagnosed breast cancer patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
604 Background: There is wide variation in the use of breast MRI to screen the contralateral breast in patients recently diagnosed with unilateral breast cancer. Some centers routinely scan all patients with a recent diagnosis of breast cancer while others restrict breast MRI to patients with dense breast tissue, patients who are pre-menopausal, or patients with infiltrating lobular carcinoma. This international study evaluated performance measures of MRI by mammographic density, menopausal status and type of index cancer. Methods: 969 women from 21 sites with a recent diagnosis of unilateral breast cancer and a negative mammogram and CBE of the contralateral breast underwent breast MRI. Presence of breast cancer in the contralateral breast was determined by cancer positive breast biopsy within 12 months after study entry. Performance measures of breast MRI (cancer yield, sensitivity, specificity, negative predictive value, positive predictive value, biopsy rate) were compared between participant subsets defined by mammographic density (fatty vs dense), menopausal status (pre/peri menopausal vs post menopausal) and type of index cancer (invasive vs in situ and lobular vs non-lobular). Results: Performance measures of breast MRI were not influenced by breast density or index cancer histology. Cancer yield of MRI in dense breast women was 3% in both fatty and dense breasted women. Although cancer yield and sensitivity of MRI did not vary based on menopausal status, specificity was significantly higher among post-menopausal women in comparison to pre- or peri-menopausal women (p-value=0.002) as was positive biopsy rate (p-value 0.009). Conclusions: Performance of MRI in screening the contralateral breast in the newly diagnosed breast cancer patient is not influenced by breast density or index cancer histology. Specificity and positive biopsy rate are higher in post-menopausal women, which may be related to hormonal influences on breast tissue enhancement. [Table: see text]
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Affiliation(s)
- C. Lehman
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - C. Gatsonis
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - C. Kuhl
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - E. Hendrick
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - E. Pisano
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - L. Hanna
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - S. Peacock
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - S. Smazal
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - D. Maki
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
| | - M. Schnall
- University of Washington, Seattle, WA; Brown University, Providence, RI; University of Bonn, Bonn, Germany; Northwestern University, Chicago, IL; University of North Carolina, Chapel Hill, NC; Radiology Imaging Associates, Denver, CO; Scottsdale Medical Imaging, Scottsdale, AZ; University of Pennsylvania, Philadelphia, PA
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van der Hoek K, Taylor SC, Peacock S, Johnston K, Melosky BL. Cost-effectiveness analysis (CEA) of third-line erlotinib therapy compared to best supportive care for advanced non-small cell lung cancer (NSCLC) in British Columbia (BC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7678 Background: Erlotinib was approved for funding as a systemic therapy treatment for 3rd line management of advanced NSCLC by the BC Cancer Agency (BCCA) in April 2004. BCCA patient outcome and cost data are routinely collected to verify the therapeutic effectiveness and cost-effectiveness of systemic treatment policies. Methods: This was a pragmatic retrospective analysis of all patients who received 3rd line erlotinib compared to a historical group treated with 2nd-line docetaxel then no further active treatment, both according to BCCA protocol. The primary end-point was cost-effectiveness, measured in terms of cost per-life-year-gained. Secondary end-points included: median overall survival (MOS); overall survival (OS) at 1 year; and comparison to phase III efficacy results. Data was retrieved from the Cancer Agency Information System (CAIS) and Systemic Therapy Data Warehouse. Life-years- gained were calculated from the area under the survival function curve. CEA took the BCCA perspective and costs included all direct drug costs for treatment of advanced disease. Sensitivity analyses included varying life expectancy across its 95% CI, cost to the extremes of ranges, and start date for length of survival: method 1. progression after 2nd line therapy or 3 weeks post last dose of chemotherapy for control group and start date of erlotinib for treatment group; method 2. last date of 2nd line therapy for both groups Results: 75 control and 70 erlotinib patients were included in the analysis. Results are presented in the table . The Incremental Cost-Effectiveness Ratio (ICER) was $28,516 per life-year-gained under method 1, and $17,632 under method 2. The erlotinib group had similar 1-year OS compared to literature (36 vs. 31%). Conclusions: Erlotinib appears to be cost-effective in terms of life-expectancy under a range of assumptions. No significant financial relationships to disclose. [Table: see text]
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Mabasa V, Taylor SC, Chu CC, Moravan V, Peacock S, Knowling M. Verification of imatiNib cost-effectiveness in advanced gastrointestinal stromal tumor in British Columbia (VINCE). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10049 Background: To evaluate the cost-effectiveness of imatinib in British Columbia Cancer Agency (BCCA) patients with advanced gastrointestinal stromal tumors (GIST) in terms of median overall survival (OS) and median progression-free survival (PFS). Results were also compared to imatinib literature reports. Methods: A pragmatic, retrospective medical record review identified BCCA patients with advanced GIST who received imatinib or historical treatment during successive, pre-specified time periods. Data was collected on survival, duration of therapy, progression free status, and cost of drug, labour and supplies. Primary outcome was the cost-effectiveness of imatinib based on median-OS (Kaplan Meier method). Secondary outcomes were cost-effectiveness based on median overall-PFS, cost of therapy per patient, 1-year OS, and 1-year PFS. This study was conducted from the perspective of the BCCA. Sensitivity analyses varying effectiveness over the 95% CI, cost over the range of treatment duration, discounting level at 0, 3 and 5%, and comparing effectiveness to literature controls were performed. Life expectancy (mean survival), was also calculated and used in the CE sensitivity analysis. Results: Forty-six and 47 patients in the imatinib and historical groups respectively were analyzed. Median-OS in the imatinib group was 66.7 months (95% CI 61.7, infinity) compared to 7.7 months (95% CI 6.0, 12.6) in the historical group. Median-PFS was 45.3 months (95% CI 24.4, infinity) and 5.6 months (95% CI 3.5, 8.5) respectively. The 1-year OS and 1-year PFS for the imatinib group was 95.4% (95% CI 82.9, 99.2) and 81.4% (95% CI 66.1, 91.1) compared to 32.6% (95% CI 20.0, 48.1) and 17.4% (95% CI 8.3 - 32.0) in the historical group. No difference was seen between the imatinib study results and literature reports. The annual incremental cost-effectiveness ratio was $15,882 per median life year gained and $23,603 per median year of PFS for imatinib. Conclusions: Imatinib for advanced GIST is a cost- effective treatment in BC. Results were robust across the range of sensitivity analyses performed. No significant financial relationships to disclose.
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Affiliation(s)
- V. Mabasa
- BC Cancer Agency, Vancouver, BC, Canada
| | | | - C. C. Chu
- BC Cancer Agency, Vancouver, BC, Canada
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Loh GW, Taylor SC, Peacock S, Moravan V, Krahn M, Sehn L. Cost-effectiveness (CE) analysis of CHOP and rituximab for diffuse large B-cell lymphoma (DLBCL) in British Columbia (BC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.6623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6623 Background: The BC Cancer Agency (BCCA) provides province-wide, population-based care. Outcomes are monitored to verify therapeutic effectiveness and justify funding for systemic treatment policies. The CE of rituximab with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) (CHOP-R) for DLBCL was compared to its predecessor, CHOP alone. Methods: This was a pragmatic population-based CE analysis based on the original cohort of advanced DLBCL patients described by Sehn et al (JCO 2005) who received either CHOP or CHOP-R between Sept 1999 and Aug 2002 (18-months pre and post availability of rituximab in BC) according to standard BCCA treatment policy at the time. The primary endpoint was CE in terms of life-expectancy (LE) at a median follow-up of 4 years (cost-per-life-year-gained). Costs were incorporated into a decision analysis including primary systemic therapy and downstream chemotherapy, radiotherapy, and stem-cell transplant (SCT). Actual incidence of each downstream therapy was converted to a probability for each group. Downstream therapy costs were then multiplied by these probabilities and added to the respective primary treatment costs. The CE analysis took the BCCA perspective which includes all direct costs for active cancer treatment, and hospitalization for SCT, but not ambulatory supportive care. Sensitivity analyses varying LE to the extremes of its 95% CI, modeling out to 15 years and discounting at 0, 3, and 5% were performed. Results: 292 patients were included and categorized to treatment received: 148 CHOP and 144 CHOP-R (median follow- up 5.4 and 4 years respectively). LE to 4 years was 30.18 months for CHOP and 39.44 for CHOP-R. OS at 4 years was 48.8% and 70.1% for CHOP and CHOP-R respectively (p<0.0001) Respective costs of primary and downstream therapy were $4,682 and $7,198 for CHOP versus $26,366 and $6,228 for CHOP-R. The incremental CE ratio at 4 years median follow-up was $26,844 CDN per life year gained. Results were robust across univariate sensitivity analyses conducted. Conclusions: At 4 years median follow-up, CHOP-R improves LE and appears to be economically attractive at conventional thresholds. CE is an increasingly useful tool for the BCCA in making decisions about new cancer therapies. No significant financial relationships to disclose.
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Affiliation(s)
- G. W. Loh
- BC Cancer Agency, Vancouver, BC, Canada; University of Toronto, Toronto, ON, Canada
| | - S. C. Taylor
- BC Cancer Agency, Vancouver, BC, Canada; University of Toronto, Toronto, ON, Canada
| | - S. Peacock
- BC Cancer Agency, Vancouver, BC, Canada; University of Toronto, Toronto, ON, Canada
| | - V. Moravan
- BC Cancer Agency, Vancouver, BC, Canada; University of Toronto, Toronto, ON, Canada
| | - M. Krahn
- BC Cancer Agency, Vancouver, BC, Canada; University of Toronto, Toronto, ON, Canada
| | - L. Sehn
- BC Cancer Agency, Vancouver, BC, Canada; University of Toronto, Toronto, ON, Canada
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Peacock S, Apicella C, Andrews L, Tucker K, Bankier A, Daly MB, Hopper JL. A discrete choice experiment of preferences for genetic counselling among Jewish women seeking cancer genetics services. Br J Cancer 2007; 95:1448-53. [PMID: 17102813 PMCID: PMC2360609 DOI: 10.1038/sj.bjc.6603451] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
To determine which aspects of breast cancer genetic counselling are important to Ashkenazi Jewish women, a discrete choice experiment was conducted. Participants consisted of 339 Australian Ashkenazi Jewish women who provided a blood sample for research used to test for Ashkenazi Jewish ancestral mutations in the genes BRCA1 and BRCA2, and were offered their genetic test result through a cancer genetics service. Main outcome measures were women's preferences for, and trade-offs between, the genetic counselling aspects of providing cancer, gene, and risk information (information); giving advice about cancer surveillance (surveillance); preparing for genetic testing (preparation); and, assistance with decision-making (direction). Respondents most valued information, about twice as much as advice about surveillance, four times as much as preparation for testing, and nine times as much as assistance with decision-making, which was least valued. Women's preferences were consistent with the major goals of genetic counselling, which include providing information and surveillance advice, and avoiding direction by facilitating autonomous decision-making. There were differences between the women in which aspects they most favoured, suggesting that counselling that elicits and responds to clients’ preferences is more likely to meet clients’ needs.
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Affiliation(s)
- S Peacock
- British Columbia Cancer Agency, Cancer Control Research, 675 West 10th Avenue, Vancouver, British Columbia V5Z 1L3, Canada
- Department of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, British Columbia V6T 1Z3, Canada
| | - C Apicella
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Level 2, 723 Swanston Street, Carlton, Victoria 3053, Australia
| | - L Andrews
- Hereditary Cancer Clinic, Prince of Wales Hospital, High St, Randwick, New South Wales 2031, Australia
| | - K Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, High St, Randwick, New South Wales 2031, Australia
| | - A Bankier
- Genetic Health Services Victoria, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
| | - M B Daly
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111-2497, USA
| | - J L Hopper
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Level 2, 723 Swanston Street, Carlton, Victoria 3053, Australia
- E-mail:
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McCarthy M, Beaumont JG, Thompson R, Peacock S. Modality-specific aspects of sustained and divided attentional performance in multiple sclerosis. Arch Clin Neuropsychol 2005; 20:705-18. [PMID: 15913949 DOI: 10.1016/j.acn.2005.04.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Accepted: 04/05/2005] [Indexed: 11/25/2022] Open
Abstract
While the prevalence of cognitive impairment in multiple sclerosis is well documented, few studies have systematically investigated the profile of attentional abilities. In the current study, 30 MS participants were assessed on measures of sustained and divided attention and compared to a sample of 30 neurologically intact healthy controls. Performance on visual and auditory unimodal and bimodal trials were conducted for measures of both forms of attention. A three-factor mixed measures analysis of variance (groupxtaskxmodality) was conducted. MS participants were impaired relative to controls on all measures of speed and accuracy across unimodal and bimodal trials and more impaired on measures of divided attention than on sustained attention measures. Performance on the bimodal trials was also significantly compromised relative to the unimodal trials especially on the divided attention task. The theoretical and clinical implications of these findings are discussed.
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Affiliation(s)
- M McCarthy
- School of Human and Life Sciences, Roehampton University, Whitelands College, Holybourne Avenue, London SW15 4JD, UK.
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Abstract
BACKGROUND Rest-activity and sleep-wake cycles are controlled by the endogenous circadian rhythm generated by the suprachiasmatic nuclei (SCN) of the hypothalamus. Degenerative changes in the SCN appear to be a biological basis for circadian disturbances in people with dementia, and might be reversed by stimulation of the SCN by light. OBJECTIVES The review assesses the efficacy of bright light therapy (BLT) in managing sleep, behaviour, mood, and cognitive disturbances associated with dementia. SEARCH STRATEGY The trials were identified from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 27 January 2004 using the terms "bright light*", "light box*", "light visor*", "dawn-dusk*", phototherapy (MESH), phototherapy, "photo therapy", "light therapy" "light treatment", light*. SELECTION CRITERIA All relevant, randomized controlled trials in which BLT, at any intensity and duration, was compared with a control group for the effect on managing sleep, behavioural, mood, and cognitive disturbances (as well as changes in institutionalization rates and cost of care) on people with dementia of any degree of severity. DATA COLLECTION AND ANALYSIS Three reviewers independently assessed the retrieved articles for relevance, methodological quality, and extracted data from the selected studies. The statistically significant differences in changes in outcomes from baseline to end of treatment and from baseline to follow-up between the light therapy and control groups were examined. Each study was summarized using a measure of effect (e.g. mean difference). Owing to lack of homogeneity between studies, their results were not combined. MAIN RESULTS Five studies met the inclusion criteria. However, only three were included in the analyses because of inappropriate analyses reported or inability to retrieve the required data from the investigators. This review revealed no adequate evidence of the effectiveness of BLT in managing sleep, behaviour, and mood disturbances associated with dementia. REVIEWERS' CONCLUSIONS There is insufficient evidence to assess the value of BLT for people with dementia. The available studies are of poor quality and further research is required.
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Affiliation(s)
- D Forbes
- Faculty of Nursing, University of Saskatchewan, 107 Wiggins Road, Saskatoon, Saskatchewan, Canada, S7N 5E5
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Smith RS, Shiel RS, Bardgett RD, Millward D, Corkhill P, Rolph G, Hobbs PJ, Peacock S. Soil microbial community, fertility, vegetation and diversity as targets in the restoration management of a meadow grassland. J Appl Ecol 2003. [DOI: 10.1046/j.1365-2664.2003.00780.x] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Andersen MR, Peacock S, Nelson J, Wilson S, McIntosh M, Drescher C, Urban N. Worry about ovarian cancer risk and use of ovarian cancer screening by women at risk for ovarian cancer. Gynecol Oncol 2002; 85:3-8. [PMID: 11925113 DOI: 10.1006/gyno.2001.6556] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study examined reports of perceived risk of ovarian cancer, worry, and screening use in a large sample of women. While screening for asymptomatic women is not generally recommended, in 1994 a consensus conference concluded that women with multiple affected relatives are at high risk for ovarian cancer and should be encouraged to participate in screening. The consensus report also suggested that women with a single affected first-degree relative are at elevated risk and while these women were not encouraged to get screening it was suggested that they may choose to pursue screening outside of a randomized trial [NIH Consensus Conference. JAMA 1995;273(6) 491-7]. METHODS A total of 3257 women participated in this research by completing a mailed survey on ovarian cancer risk, worry, and use of screening. One hundred forty-two of these women were at high risk for this disease due to a strong family history. An additional 144 women were at elevated risk due to a single first-degree affected relative with ovarian cancer. RESULTS Family history did predict perceived risk, difficulties due to worry, and use of ovarian cancer screening. However, the group of women most likely to report high levels of perceived risk and to have received screening for ovarian cancer were women with a single affected relative rather than those at high risk, for whom screening is recommended. CONCLUSIONS These results suggest that many women need additional education about ovarian cancer risk. Most women overestimated their risk for this disease. Some average-risk women get screening although it is not recommended outside of randomized trials, and a significant percentage of women at high risk fail to get recommended screening.
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Affiliation(s)
- M R Andersen
- Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
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Wright RM, Moore JE, Shaw A, Dunbar K, Dodd M, Webb K, Redmond AO, Crowe M, Murphy PG, Peacock S, Elborn JS. Improved cultural detection of Burkholderia cepacia from sputum in patients with cystic fibrosis. J Clin Pathol 2001; 54:803-5. [PMID: 11577134 PMCID: PMC1731301 DOI: 10.1136/jcp.54.10.803] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To evaluate the sensitivity and specificity of two selective media for the isolation of Burkholderia cepacia from sputum specimens in patients with cystic fibrosis (CF). METHODS In total, 149 expectorated sputum specimens from 113 patients with CF (32 cepacia colonised patients and 81 non-cepacia colonised patients) attending three CF centres were examined for the presence of B cepacia on two selective media: (1) MAST selective agar, a commercially available selective medium widely used in the UK and (2) BCSA (B cepacia selective agar), a new medium recently described, which is used predominantly in North America. RESULTS Burkholderia cepacia was isolated from 53 of 149 (35.6%) specimens examined, representing 32 of 113 (28.3%) patients, using both the MAST and BCSA media. Growth was most rapid on BCSA with all (53 of 53) isolates detectable after 48 hours, compared with 50 of the 53 isolates on MAST agar, with the remaining three isolates detectable at five days. Twenty eight contaminants were identified on MAST agar and 13 on BCSA agar; mainly Alcaligenes xylosoxidans and yeast on MAST agar and Flavobacterium indologenes on BCSA medium. BCSA was equivalent to MAST agar in its ability to isolate B cepacia from patients with CF with a history of B cepacia infection. CONCLUSIONS The increased selectivity and reduced time to detection of BCSA makes it an attractive alternative to MAST. However, its present limited commercial availability in the UK may delay its use in routine diagnostic laboratories because of complications with media preparation and quality control.
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Affiliation(s)
- R M Wright
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast BT9 7AD, Northern Ireland, UK
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Abstract
BACKGROUND Colon carcinoma is a common malignancy that accounts for a substantial share of all cancer-related morbidity and mortality. However, little is known with regard to general and disease specific quality of life in survivors of colorectal carcinoma, particularly from community-based samples of cases across stage and survival times from diagnosis. METHODS Subjects with colorectal carcinoma were recruited from the National Cancer Institute's Surveillance, Epidemiology, and End Results cancer registry. Subjects completed two self-administered surveys: the Functional Assessment of Cancer Therapy Scales for Colorectal Cancer (FACT-C) and the Health Utilities Index (HUI) Mark III. RESULTS One hundred seventy-three respondents (average age: 70.4 years, 71.4% female) completed the survey. In the first 3 years after diagnosis, quality of life was lower and varied substantially among respondents. After 3 years, respondents in all TNM stages of disease except Stage IV reported a relatively uniform and high quality of life. Pain, functional well-being, and social well-being were affected most substantially across all stages and times from diagnosis. Low income status was associated with worse outcomes for pain, ambulation, and social and emotional well-being. Only emotional well-being scores improved significantly over time in both surveys. CONCLUSIONS Those individuals who achieve a long term remission from colorectal carcinoma may experience a relatively high quality of life, although deficits remain for several areas, particularly in those of low socioeconomic status. Sampling design may have excluded the most severely ill patients.
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Affiliation(s)
- S D Ramsey
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Day N, Davies C, Enright M, Peacock S, Berendt A, Spratt B. Do bacterial factors determine severe Staphylococcus aureus disease? J Infect 2000. [DOI: 10.1016/s0163-4453(00)80055-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Health service funding mechanisms are pivotal in the pursuit of health system objectives, as they provide strong financial incentives for actors in the system to achieve policy goals. Underpinning funding mechanisms is a set of key economic principles, or objectives, that should guide their design and use: efficiency, equity, and accountability. The Australian health system has historically performed relatively poorly in relation to these objectives, with evidence of inefficiencies, inequities, and poor accountability in many areas of health services. The primary cause of these shortcomings may lie in the complex set of funding and delivery arrangements at the State and Federal levels of government. Potentially significant improvements in the performance of the health system would be available from the integration of the funding and delivery of services within a single tier of government, coupled with the development of a national weighted capitation approach to funding. To develop a national capitation funding model a number of unique factors require consideration, including the current fragmentation of services, the role of the private sector, the needs of indigenous populations, and the effects of rurality. The data available to develop a capitation model is of a level of detail and quality not readily found elsewhere. If policy statements promoting efficiency, accountability, and particularly equity are to be actively pursued, a national capitation model based on robust methods should become a cornerstone of Australian health system reform.
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Affiliation(s)
- S Peacock
- Health Economics Unit, Monash University, West Heidelberg, Victoria, Australia.
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Peacock S, Visbeck M, Broecker W. Deep water formation rates inferred from global tracer distributions: An inverse approach. Inverse Methods in Global Biogeochemical Cycles 2000. [DOI: 10.1029/gm114p0185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Abstract
OBJECTIVE The objective of this study was to examine the effect of breast density and age on screening mammograms with false-positive findings. MATERIALS AND METHODS The study sample was taken from the Washington State Mammography Tumor Registry, which links data from participating radiologists with the Puget Sound Cancer Surveillance System and the Washington State Cancer Registry. Participants (n = 73,247) were women 35 years old and older who underwent screening mammography for which an assessment and a four-category density rating were coded. A total of 46,340 mammograms were sampled to avoid interpreter bias. In this study of false-positive mammograms, only women with no diagnosis of breast cancer within 12 months of the index mammogram were included. Logistic regression was used to estimate the odds ratios of a false-positive mammogram being associated with each category of breast density or age, adjusting for the other factor as a covariate. RESULTS After controlling for breast density, we found that the risk of a false-positive mammogram was not affected by age (p = 27). However, the trend of increasing risk of a false-positive mammogram with increasing breast density was highly significant (p < .001). Women with extremely dense breast tissue were almost two times more likely to have a false-positive mammogram than were women with fatty breast tissue. This effect persisted after controlling for age. CONCLUSION Breast density, not age, is an important factor when predicting risk of a false-positive mammogram. Breast density should be considered when educating individual women on the risks and benefits of screening mammography.
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Affiliation(s)
- C D Lehman
- Department of Radiology, University of Washington Medical Center, Seattle 98195-7115, USA
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Davies C, Peacock S, Day N, Berendt A. Clinical correlates of adhesion and slime production in coagulase-negative staphylococcal prospthetic joint infection. J Infect 1999. [DOI: 10.1016/s0163-4453(99)90156-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Thomas MG, Peacock S, Daenke S, Berendt AR. Adhesion of Staphylococcus aureus to collagen is not a major virulence determinant for septic arthritis, osteomyelitis, or endocarditis. J Infect Dis 1999; 179:291-3. [PMID: 9843360 DOI: 10.1086/314576] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Mullin W, Peacock S, Loewen D, Turner N. Macronutrients content of Yellow Glacier Lily and Balsamroot; root vegetables used by indigenous peoples of northwestern North America. Food Res Int 1997. [DOI: 10.1016/s0963-9969(98)00044-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Severe cytomegalovirus (CMV) infection is rare in previously healthy immunocompetent individuals; to our knowledge, only thirty-four such cases have been reported in the worldwide literature. Multiorgan involvement was associated with a high mortality rate among these patients. Disease that clinically involves only the liver or lungs could be fatal; in contrast, none of the patients with isolated central nervous system infection died. Although few patients were treated with specific antiviral therapy, five of six patients with severe infection recovered after receiving therapy with ganciclovir or foscarnet. The rarity of severe CMV disease in immunocompetent patients probably precludes the performance of a clinical trial to evaluate the efficacy of specific antiviral therapy. However, the historically poor prognosis in the absence of such therapy suggests that rapid diagnosis of CMV disease and early instigation of specific treatment may be important.
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Affiliation(s)
- M Eddleston
- Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, United Kingdom
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Taylor VM, Taplin SH, Urban N, White E, Mahloch J, Majer K, McLerran D, Peacock S. Community organization to promote breast cancer screening ordering by primary care physicians. J Community Health 1996; 21:277-91. [PMID: 8842890 DOI: 10.1007/bf01794878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Community organization has been viewed as a promising approach to changing preventive behaviors. We evaluated the impact of community organization strategies to promote breast cancer screening ordering by primary care physicians in Washington State. Physicians practicing in two intervention and two control communities were surveyed by mail pre-intervention (1989) and post-intervention (1993). Intervention activities targeting the health care sector included the formation of local physician planning groups, a series of informational mailings, medical office staff training sessions, and reminder system support. There were no significant post-intervention differences in the self-reported mammography ordering of physicians practicing in the intervention and control areas. Over the four-year study period, the proportions of physicians who ordered regular mammography increased by 36%. By 1993, over 80% of the respondents routinely used mammographic screening. Concerns about the high price of mammograms and inadequate insurance coverage were significantly reduced over time in both community pairs. Also, use of patient reminder systems increased significantly between 1989 and 1993. Secular trends resulting from diffusion of strategies to promote mammography were responsible for increases in physician ordering of the procedure. Year 2000 goals for breast cancer screening use by physicians may already have been met in some communities.
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Affiliation(s)
- V M Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98104, USA
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Peacock S, Murray V, Turton C. Respiratory distress and royal jelly. BMJ 1995; 311:1472. [PMID: 8520337 PMCID: PMC2543717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- S Peacock
- Royal Sussex County Hospital, Brighton
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Abstract
OBJECTIVE To investigate the frequency of placenta previa among Asian women. METHODS We conducted a population-based case-control study using Washington state birth certificate data from 1984-1987. Our study population included 810 women with pregnancies complicated by placenta previa and 2917 randomly selected controls. Unconditional logistic regression was used to estimate odds ratios (OR) and their 95% confidence intervals (CI), and interaction terms were used to examine effect modification. Potential confounding by maternal age, gravidity and parity, maternal smoking during pregnancy, and a history of abortion or cesarean delivery was adjusted for in the analysis. RESULTS The frequency of placenta previa during the study period was 3.3 per 1000 live births. Women of Asian origin were 86% more likely (OR 1.86, 95% CI 1.38-2.51) to have a delivery complicated by placenta previa than were white women. This association was stronger among women without a previous live birth (OR 2.51, 95% CI 1.57-4.01) than those who previously had experienced a live birth (OR 1.50, 95% CI 1.01-2.25). CONCLUSION Asian women residing in the United States are at increased risk of placenta previa. If confirmed by others, our results suggest that obstetricians should consider meticulous ultrasound evaluations during pregnancy to rule out the presence of placenta previa in Asian-American women.
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Affiliation(s)
- V M Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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