scholarly journals Predictors of Opioid Prescription After Early Stage Lung Cancer Surgery

2019 ◽  
Vol 107 (6) ◽  
pp. 1915 ◽  
Author(s):  
Stephanie Tuminello ◽  
Rebecca M. Schwartz ◽  
Bian Liu ◽  
Juan Wisnivesky ◽  
Raja Flores ◽  
...  
2018 ◽  
Vol 14 (2) ◽  
pp. 151-163 ◽  
Author(s):  
Rebecca M Schwartz ◽  
Ksenia Gorbenko ◽  
Samantha M Kerath ◽  
Raja Flores ◽  
Sheila Ross ◽  
...  

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 101-101
Author(s):  
Jacob Newton Stein ◽  
Samuel Cykert ◽  
Christina Yongue ◽  
Eugenia Eng ◽  
Isabella Kathryn Wood ◽  
...  

101 Background: Racial disparities are well described in the management of early-stage lung cancer, with Black patients less likely to receive potentially curative surgery than non-Hispanic Whites. A multi-site pragmatic trial entitled Accountability for Cancer Care through Undoing Racism and Equity (ACCURE), designed in collaboration with community partners, eliminated racial disparities in lung cancer surgery through a multi-component intervention. The study involved real-time electronic health record (EHR) monitoring to identify patients not receiving recommended care, a nurse navigator who reviewed and addressed EHR alerts daily, and race-specific feedback provided to clinical teams. Timeliness of cancer care is an important quality metric. Delays can lead to disease progression, upstaging, and worse survival, and Black patients are more likely to experience longer wait times to lung cancer surgery. Yet interventions to reduce racial disparities in timely delivery of lung cancer surgery have not been well studied. We evaluated the effect of ACCURE on timely receipt of lung cancer surgery. Methods: We analyzed data of a retrospective cohort at five cancer centers gathered prior to the ACCURE intervention and compared results with prospective data collected during the intervention. We calculated mean time from clinical suspicion of lung cancer to surgery and evaluated the proportion of patients who received surgery within 60 days stratified by race. We performed a t-test to compare mean days to surgery and chi2 for the delivery of surgery within 60 days. Results: 1320 patients underwent surgery in the retrospective arm, 160 were Black. 254 patients received surgery in the intervention arm, 85 were Black. Results are summarized in Table. Mean time to surgery in the retrospective cohort was 41.8 days, compared with 25.5 days in the intervention cohort (p<0.01). In the retrospective cohort, 68.8% of Black patients received surgery within 60 days versus 78.9% of White patients (p<0.01). In the intervention, the difference between Blacks and Whites with respect to surgery within 60 days was no longer significant (89.41% of Black patients vs 94.67% of White patients, p=0.12). Conclusions: Racial disparities exist in the delivery of timely lung cancer surgery. The ACCURE intervention improved time to surgery and timeliness of surgery for Black and White patients with early-stage lung cancer. A combination of real-time EHR monitoring, nurse navigation, and race-based feedback markedly reduced racial disparities in timely lung cancer care. [Table: see text]


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Dariusz Dziedzic ◽  
Tadeusz Orlowski

Since the introduction of anatomic lung resection by video-assisted thoracoscopic surgery (VATS) 20 years ago, VATS has experienced major advances in both equipment and technique, introducing a technical challenge in the surgical treatment of both benign and malignant lung disease. The demonstrated safety, decreased morbidity, and equivalent efficacy of this minimally invasive technique have led to the acceptance of VATS as a standard surgical modality for early-stage lung cancer and increasing application to more advanced disease. Formerly there was much debate about the feasibility of the technique in cancer surgery and proper lymph node handling. Although there is a lack of proper randomized studies, it is now generally accepted that the outcome of a VATS procedure is at least not inferior to a resection via a traditional thoracotomy.


2021 ◽  
Vol 16 (3) ◽  
pp. S264-S265
Author(s):  
F. Xu ◽  
L. Yang ◽  
C. Liu ◽  
J. Ying ◽  
Y. Wang

Author(s):  
Guangyao Wu ◽  
Arthur Jochems ◽  
Turkey Refaee ◽  
Abdalla Ibrahim ◽  
Chenggong Yan ◽  
...  

Abstract Introduction Lung cancer ranks second in new cancer cases and first in cancer-related deaths worldwide. Precision medicine is working on altering treatment approaches and improving outcomes in this patient population. Radiological images are a powerful non-invasive tool in the screening and diagnosis of early-stage lung cancer, treatment strategy support, prognosis assessment, and follow-up for advanced-stage lung cancer. Recently, radiological features have evolved from solely semantic to include (handcrafted and deep) radiomic features. Radiomics entails the extraction and analysis of quantitative features from medical images using mathematical and machine learning methods to explore possible ties with biology and clinical outcomes. Methods Here, we outline the latest applications of both structural and functional radiomics in detection, diagnosis, and prediction of pathology, gene mutation, treatment strategy, follow-up, treatment response evaluation, and prognosis in the field of lung cancer. Conclusion The major drawbacks of radiomics are the lack of large datasets with high-quality data, standardization of methodology, the black-box nature of deep learning, and reproducibility. The prerequisite for the clinical implementation of radiomics is that these limitations are addressed. Future directions include a safer and more efficient model-training mode, merge multi-modality images, and combined multi-discipline or multi-omics to form “Medomics.”


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