scholarly journals Follow-up Interactive Long-Term Expert Ranking (FILTER): a crowdsourcing platform to adjudicate risk for survivorship care

JAMIA Open ◽  
2021 ◽  
Vol 4 (4) ◽  
Author(s):  
Alex C Cheng ◽  
Li Wen ◽  
Yanwei Li ◽  
Tatsuki Koyama ◽  
Lynne D Berry ◽  
...  
Keyword(s):  
Relative Risk ◽  
Web Application ◽  
Ranking Algorithm ◽  
Survivorship Care ◽  
Allocation Of Resources ◽  
Individual Outcomes ◽  
Long Term Follow Up ◽  
Expert Ranking

Abstract Objectives To develop an online crowdsourcing platform where oncologists and other survivorship experts can adjudicate risk for complications in follow-up. Materials and Methods This platform, called Follow-up Interactive Long-Term Expert Ranking (FILTER), prompts participants to adjudicate risk between each of a series of pairs of synthetic cases. The Elo ranking algorithm is used to assign relative risk to each synthetic case. Results The FILTER application is currently live and implemented as a web application deployed on the cloud. Discussion While guidelines for following cancer survivors exist, refinement of survivorship care based on risk for complications after active treatment could improve both allocation of resources and individual outcomes in long-term follow-up. Conclusion FILTER provides a means for a large number of experts to adjudicate risk for survivorship complications with a low barrier of entry.

Barriers to survivorship care in the Consortium for New England Childhood Cancer Survivors (CONNECCS).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10035-10035
Author(s):  
Cindy L. Schwartz ◽  
Priay Hirway ◽  
Jeremy Ader ◽  
Heather Appleton Bradeen ◽  
Satkiran S. Grewal ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Lymphoblastic Leukemia ◽  
Private Insurance ◽  
Healthcare Access ◽  
Socioeconomic Background ◽  
Survivorship Care ◽  
Cns Disease ◽  
Long Term Follow Up

10035 Background: Although long-term adverse consequences of childhood cancer treatment may be mitigated by screening, prevention, and interventions, many survivors do not take advantage of survivorship care. We hypothesized that patients who are at risk for poor compliance with long-term follow-up are identifiable at diagnosis. Methods: To identify factors associated with poor follow-up compliance, 7 CONNECCS institutions evaluated a childhood acute lymphoblastic leukemia (ALL) survivor cohort diagnosed 1996-99. Data collected included: diagnosis year, age, race, ethnicity, gender, insurance, distance from center, CNS disease, and risk classification. Primary endpoints were compliance with 5 and 10-year follow-up. Differences in compliance were tested using chi-squared or t-tests. Logistic regression (including institution as a clustering variable) was used to calculate adjusted odds ratios (OR). Results: At diagnosis, the 358 ALL patients were: female (47%), age= 6.5 + 4.6 years, white/non-Hispanic (84%), black non-Hispanic (7%), high-risk (52%), CNS involvement (10%), privately insured (68%). Private insurance (OR 4.0; 95% CI 2.1-7.8) significantly increased the odds of 5-year compliance. Compliance with 10-year follow-up increased with private insurance (OR 3.3; 95% CI 1.4-8.1) but decreased with CNS disease (OR 0.36; 95% CI 0.31- 0.42) and with years of age (OR 0.93; 95% CI 0.88- 0.96). Conclusions: We evaluated predictors of long-term follow-up based on disease/demographic characteristics at diagnosis to identify cohorts in need of early interventions. In this regional cohort, patients from lower socioeconomic background (without private insurance) at diagnosis were less likely to participate in long-term follow-up care at 5 and 10 years from diagnosis. Older survivors and those with CNS disease were less likely to be in follow-up at 10 years. Future studies should investigate reasons why follow-up compliance is affected by 1) private insurance at diagnosis, 2) older age, and 3) CNS disease. Remediable causes might include: understanding of risk, adolescence/young adult transitions, and healthcare access.

Variation among follow-up survivorship guidelines for adolescent and young adults (AYA).

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 147-147
Author(s):  
Erin Marie Barthel ◽  
Elizabeth Kiernan ◽  
Darcy Banco ◽  
Katherine Spencer ◽  
Susan K. Parsons
Keyword(s):  
Hodgkin Lymphoma ◽  
Late Effects ◽  
Time Interval ◽  
Survivorship Care ◽  
Nccn Guidelines ◽  
Care Plans ◽  
Follow Up Care ◽  
Long Term Follow Up

147 Background: The AYA population is a growing group of survivors, exceeding more than 600,000 who are at high risk for late effects of cancer-directed therapy. While many guidelines exist for cancer survivorship care, choosing which to use for an AYA cancer survivor is challenging, yet essential, to ensure comprehensive follow-up care. Methods: Survivorship care plans, including treatment summaries and follow-up care plans, were created for three clinical vignettes (acute lymphoblastic leukemia, osteosarcoma, and Hodgkin Lymphoma). Four sets of guidelines were used including the Children’s Oncology Group Long-Term Follow-Up Guidelines (COG LTFU), National Comprehensive Cancer Network (NCCN) Guidelines for Age- Related Recommendations: AYA Oncology (NCCN-AYA), NCCN Guidelines for Treatment of Cancer by Site (NCCN-Site), and NCCN Guidelines for Supportive Care: Survivorship (NCCN-Survivor) and NCCN supplemental cancer screening guidelines. The follow-up care plans were compared across guidelines to determine the extent and nature of the similarities and differences concerning AYA survivorship care. Results: The guidelines differ widely on surveillance recommendations based on risk, test, and frequency. The COG LTFU recommends screening all individuals with a specific treatment exposure, whereas the NCCN-AYA recommends screening based on risk and the NCCN-Survivor recommends testing individuals with a positive review of systems and other health risk factors. To illustrate this, in the follow-up care plan for our Hodgkin Lymphoma case, recommended monitoring for cardiac toxicity varied from annual screening (COG LTFU) to ten year intervals (NCCN-Survivor), based on which guideline was used. Conclusions: The guidelines disagree on the link between treatment exposures and late effects, on the population to be screened, on the screening test to be used, and on the time interval of testing. This has significant implications for the long-term follow-up care an AYA survivor will receive. We highlight differences across the guidelines and offer solutions to harmonize guidelines to ensure comprehensive, quality survivorship care for this population.

scholarly journals On the reliability of examining dual-tasking abilities using a novel e-Health device – a proof of concept study in Multiple Sclerosis

2020 ◽  
Author(s):  
Niels Böttrich ◽  
Moritz Mückschel ◽  
Anja Dillenseger ◽  
Christoph Lange ◽  
Raimar Kern ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Web Application ◽  
Outpatient Setting ◽  
Dual Tasking ◽  
Health Device ◽  
Long Term Follow Up ◽  
Neuropsychological Functions ◽  
Neuropsychological Assessments

The assessment of neuropsychological functions and especially dual-tasking abilities is considered to be increasingly relevant in the assessment of neurological disease and Multiple Sclerosis (MS) in particular. Yet, the assessment of dual-tasking abilities is hindered by specific software requirements and extensive testing times. We designed a novel e-health (progressive web application-based) device for the assessment of dual-tasking abilities usable in “bedside” and outpatient clinic settings and examined its reliability in a sample of N=184 MS patients in an outpatient setting. Moreover, we examined the relevance of dual-tasking assessment using this device with respect to clinically relevant parameters in MS. We show that a meaningful assessment of dual-tasking is possible within 6 minutes and that reliabilities of the behavioral readouts ranged between .81 to .92 depending on dual-tasking difficulty. We show that dual-tasking readouts were correlated with clinically relevant parameters (e.g. EDSS, disease duration, processing speed) and were not affected by fatigue levels. We consider the tested dual-tasking assessment device suitable for routine clinical neuropsychological assessments of dual-tasking abilities. Future studies may further evaluate this test regarding its suitability in the long-term follow up assessments and to assess dual-tasking abilities in other neurological and psychiatric disorders.

scholarly journals A long term follow-up study on hepatic diseases and their relative risk of death after blood transfusion.

Kanzo ◽  
1986 ◽  
Vol 27 (12) ◽  
pp. 1665-1669
Author(s):  
Izumi YOSHINO ◽  
Toshihiko IIJIMA ◽  
Yasutomo IMAI ◽  
Akira TERANO
Keyword(s):  
Relative Risk ◽  
Blood Transfusion ◽  
Risk Of Death ◽  
Follow Up Study ◽  
Hepatic Diseases ◽  
Long Term Follow Up ◽  
Relative Risk Of Death

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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