scholarly journals From Patient Engagement to Precision Oncology: Leveraging Informatics to Advance Cancer Care

2020 ◽  
Vol 29 (01) ◽  
pp. 235-242
Author(s):  
Ashley C. Griffin ◽  
Umit Topaloglu ◽  
Sean Davis ◽  
Arlene E. Chung
Keyword(s):  
Machine Learning ◽  
Cancer Care ◽  
Digital Health ◽  
Clinical Care ◽  
Google Scholar ◽  
Precision Oncology ◽  
Scientific Impact ◽  
Ethical Implications ◽  
Search Terms ◽  
Methodological Rigor

Objectives: Conduct a survey of the literature for advancements in cancer informatics over the last three years in three specific areas where there has been unprecedented growth: 1) digital health; 2) machine learning; and 3) precision oncology. We also highlight the ethical implications and future opportunities within each area. Methods: A search was conducted over a three-year period in two electronic databases (PubMed, Google Scholar) to identify peer-reviewed articles and conference proceedings. Search terms included variations of the following: neoplasms[MeSH], informatics[MeSH], cancer, oncology, clinical cancer informatics, medical cancer informatics. The search returned too many articles for practical review (23,994 from PubMed and 23,100 from Google Scholar). Thus, we conducted searches of key PubMed-indexed informatics journals and proceedings. We further limited our search to manuscripts that demonstrated a clear focus on clinical or translational cancer informatics. Manuscripts were then selected based on their methodological rigor, scientific impact, innovation, and contribution towards cancer informatics as a field or on their impact on cancer care and research. Results: Key developments and opportunities in cancer informatics research in the areas of digital health, machine learning, and precision oncology were summarized. Conclusion: While there are numerous innovations in the field of cancer informatics to advance prevention and clinical care, considerable challenges remain related to data sharing and privacy, digital accessibility, and algorithm biases and interpretation. The implementation and application of these findings in cancer care necessitates further consideration and research.

scholarly journals Molecular Subtypes and Precision Oncology in Intrahepatic Cholangiocarcinoma

2021 ◽  
Vol 10 (13) ◽  
pp. 2803
Author(s):  
Carolin Czauderna ◽  
Martha M. Kirstein ◽  
Hauke C. Tews ◽  
Arndt Vogel ◽  
Jens U. Marquardt
Keyword(s):  
Clinical Care ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Growth Factor Receptor ◽  
Treatment Modalities ◽  
Precision Oncology ◽  
Recurrence Rates ◽  
Isocitrate Dehydrogenase 1 ◽  
Liver Cancers

Cholangiocarcinomas (CCAs) are the second-most common primary liver cancers. CCAs represent a group of highly heterogeneous tumors classified based on anatomical localization into intra- (iCCA) and extrahepatic CCA (eCCA). In contrast to eCCA, the incidence of iCCA is increasing worldwide. Curative treatment strategies for all CCAs involve oncological resection followed by adjuvant chemotherapy in early stages, whereas chemotherapy is administered at advanced stages of disease. Due to late diagnosis, high recurrence rates, and limited treatment options, the prognosis of patients remains poor. Comprehensive molecular characterization has further revealed considerable heterogeneity and distinct prognostic and therapeutic traits for iCCA and eCCA, indicating that specific treatment modalities are required for different subclasses. Several druggable alterations and oncogenic drivers such as fibroblast growth factor receptor 2 gene fusions and hotspot mutations in isocitrate dehydrogenase 1 and 2 mutations have been identified. Specific inhibitors have demonstrated striking antitumor activity in affected subgroups of patients in phase II and III clinical trials. Thus, improved understanding of the molecular complexity has paved the way for precision oncological approaches. Here, we outline current advances in targeted treatments and immunotherapeutic approaches. In addition, we delineate future perspectives for different molecular subclasses that will improve the clinical care of iCCA patients.

Children’s assent within clinical care: A concept analysis

2020 ◽  
pp. 136749352097630
Author(s):  
Marjorie Montreuil ◽  
Justine Fortin ◽  
Eric Racine
Keyword(s):  
Clinical Care ◽  
Concept Analysis ◽  
Process Of Care ◽  
Deliberative Process ◽  
Ethical Implications ◽  
Rights Of The Child ◽  
Healthcare Decision Making ◽  
Psychological Harm ◽  
Practical Implications ◽  
Made In

Seeking children’s assent has been put forward as a way to foster children’s involvement in the healthcare decision-making process. However, the functions of the concept of assent within clinical care are manifold, and methods used to recognize children’s capacities and promote their involvement in their care remain debated. We performed an instrumentalist concept analysis of assent, with 58 included articles. Final themes were jointly identified through a deliberative process. Two distinct perspectives of assent were predominant: as an affirmative agreement for a specific decision and as part of a continuous, interactive process of care. Differing standards were provided as to how and when to apply the concept of assent. The concept of dissent was largely omitted from conceptions of assent, especially in situations for which children’s refusal would lead to severe health consequences. Ethical implications included fostering autonomy, reducing physical/psychological harm to the child, respecting the child as a human being, and fulfilling the universal rights of the child. There remain important gaps in the theory of assent and its desirable and possible practical implications. Practical standards are largely missing, and evidence supporting the claims made in the literature requires further investigation.

scholarly journals COVID-19 Misinformation Online and Health Literacy: A Brief Overview

2021 ◽  
Vol 18 (15) ◽  
pp. 8091
Author(s):  
Salman Bin Naeem ◽  
Maged N. Kamel Boulos
Keyword(s):  
Machine Learning ◽  
Social Media ◽  
Health Literacy ◽  
Information Content ◽  
Digital Health ◽  
Negative Effects ◽  
The World ◽  
Synergistic Approach ◽  
Viral Nature

Low digital health literacy affects large percentages of populations around the world and is a direct contributor to the spread of COVID-19-related online misinformation (together with bots). The ease and ‘viral’ nature of social media sharing further complicate the situation. This paper provides a quick overview of the magnitude of the problem of COVID-19 misinformation on social media, its devastating effects, and its intricate relation to digital health literacy. The main strategies, methods and services that can be used to detect and prevent the spread of COVID-19 misinformation, including machine learning-based approaches, health literacy guidelines, checklists, mythbusters and fact-checkers, are then briefly reviewed. Given the complexity of the COVID-19 infodemic, it is very unlikely that any of these approaches or tools will be fully effective alone in stopping the spread of COVID-19 misinformation. Instead, a mixed, synergistic approach, combining the best of these strategies, methods, and services together, is highly recommended in tackling online health misinformation, and mitigating its negative effects in COVID-19 and future pandemics. Furthermore, techniques and tools should ideally focus on evaluating both the message (information content) and the messenger (information author/source) and not just rely on assessing the latter as a quick and easy proxy for the trustworthiness and truthfulness of the former. Surveying and improving population digital health literacy levels are also essential for future infodemic preparedness.

scholarly journals Considerations for the Management of Women with Breast Cancer during the COVID-19 Pandemic

2020 ◽  
Vol 5 (03) ◽  
pp. 260-263
Author(s):  
Monica Irukulla ◽  
Palwai Vinitha Reddy
Keyword(s):  
Breast Cancer ◽  
Resource Allocation ◽  
Patient Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Clinical Care ◽  
Current Availability ◽  
The Individual

AbstractOutcomes in cancer patients are strongly influenced by timeliness and quality of multidisciplinary interventions. The COVID-19 pandemic has led to severe disruption in cancer care in many countries. This has necessitated several changes in clinical care and workflow, including resource allocation, team segregation and deferment of many elective procedures. Several international oncological societies have proposed guidelines for the care of patients afflicted with breast cancer during the pandemic with a view to optimize resource allocation and maximize risk versus benefit for the individual and society. Clinicians may utilize these recommendations to adapt patient care, based on the current availability of resources and severity of the COVID-19 pandemic in each region. This article discusses the guidelines for care of patients afflicted with breast cancer during the pandemic.

scholarly journals Delivering healthcare remotely to cardiovascular patients during COVID-19

2020 ◽  
Vol 19 (6) ◽  
pp. 486-494 ◽  
Author(s):  
Lis Neubeck ◽  
Tina Hansen ◽  
Tiny Jaarsma ◽  
Leonie Klompstra ◽  
Robyn Gallagher
Keyword(s):  
Cardiovascular Disease ◽  
Usual Care ◽  
Mobile Apps ◽  
Digital Health ◽  
Well Being ◽  
Search Terms ◽  
Cardiovascular Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Remote Healthcare ◽  
Healthcare Interventions

Background Although attention is focused on addressing the acute situation created by the COVID-19 illness, it is imperative to continue our efforts to prevent cardiovascular morbidity and mortality, particularly during a period of prolonged social isolation which may limit physical activity, adversely affect mental health and reduce access to usual care. One option may be to deliver healthcare interventions remotely through digital healthcare solutions. Therefore, the aim of this paper is to bring together the evidence for remote healthcare during a quarantine situation period to support people living with cardiovascular disease during COVID-19 isolation. Methods The PubMed, CINAHL and Google Scholar were searched using telehealth OR digital health OR mHealth OR eHealth OR mobile apps AND COVID-19 OR quarantine search terms. We also searched for literature relating to cardiovascular disease AND quarantine. Results The literature search identified 45 potentially relevant publications, out of which nine articles were included. Three overarching themes emerged from this review: (1) preparing the workforce and ensuring reimbursement for remote healthcare, (2) supporting mental and physical health and (3) supporting usual care. Conclusion To support people living with cardiovascular disease during COVID-19 isolation and to mitigate the effects of quarantine and adverse effect on mental and physical well-being, we should offer remote healthcare and provide access to their usual care.

scholarly journals Preparing for partnerships in cancer care: an explorative analysis of the role of family-based caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Reema Harrison ◽  
Madhav Raman ◽  
Ramesh Lahiru Walpola ◽  
Ashfaq Chauhan ◽  
Ursula M. Sansom-Daly
Keyword(s):  
Ethnic Minority ◽  
Cancer Care ◽  
Psychosocial Support ◽  
Clinical Care ◽  
Medication Administration ◽  
Substantial Contribution ◽  
Clinical Aspects ◽  
Management Support ◽  
Unique Challenge ◽  
Family Based

Abstract Background Family-based ‘informal’ caregivers are critical to enable sustainable cancer care that produces optimal health outcomes but also gives rise to psychological burdens on caregivers. Evidence of psychosocial support for caregivers does not currently address the impacts of their role in providing clinical and health-related care for their loved ones. The present study sought to address this gap including with those from priority populations. Methods Qualitative data was collected using focus group and interview methods. We purposively sampled caregivers identified as having a high burden of responsibility for providing clinical care including those from ethnic minority backgrounds, parental caregivers and those living rurally. Transcripts were subject to thematic analysis utilising a team-based approach. Results Family-based caregivers included spouses (11), parents (7), children (1), siblings (1). Ten participants were from ethnic minority backgrounds and five participants were from regional or rural locations. Four resulting inter-related themes were; 1) Dual burden of providing clinical care and managing personal emotional distress; 2) Navigating healthcare partnership dynamics; 3) Developing a caregiving skillset, and 4) Unique supportive needs and barriers to access. These data provide evidence of the unique challenge of providing clinical care as part of family-based caregiving for a loved one with cancer, and the absence of support for caregivers to take up this role. Conclusion Our findings highlight the substantial contribution of family-based caregivers to the provision of cancer care in contemporary health systems. Inadequate support for caregivers is apparent with regard to their role in providing clinical aspects of care such as medication administration and management. Support programs to prepare caregivers to provide clinical care while building capacity to manage their stressors and emotions through this challenging period may be valuable towards sustainable, person-centred care.

Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia

2021 ◽  
Vol 12 (05) ◽  
pp. 1135-1143
Author(s):  
Amalie Dyda ◽  
Magid Fahim ◽  
Jon Fraser ◽  
Marianne Kirrane ◽  
Ides Wong ◽  
...  
Keyword(s):  
Care Delivery ◽  
Digital Health ◽  
Clinical Care ◽  
Models Of Care ◽  
Digital Transformation ◽  
Lessons Learned ◽  
Digital Data ◽  
Routine Practice ◽  
Action Research Project ◽  
Digital Disruption

Abstract Background The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption. Objective We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned. Methods Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content. Results Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital “depression.” Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland. Conclusion The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.

Leveraging machine learning technology to efficiently identify and match patients for precision oncology clinical trials.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13588-e13588
Author(s):  
Laura Sachse ◽  
Smriti Dasari ◽  
Marc Ackermann ◽  
Emily Patnaude ◽  
Stephanie OLeary ◽  
...  
Keyword(s):  
Machine Learning ◽  
Clinical Trials ◽  
Language Processing ◽  
Time Trial ◽  
High Fidelity ◽  
Learning Technology ◽  
Precision Oncology ◽  
Sequencing Data ◽  
Clinical Criteria ◽  
Patient Table

e13588 Background: Pre-screening for clinical trials is becoming more challenging as inclusion/exclusion criteria becomes increasingly complex. Oncology precision medicine provides an exciting opportunity to simplify this process and quickly match patients with trials by leveraging machine learning technology. The Tempus TIME Trial site network matches patients to relevant, open, and recruiting clinical trials, personalized to each patient’s clinical and molecular biology. Methods: Tempus screens patients at sites within the TIME Trial Network to find high-fidelity matches to clinical trials. The patient records include documentation submitted alongside NGS orders as well as electronic medical records (EMR) ingested through EMR Integrations. While Tempus-sequenced patients were automatically matched to trials using a Tempus-built matching application, EMR records were run through a natural language processing (NLP) data abstraction model to identify patients with an actionable gene of interest. Structured data were analyzed to filter to patients that lack a deceased date and have an encounter date within a predefined time period. Tempus abstractors manually validated the resulting unstructured records to ensure each patient was matched to a TIME Trial at a site capable of running the trial. For all high-level patient matches, a Tempus Clinical Navigator manually evaluated other clinical criteria to confirm trial matches and communicated with the site about trial options. Results: Patient matching was accelerated by implementing NLP gene and report detection (which isolated 17% of records) and manual screening. As a result, Tempus facilitated screening of over 190,000 patients efficiently using proprietary NLP technology to match 332 patients to 21 unique interventional clinical trials since program launch. Tempus continues to optimize its NLP models to increase high-fidelity trial matching at scale. Conclusions: The TIME Trial Network is an evolving, dynamic program that efficiently matches patients with clinical trial sites using both EMR and Tempus sequencing data. Here, we show how machine learning technology can be utilized to efficiently identify and recruit patients to clinical trials, thereby personalizing trial enrollment for each patient.[Table: see text]

scholarly journals Network-based machine learning and graph theory algorithms for precision oncology

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Wei Zhang ◽  
Jeremy Chien ◽  
Jeongsik Yong ◽  
Rui Kuang
Keyword(s):  
Machine Learning ◽  
Graph Theory ◽  
Precision Oncology
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