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Bagai P, Sharma P, Ansari A, Singh N, Sharma S, Singh P, Chougule D, Singh MK, Singh G, Singh S. Patient Advocates for Clinical Research (PACER): A Step Toward Ethical, Relevant, and Truly Participatory Clinical Research in India. Cureus 2024; 16:e58454. [PMID: 38765448 PMCID: PMC11100276 DOI: 10.7759/cureus.58454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Background Clinical research presents a promising path for improving healthcare in contemporary India. Yet, researchers identify gaps in trust, awareness, as well as misconceptions about being a '"guinea pig." We proposed building the capacity of training patient advocacy groups (PAGs) in patient-centered clinical research and through them creating aware patients as research partners. Methodology Patient Advocates for Clinical Research (PACER) is a tiered program to share information and education about clinical research with PAGs. Tier one is a self-paced online learning course, followed by workshops on clinical research, Good Clinical Practice, research consent, case studies, and group discussions. Results A total of 20 PAGs represented by 48 participants, active in areas of pediatric cancer, breast cancer, multiple myeloma, type I diabetes, spinal muscular atrophy, sickle cell disease, and inflammatory bowel diseases, participated. Among 48 participants 30 successfully completed the online course (multiple-choice question evaluation score cut-off >70%), attaining an average score of 23.9 ± 2.1 out of 30. Overall, 48 participants attended workshop 1 and 45 workshop 2, with 140 participants joining the focus group discussion (FGD). An overall improvement of 9.4% (𝜒2 = 46.173; p < 0.001) for workshop 1 and 8.2% (𝜒2 = 25.412; p < 0.001) for workshop 2 was seen in knowledge gain about clinical research. The FGD raised issues such as misleading information from research teams, unethical recruitment, incomprehensible information sheets, and limited trial-related knowledge fostering fear of participation in clinical research. Conclusions Multimodal and tiered learning of clinical research such as that used by PACER has a good participatory and learning response from PAGs and may be further explored.
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Affiliation(s)
- Poonam Bagai
- Pediatric Cancer Research Institute, CanKids KidsCan, New Delhi, IND
| | - Pooja Sharma
- Obstetrics and Gynecology, APAR Health, Gurugram, IND
| | - Aala Ansari
- Pediatric Cancer Research Institute, CanKids KidsCan, New Delhi, IND
| | - Nirbhay Singh
- Patient Navigation, Advocacy, and Family Engagement, CanKids KidsCan, New Delhi, IND
| | - Sonal Sharma
- Patient Navigation, Advocacy, and Family Engagement, CanKids KidsCan, New Delhi, IND
| | - Padam Singh
- Clinical Research, Medanta Institute of Education and Research, Gurugram, IND
| | - Durga Chougule
- Clinical Research, Medanta Institute of Education and Research, Gurugram, IND
| | - Manish Kumar Singh
- Clinical Research, Medanta Institute of Education and Research, Gurugram, IND
| | - Gargi Singh
- Clinical Research, Medanta Institute of Education and Research, Gurugram, IND
| | - Sanjeev Singh
- Amrita Institute of Medical Sciences, Amrita Hospital, Faridabad, IND
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Bhatia KP, Ganguly S, Sasi A, Kumar V, Agarwala S, Meel R, Khan SA, Pushpam D, Bagai P, Sharma S, Ahamad N, Kumari M, Bakhshi S. Sex Bias in Treatment Abandonment of Childhood Cancer in India. Indian J Pediatr 2024:10.1007/s12098-023-05010-z. [PMID: 38270753 DOI: 10.1007/s12098-023-05010-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To explore the magnitude of sex bias and determinants of treatment abandonment (TA) in childhood cancer in India. METHODS Individual data of children (0-19 y) registered between January 1, 2017 and July 31, 2022, was compiled. TA was defined as defaulting curative intent treatment ≥4 wk. Defaulting treatment irrespective of intent ≥4 wk was defined as Treatment Default (TD). The primary outcome was the proportion of male-to-female children with TA. Secondary outcomes included the proportion of male-to-female children with upfront TA, TA at relapse, TD, TD-p (TD only in the palliative setting). The impact of clinico-demographic factors on TA was analysed using multivariable regression and propensity score matching (PSM). RESULTS Three thousand two hundred eighty four patients were analysed. The overall male-to-female ratio (MFR) was 2.08 (95% CI 1.94-2.24). Of 2906 patients treated with curative intent, 415 (14·3%) abandoned treatment. TA was higher in females than males (16·4% vs. 13·3%; p = 0·022) with adjusted MFR of 0·81 (0·66-0·98). The adjusted MFR of TA for treatment-naïve and relapsed patients and TD were 0·73 (0·59-0·91), 1·13 (0·65-1·96) and 0·84 (0·71-1·00) respectively. Sex independently predicted TA on multivariable analysis. However, on PSM analysis including socio-economic variables, lower maternal education predicted higher TA in children with cancer (10·1% vs. 6%, p = 0·015). CONCLUSIONS Child sex predicted TA in childhood cancer in India with more females abandoning treatment. Maternal education is a more crucial factor predicting TA over child sex, when socio-economic factors were considered. Hence, policies promoting female education and gender equality may mitigate sex-based gaps in childhood cancer care.
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Affiliation(s)
- Kanu Priya Bhatia
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shuvadeep Ganguly
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Archana Sasi
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vivek Kumar
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sandeep Agarwala
- Department of Pediatric Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rachna Meel
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shah Alam Khan
- Department of Orthopedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Deepam Pushpam
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Poonam Bagai
- CanKids KidsCan, National Society for Change for Childhood Cancer in India, New Delhi, India
| | - Sonal Sharma
- CanKids KidsCan, National Society for Change for Childhood Cancer in India, New Delhi, India
| | - Nasim Ahamad
- CanKids KidsCan, National Society for Change for Childhood Cancer in India, New Delhi, India
| | - Mamta Kumari
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
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Tsimicalis A, Arora RS, Bagai P, Ranasinghe N, Zubieta M. Patient‐led research and Advocacy Efforts. Cancer Rep (Hoboken) 2022; 5:e1657. [PMID: 35703915 PMCID: PMC9199502 DOI: 10.1002/cnr2.1657] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Argerie Tsimicalis
- Ingram School of Nursing and Gerald Bronfman Department of Oncology Faculty of Medicine and Health Sciences, McGill University Quebec Canada
| | | | - Poonam Bagai
- Department of Medical Projects and Social Support Program Cankids Kidscan New Delhi India
| | - Neil Ranasinghe
- SIOP GLobal Health Network, International Society of Paediatric Oncology SIOP Global Health Network London UK
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Sharma J, Arora RS, Trehan A, Bakhshi S, Hazarika M, Verma N, Malhotra P, Tripathi R, Majhi I, Lowe J, William J, Bagai P, Guilmoto C, Arora R. Diagnosis interval is the largest contributor to time to diagnosis and treatment for childhood cancer patients in India results of the InPOG-ACC-16-02 study. Pediatric Hematology Oncology Journal 2022. [DOI: 10.1016/j.phoj.2022.10.246] [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: 11/27/2022] Open
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Bansal R, Aishwarya A, Rao R, Christy MC, Sen M, Regani H, Bagai P, Reddy VA, Mulay K, Bongoni P, Honavar SG. Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children. Indian J Ophthalmol 2021; 69:2617-2624. [PMID: 34571599 PMCID: PMC8597487 DOI: 10.4103/ijo.ijo_2243_21] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose The novel coronavirus SARS-CoV-2 (COVID-19) and the resultant nationwide lockdown and travel restrictions led to difficulty in providing timely and regular treatment to patients with childhood cancers such as retinoblastoma. This study is aimed at assessing the demography, clinical presentation, treatment strategies, and outcome of treatment defaulters due to the lockdown. Methods Cross-sectional, observational study of retinoblastoma patients at a tertiary care ocular oncology center during the first wave of COVID-19 and the resulting nationwide lockdown. Results Of the 476 eyes of 326 patients undergoing active management with a median age of 57 months (range: 4-214 months), 205 (63%) patients returned for follow-up after a mean delay of 45.8 ± 24.3 weeks (range: 8-80 weeks) and 121 (37%) were defaulters according to the data analyzed till June 30, 2021. Distance of residence was ≥1000 km for 148 patients (46%). In terms of need for active treatment, the number of emergent cases was 2 (<1%), 11 (3%) were urgent, and 313 (96%) were semi-urgent. International classification groups D (n = 107 eyes, 23%) and E (n = 173 eyes, 36%) were in majority, and 13 eyes (4%) and 4 eyes (1%) were at stages 3 and 4, respectively. Prior to lockdown, 86 eyes (18%) had active tumor, which remained unchanged (n = 26, 30%) or worsened (n = 49, 60%) after failure to follow-up. Vision (47%), eye (92%), and life salvage (98%) were achieved by individualized protocol-based management after the patients returned for further management. Five children succumbed to intracranial extension. Conclusion The COVID-19-related nationwide lockdown has deprived retinoblastoma patients of optimal and timely management, leading to prolonged treatment interruptions, delays, permanent default, and death. It is of paramount importance for all the stakeholders to increase awareness, make necessary travel and logistic arrangements, and ensure continuity of care for children with retinoblastoma.
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Affiliation(s)
| | | | - Raksha Rao
- Narayana Nethralaya, Bangalore, Karnataka, India
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Mahajan A, Arora RS, Sahi PK, Gomber S, Radhakrishnan N, Bagchi B, Jain P, Kumar A, Singh A, Gupta H, Sharma S, Ahamad N, Bagai P, Kumar A. Shared care for children with cancer in India through social and healthcare partnerships during the COVID-19 pandemic. Cancer Rep (Hoboken) 2021; 5:e1486. [PMID: 34180154 PMCID: PMC8420228 DOI: 10.1002/cnr2.1486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/05/2021] [Revised: 05/31/2021] [Accepted: 06/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background The COVID pandemic posed a challenge for the tertiary centers to continue treatment. Some tertiary centers were designated as COVID‐only hospitals, making it difficult for existing childhood cancer patients to continue their treatment at those centres. The need for shared care in childhood cancer was perceived by Cankids and its partnering childhood cancer‐treating centers in North and East India. Aim We aim to show how Cankids upscaled its shared care model to ensure that COVID designated hospitals connected with other hospitals who have to continue to provide care to childhood cancer patients in the pandemic and thus ensured the continuation of treatment for these patients. Methods and result The need assessment of the beneficiaries was done in discussion with the hospital of origin and destination hospital. The need for shared care was also discussed with the families and consent was taken before shifting their children. Cankids with the help of advisors identified cases of high risk that need immediate attention, proactive regular monitoring, and help in care planning with the perspective and recommendation of the multiple providers. The shared care unit came forward with reasonable and discounted packages for treatment. There was a total of five hospitals requiring shared care, and 55 children were supported from April to November 2020. The median age was 8 years and their hospital of origin are in Bihar, Uttar Pradesh, West Bengal, and Delhi. The expenditure on the treatment of the 55 patients was INR 61 61 636 ($ 84 843), with a median of INR 41765 (IQR 19491–174 129) on each patient. Total 291 trips for the transport were arranged and all the patients combined stayed 174 days at Cankids accommodation facility. Conclusion The shared care helped the patients access standard treatment and reduce the financial burden.
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Affiliation(s)
- Amita Mahajan
- Department of Pediatrics Oncology and Hematology, Indraprastha Apollo Hospital, Delhi, India
| | | | - Puneet Kaur Sahi
- Department of Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital, Delhi, India
| | - Sunil Gomber
- Department of Pediatric, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Nita Radhakrishnan
- Department of Paediatric Hemato-Oncology, Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida, Uttar Pradesh, India
| | - Basab Bagchi
- Department of Medical Oncology & Haematology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Prachi Jain
- Department of Pediatric Oncology, Max Super Specialty Hospital, Vaishali, Delhi, India
| | - Arvind Kumar
- Department of Hemato-Oncologist, Buddha Cancer Centre, Patna, Bihar, India
| | - Avinash Singh
- Department of Hemato-Oncology, Paras HMRI Hospital, Patna, Bihar, India
| | - Haresh Gupta
- Department of Medical Projects and Social Support Program, Cankids Kidscan, Delhi, India
| | - Sonal Sharma
- Department of Medical Projects and Social Support Program, Cankids Kidscan, Delhi, India
| | - Nasim Ahamad
- Department of Medical Projects and Social Support Program, Cankids Kidscan, Delhi, India
| | - Poonam Bagai
- Department of Medical Projects and Social Support Program, Cankids Kidscan, Delhi, India
| | - Arvind Kumar
- Department of Medical Projects and Social Support Program, Cankids Kidscan, Delhi, India
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Rathore V, Taluja A, Arora PR, Bagai P, Kapoor G, Seth R, Arora RS. Delivery of services to childhood cancer survivors in India: A national survey. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_6_20] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Continuum of care is an important concern for childhood cancer survivors. Studies from high-income countries indicate a significant development in services to these survivors. Similar information is unavailable from India. Methods: An online survey form was developed and sent to 86 centers. Data were collected over a 6-month period in 2017. Results: Fifty nine centers responded (44.1% private sector, 33.9% public, and 22.0% charitable trust). The services are mainly provided (91%) within routine oncology clinics. There is no upper age limit (61%) or time period limit (63%) for follow-up at most of the centers. The major barriers for follow-up are distance, lack of knowledge, lack of adequate facilities, and patient priority for follow-up. Conclusion: This survey provides baseline information on current service provided to childhood cancer survivors in India. There is a need to inform, educate, and sensitize the survivor and their family as well as improving services.
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Affiliation(s)
- Vatsna Rathore
- Department of Quality Care, Research and Impact, Can Kids, New Delhi, India
| | - Ankit Taluja
- Department of Quality Care, Research and Impact, Can Kids, New Delhi, India
| | - Puneet Rana Arora
- Department of Reproductive Medicine, Milann Fertility Centre, New Delhi, India
| | - Poonam Bagai
- Department of Quality Care, Research and Impact, Can Kids, New Delhi, India
| | - Gauri Kapoor
- Department of Pediatric Hematology and Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Rachna Seth
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Ramandeep Singh Arora
- Department of Quality Care, Research and Impact, Can Kids; Department of Medical Oncology, Max Super Speciality Hospital, New Delhi, India
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Arora RS, Bagai P, Bhakta N. Estimated National and State Level Incidence of Childhood and Adolescent Cancer in India. Indian Pediatr 2021; 58:417-423. [PMID: 33980727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Hitherto, incidence burden of childhood cancer in India has been derived from GLOBOCAN data. Recent analyses have challenged whether this accurately measures the true incidence of childhood cancer. OBJECTIVE To use observed data rather than simulation to estimate the number of children (0-14 years), as well as number of children and adolescents (0-19 years), in India who develop cancer every year at the national and state/union territory (UT) level. METHODS Age-specific (five year groups), sex-specific, and state/UT specific population data from India Census 2011 was used. Global average incidence rates from the International Incidence of Childhood Cancer 3 (IICC3) report were used. Incidence rates per million person-years for the 0-14 years and 0-19 years age groups were age-adjusted using the world standard population to provide age-standardized incidence rates, using the age-specific incidence rates for individual age groups (0-4 years, 5-9 years, 10-14 years, and 15-19 years). RESULTS The national number of children (0-14 years) and, children and adolescents (0-19 years) that may develop cancer every year based on 2011 census are 52,366 and 76,805 persons respectively. Cancer type specific incidence is provided for each state/UT for these age ranges. This national incidence is approximately double of the GLOBOCAN 2018 estimates of incidence of children diagnosed and registered with cancer and the differential is greater in girls. CONCLUSIONS Our analysis proposes new estimates of incident childhood cancer cases in India for children and adolescents. Future regional, national and international research on childhood cancer epidemiology and healthcare accessibility would help further refine these estimates.
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Affiliation(s)
- Ramandeep Singh Arora
- Department of Medical Oncology, Max Super Speciality Hospital, Saket, New Delhi, India and Quality Care, Research and Impact, Can Kids, New Delhi, India. Correspondence to: Dr Ramandeep Singh Arora, Consultant Pediatric Oncology, Department of Medical Oncology, Max Super-Speciality Hospital, Saket, New Delhi, India.
| | - Poonam Bagai
- Quality Care, Research and Impact, Can Kids, New Delhi, India
| | - Nickhill Bhakta
- Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, USA
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Kakkar S, Anand V, Mahajan M, Sandhu P, Rana M, Singh K, Kaur A, Kaur I, Jindal A, Gupta H, Bagai P. Stakeholder collaboration: Government, private sector and non-governmental organizations can build pediatric oncology services in India. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ahuja S, Sharma J, Gupta S, Bakhshi S, Seth R, Singh A, Bagai P, Arora RS. Patient tracking during treatment of children with cancer in India - An exploratory study. Cancer Rep (Hoboken) 2021; 5:e1359. [PMID: 33624448 PMCID: PMC9199505 DOI: 10.1002/cnr2.1359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/18/2021] [Accepted: 02/03/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Abandonment of treatment, a major cause of treatment failure in low- and middle-income countries like India, is particularly high during the diagnostic and initial phase of treatment. Tracking of patients during this risk period may reduce treatment abandonment rates and increase quality of care. AIM The primary aim was to pilot the use and check the acceptability of a tool for tracking children with cancer in New Delhi during the initial part of their treatment. Secondary aim was to estimate abandonment rates among these patients. METHODS This prospective study was carried out in two centers of North India in New Delhi and enrolled children less than 18 years diagnosed with cancer at these centers and who had registered with Cankids for social support. Parent support group (PSG) workers maintained contact with the child's family at least once a week for the first 12 weeks. Details of each contact and subsequent action were recorded in a customized book (called "You are not alone" or YANA Book). Descriptive analysis of these contacts was done in Microsoft Excel and presented in frequencies and percentages. The five-point Likert scale was used to check the acceptability of the tool among the PSG workers. RESULTS Seven PSG workers enrolled and tracked 81 patients (73% male with a median age of 6 years). During the 12-week study period, 986 contacts were attempted and three (3.7%) patients had abandoned their treatment. All PSG workers strongly agreed that the YANA book was simple to understand and use, decreased their workload, and helped provide better assistance to patients. CONCLUSION The tool for patient tracking was well accepted by the PSG workers and considered easy to use. We now plan to implement our model as a routine service at all the partnering hospitals in India.
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Affiliation(s)
- S Ahuja
- Quality Care Research and Impact, Cankids, New Delhi, India
| | - J Sharma
- Quality Care Research and Impact, Cankids, New Delhi, India
| | - S Gupta
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - S Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - R Seth
- Department of Paediatrics, Division of Paediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - A Singh
- Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - P Bagai
- Quality Care Research and Impact, Cankids, New Delhi, India
| | - R S Arora
- Quality Care Research and Impact, Cankids, New Delhi, India.,Max Super-Speciality Hospital, Medical Oncology, New Delhi, India
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Sharma J, Lowe J, Tripathi R, Maji I, Mitra V, Bagai P, Arora R. Successful initiation of a prospective multicentre study (InPOG-ACC-16-02) examining journey of children with cancer in North and East India. Pediatric Hematology Oncology Journal 2020. [DOI: 10.1016/j.phoj.2021.04.043] [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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Kanwar VS, Bhattacharya A, Arora RS, Bagai P, Shah P, Howard S. India neuroblastoma registration and biology study (INPOG-NB-18-01): Barriers to childhood cancer research in a lower-middle income country. Pediatric Hematology Oncology Journal 2020. [DOI: 10.1016/j.phoj.2021.04.143] [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: 10/20/2022] Open
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Ahuja S, Tsimicalis A, Lederman S, Bagai P, Martiniuk A, Srinivas S, Arora RS. A pilot study to determine out-of-pocket expenditures by families of children being treated for cancer at public hospitals in New Delhi, India. Psychooncology 2019; 28:1349-1353. [PMID: 30946504 DOI: 10.1002/pon.5077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Shivani Ahuja
- Quality Care Research and Impact, Cankids…Kidscan, New Delhi
| | | | - Sara Lederman
- Quality Care Research and Impact, Cankids…Kidscan, New Delhi
| | - Poonam Bagai
- Quality Care Research and Impact, Cankids…Kidscan, New Delhi
| | - Alexandra Martiniuk
- Faculty of Medicine and Health, University of Sydney, Sydney.,Office of the Chief Scientist, Health Systems Science, George Institute for Global Health, Sydney.,Dalla Lana School of Public Health, University of Toronto, Toronto
| | | | - Ramandeep Singh Arora
- Quality Care Research and Impact, Cankids…Kidscan, New Delhi.,Medical Oncology, Max Super-Speciality Hospital, New Delhi
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Kanwar VS, Bhattacharya A, Chinnaswamy G, Arora RS, Bagai P, Howard SC, Shah P, Modak S. India Neuroblastoma Registration and Biology Study (InPOG-NB-18-01): A model of diverse stakeholder involvement to advance childhood cancer care and research in India. Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.016] [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: 11/26/2022] Open
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Mahajan A, Gupta H, Jain S, Dang N, Sehgal K, Verma N, Mudaliar S, Singh M, Singh A, Kakkar S, Garg K, Jain P, Radhakrishnan N, Chandra J, Digra S, Rajendran A, Bagai P. Improving Access to Minimal Residual Disease Assessment: Lessons Learnt! Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.175] [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] Open
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Arora R, Rahman R, Joe W, Bakhshi S, Dhawan D, Radhakrishnan V, Kalra M, Chinnaswamy G, Das A, Mudaliar S, Sangareddi S, Sharma S, Seth R, Singh A, De S, Scott J, Uppuluri R, Borker A, Sankaran H, Bagai P. Families Of Children Newly Diagnosed With Cancer Incur Significant Out-Of-Pocket Expenditure For Treatment – Report Of A Multi-Site Prospective Longitudinal Study From India (INPOG-ACC-16-01). Pediatric Hematology Oncology Journal 2018. [DOI: 10.1016/j.phoj.2018.11.038] [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: 11/29/2022] Open
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Lowe J, Arora R, Bagai P, Banerji U. Plotting Healthcare Journeys And Exploring Time Taken For Childhood Cancer Patients To Access Care In India. Pediatric Hematology Oncology Journal 2018. [DOI: 10.1016/j.phoj.2018.11.036] [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] Open
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Arora PR, Misra R, Mehrotra S, Mittal C, Sharma S, Bagai P, Arora RS. Pilot initiative in India to explore the gonadal function and fertility outcomes of a cohort of childhood cancer survivors. J Hum Reprod Sci 2016; 9:90-3. [PMID: 27382233 PMCID: PMC4915292 DOI: 10.4103/0974-1208.183508] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
CONTEXT: Steady improvement in childhood cancer outcomes has led to a growing number of survivors, many of who develop long-term sequelae. There is limited data about these sequelae (including those related to fertility) on childhood cancer survivors from India. AIMS: We undertook a prospective pilot study on childhood cancer survivors from India to assess their gonadal function and fertility. SUBJECTS AND METHODS: A pediatric oncologist and a reproductive medicine specialist assessed 21 childhood cancer survivors. The risk of infertility was established using disease and treatment variables. Current status of puberty, sexuality, and fertility were assessed using clinical and biochemical parameters. Outcomes were correlated with risk group of infertility. Information was also ascertained on counseling with regards to risk of infertility. RESULTS: The cohort included 21 survivors (71% males) with a median age of 18 years who were off treatment for a median age of 7 years. Ten (48%) survivors were at low risk for infertility, 9 (43%) at medium risk and 2 (9%) at high risk. Gonadal dysfunction was seen in 3 (14%) survivors: 0/10 (0%) low risk, 1/9 (11%) medium risk, and 2/2 (100%) high risk. None of the survivors, who are at high risk or medium risk of infertility, received any counseling before treatment. CONCLUSIONS: This prospective pilot study of a cohort of childhood cancer survivors from India demonstrates a deficiency in the information provided and counseling of patients/families at the time of diagnosis with regards to the risk of infertility. Fertility outcomes of childhood cancer survivors were congruent with recognized risk groups for infertility. Future action points have been identified.
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Arora RS, Prabha S, Roy Moulik N, Bagai P. A survey of immunization practices in children with cancer in India. Pediatric Hematology Oncology Journal 2016. [DOI: 10.1016/j.phoj.2016.03.001] [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: 10/22/2022] Open
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Sharma A, Negi EF, Arora B, Pradhan D, Khurana M, Bagai P, Arora RS. A survey of nutritional practices for children with cancer in India. Indian J Cancer 2015; 52:191-3. [DOI: 10.4103/0019-509x.175831] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mostert S, Arora RS, Arreola M, Bagai P, Friedrich P, Gupta S, Kaur G, Koodiyedath B, Kulkarni K, Lam CG, Luna-Fineman S, Pizer B, Rivas S, Rossell N, Sitaresmi MN, Tsimicalis A, Weaver M, Ribeiro RC. Abandonment of treatment for childhood cancer: position statement of a SIOP PODC Working Group. Lancet Oncol 2011; 12:719-20. [PMID: 21719348 DOI: 10.1016/s1470-2045(11)70128-0] [Citation(s) in RCA: 173] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Saskia Mostert
- Department of Pediatrics, VU University Medical Center, Amsterdam, Netherlands
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