scholarly journals Lessons learned from the delivery of virtual integrative oncology interventions in clinical practice and research during the COVID-19 pandemic

2021 ◽  
Author(s):  
Robert Knoerl ◽  
Carolyn S. Phillips ◽  
Juliana Berfield ◽  
Heather Woods ◽  
Meghan Acosta ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Lessons Learned ◽  
Integrative Oncology

Development of Harmonized Outcome Measures for Use in Patient Registries and Clinical Practice: Methods and Lessons Learned

2019 ◽  
Author(s):  
Michelle B. Leavy ◽  
Claudia Schur ◽  
Ferhat Q. Kassamali ◽  
Margaret Edder Johnson ◽  
Raj Sabharwal ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Outcome Measures ◽  
Lessons Learned ◽  
Patient Registries ◽  
Practice Methods

scholarly journals Wiki-Based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma: A New Paradigm in Sarcoma Evidence

Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
S. J. Neuhaus ◽  
D. Thomas ◽  
J. Desai ◽  
C. Vuletich ◽  
J. von Dincklage ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Guideline Development ◽  
Lessons Learned ◽  
Evidence Based ◽  
Adult Onset ◽  
New Paradigm ◽  
Software Application ◽  
Evidence Based Guidelines

In 2013 Australia introduced Wiki-based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma. These guidelines utilized a customized MediaWiki software application for guideline development and are the first evidence-based guidelines for clinical management of sarcoma. This paper presents our experience with developing and implementing web-based interactive guidelines and reviews some of the challenges and lessons from adopting an evidence-based (rather than consensus-based) approach to clinical sarcoma guidelines. Digital guidelines can be easily updated with new evidence, continuously reviewed and widely disseminated. They provide an accessible method of enabling clinicians and consumers to access evidence-based clinical practice recommendations and, as evidenced by over 2000 views in the first four months after release, with 49% of those visits being from countries outside of Australia. The lessons learned have relevance to other rare cancers in addition to the international sarcoma community.

Quality Care in Survivorship: Lessons Learned From the ASCO Quality Oncology Practice Initiative

2021 ◽  
pp. OP.21.00290
Author(s):  
Charles L. Shapiro ◽  
Nicole Zubizarreta ◽  
Erin Moshier ◽  
Julia P. Brockway ◽  
John Mandeli ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Clinical Practice ◽  
Negative Binomial ◽  
Scientific Evidence ◽  
Lessons Learned ◽  
Negative Binomial Regression Model ◽  
Smoking Cessation Counseling ◽  
Curative Intent ◽  
Oncology Practice ◽  
Over Time

PURPOSE: The ASCO Quality Oncology Practice Initiative (QOPI) project was established to evaluate the influence of guideline recommendations on routine clinical practice. METHODS: QOPI provided summary data from 839 unique practices in which data were collected every six months from the Fall of 2015 to the Spring of 2019. From these data, six items were chosen based on their relationship to domains of survivorship. A zero-inflated negative binomial regression model was used to test for trends in QOPI measures adherence rates over time. The models were adjusted for the time period, region, practice-ownership, multispecialty site, fellowship program, and hospital type. RESULTS: Smoking cessation counseling recommended and smoking cessation counseling administered or referred both increased over time, 50%-61% (adjusted incidence rate ratios (IRR), 1.028; 95% CI, 1.016 to 1.040; P < .001) and 34%-49% (adjusted IRR, 1.052; 95% CI, 1.035 to 1.070; P < .001), respectively. Infertility risks discussed before chemotherapy increased from 36% to 53% (adjusted IRR, 1.056; 95% CI, 1.035 to 1.078; P < .001) and fertility options discussed or referred to specialists increased from 23% to 38% (adjusted IRR, 1.074; 95% CI, 1.046 to 1.102; P < .001). Twenty-nine percent documented a positron emission tomography, computed tomography, or bone scan within the first 12 months for women diagnosed with early breast cancer treated for curative intent (adjusted IRR, 1.000; 95% CI, 0.977 to 1.024; P = .971). Tumor marker surveillance within 12 months increased from 78% to 87% (adjusted IRR, 1.018; 95% CI, 1.002 to 1.033; P = .023). CONCLUSION: As scientific evidence to guide cancer survivorship care grows, the role of guideline recommendations permeating clinical practice using quality metrics will become increasingly important.

Intervention Fidelity in a Translational Study: Lessons Learned

2013 ◽  
Vol 27 (2) ◽  
pp. 131-148 ◽  
Author(s):  
Bernice C. Yates ◽  
Karen L. Schumacher ◽  
Joseph F. Norman ◽  
Kaye Stanek Krogstrand ◽  
Jane Meza ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Behavioral Intervention ◽  
Intervention Studies ◽  
Research Participant ◽  
Lessons Learned ◽  
Intervention Fidelity ◽  
Research Staff ◽  
Translational Study ◽  
Design Component ◽  
Clinical Environments

This article examined the intervention fidelity strategies used and lessons learned in a translational study. In this study, the behavioral intervention was delivered within an existing clinical practice environment, outpatient cardiac rehabilitation (CR). The primary lessons learned were that the fidelity components of design, training, and delivery of the intervention were the most different from fidelity strategies used in typical intervention studies. The design component needed to take into account the unique characteristics of the clinical environments where the study was conducted and build these unique differences into the study design. Training and delivery of the intervention was different because existing CR staff delivered the intervention in this study; which is unlike typical intervention studies where research staff are trained to deliver the intervention. Monitoring receipt and enactment fidelity components were similar to monitoring in usual intervention studies probably because these components focus on monitoring the behaviors of the research participant. Translational research presents unique challenges and requires the development of a flexible and novel intervention fidelity plan tailored to a particular study.

scholarly journals Tractable targets for meropenem-sparing antimicrobial stewardship interventions

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Clark D Russell ◽  
Ian F Laurenson ◽  
Morgan H Evans ◽  
Claire L Mackintosh
Keyword(s):  
Clinical Practice ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Real Life ◽  
Lessons Learned ◽  
Source Control ◽  
First Line ◽  
Escalation Therapy ◽  
Clinical Records

Abstract Background As meropenem is a restricted antimicrobial, lessons learned from its real-life usage will be applicable to antimicrobial stewardship (AMS) more generally. Objectives To retrospectively evaluate meropenem usage at our institution to identify targets for AMS interventions. Methods Patients receiving meropenem documented with an ‘alert antimicrobial’ form at two tertiary care UK hospitals were identified retrospectively. Clinical records and microbiology results were reviewed. Results A total of 107 adult inpatients receiving meropenem were identified. This was first-line in 47% and escalation therapy in 53%. Source control was required in 28% of cases after escalation, for predictable reasons. Those ultimately requiring source control had received more prior antimicrobial agents than those who did not (P = 0.03). Meropenem was rationalized in 24% of cases (after median 4 days). Positive microbiology enabled rationalization (OR 12.3, 95% CI 2.7–55.5, P = 0.001) but rates of appropriate sampling varied. In cases with positive microbiology where meropenem was not rationalized, continuation was retrospectively considered clinically and microbiologically necessary in 8/40 cases (0/17 empirical first-line usage). Rationalization was more likely when meropenem susceptibility was not released on the microbiology report (OR 5.2, 95% CI 1.3–20.2, P = 0.02). Input from an infection specialist was associated with a reduced duration of meropenem therapy (P < 0.0001). Early review by an infection specialist has the potential to further facilitate rationalization. Conclusions In real-life clinical practice, core aspects of infection management remain tractable targets for AMS interventions: microbiological sampling, source control and infection specialist input. Further targets include supporting rationalization to less familiar carbapenem-sparing antimicrobials, restricting first-line meropenem usage and selectively reporting meropenem susceptibility.

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