Adherence to childhood cancer treatment: a prospective cohort study from Northern Vietnam

ObjectivesGlobal incidence and attention to childhood cancer is increasing and treatment abandonment is a major cause of treatment failure in low- and middle-income countries. The purpose of this study was to gain an understanding of factors contributing to non-adherence to treatment.DesignA prospective cohort study with 2 year follow-up of incidence, family-reported motives and risk factors.SettingThe largest tertiary paediatric oncology centre in Northern Vietnam.ParticipantsAll children offered curative cancer treatment, from January 2008 to December 2009.Primary and secondary outcome measuresFamily decision to start treatment was analysed with multivariable logistic regression, and family decision to continue treatment was analysed with a multivariable Cox model. This assessment of non-adherence is thereby methodologically consistent with the accepted definitions and recommended practices for evaluation of treatment abandonment.ResultsAmong 731 consecutively admitted patients, 677 were eligible for treatment and were followed for a maximum 2 years. Almost half the parents chose to decline curative care (45.5%), either before (35.2%) or during (10.3%) the course of treatment. Most parents reported perceived poor prognosis as the main reason for non-adherence, followed by financial constraints and traditional medicine preference. The odds of starting treatment increased throughout the study-period (OR 1.04 per month (1.01 to 1.07), p=0.002), and were independently associated with prognosis (OR 0.51 (0.41 to 0.64), p=<0.0001) and travel distance to hospital (OR 0.998 per km (0.996 to 0.999), p=0.004). The results also suggest that adherence to initiated treatment was significantly higher among boys than girls (HR 1.69 (1.05 to 2.73), p=0.03).ConclusionsNon-adherence influenced the prognosis of childhood cancer, and was associated with cultural and local perceptions of cancer and the economic power of the affected families. Prevention of abandonment is a prerequisite for successful cancer care, and a crucial early step in quality improvements to care for all children with cancer.

Download Full-text

The INTREST registry: protocol of a multicenter prospective cohort study of predictors of women’s response to integrative breast cancer treatment

BMC Cancer ◽

10.1186/s12885-021-08468-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Heidemarie Haller ◽

Petra Voiß ◽

Holger Cramer ◽

Anna Paul ◽

Mattea Reinisch ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Trial ◽

Cohort Study ◽

Cancer Treatment ◽

Prospective Cohort Study ◽

Cancer Care ◽

Prospective Cohort ◽

Breast Cancer Treatment ◽

Cancer Data ◽

Patient Reported

Abstract Background Cancer registries usually assess data of conventional treatments and/or patient survival. Beyond that, little is known about the influence of other predictors of treatment response related to the use of complementary therapies (CM) and lifestyle factors affecting patients’ quality and quantity of life. Methods INTREST is a prospective cohort study collecting register data at multiple German certified cancer centers, which provide individualized, integrative, in- and outpatient breast cancer care. Patient-reported outcomes and clinical cancer data of anticipated N = 715 women with pTNM stage I-III breast cancer are collected using standardized case report forms at the time of diagnosis, after completing neo−/adjuvant chemotherapy, after completing adjuvant therapy (with the exception of endocrine therapy) as well as 1, 2, 5, and 10 years after baseline. Endpoints for multivariable prediction models are quality of life, fatigue, treatment adherence, and progression-based outcomes/survival. Predictors include the study center, sociodemographic characteristics, histologic cancer and comorbidity data, performance status, stress perception, depression, anxiety, sleep quality, spirituality, social support, physical activity, diet behavior, type of conventional treatments, use of and belief in CM treatments, and participation in a clinical trial. Safety is recorded following the Common Terminology Criteria for Adverse Events. Discussion This trial is currently recruiting participants. Future analyses will allow to identify predictors of short- and long-term response to integrative breast cancer treatment in women, which, in turn, may improve cancer care as well as quality and quantity of life with cancer. Trial registration German Clinical Trial Register DRKS00014852. Retrospectively registered at July 4th, 2018.

Download Full-text

Nurse-led PrEP-RN clinic: a prospective cohort study exploring task-Shifting HIV prevention to public health nurses

BMJ Open ◽

10.1136/bmjopen-2020-040817 ◽

2021 ◽

Vol 11 (1) ◽

pp. e040817

Author(s):

Patrick O'Byrne ◽

Amanda Vandyk ◽

Lauren Orser ◽

Marlene Haines

Keyword(s):

Public Health ◽

Cohort Study ◽

High Risk ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Secondary Outcome ◽

Bivariate Analysis ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Risk Criteria

ObjectiveTo report the results of a nurse-led pre-exposure prophylaxis (PrEP) delivery service.DesignThis was a prospective cohort study conducted from 5 August 2018 to 4 March 2020. It involved manual chart review to collect data. Variables were described using frequencies and percentages and analysed using χ2 testing. Those significant in bivariate analysis were retained and entered into a binary multiple logistic regression. Hierarchical modelling was used, and only significant factors were retained.SettingThis study occurred in an urban public health unit and community-based sexually transmitted infection (STI) clinic in Ottawa, Canada.ParticipantsOf all persons who were diagnosed with a bacterial STI in Ottawa and everyone who presented to our STI clinic during the study period, there were 347 patients who met our high-risk criteria for PrEP; these criteria included patients who newly presented with any of the following: HIV contacts, diagnosed with a bacterial STI or single use of HIV PEP. Further, eligibility could be determined based on clinical judgement. Patients who met the foregoing criteria were appropriate for PrEP-RN, while lower-risk patients were referred to elsewhere. Of the 347 patients who met our high-risk criteria, 47% accepted and 53% declined. Of those who accepted, 80% selected PrEP-registered nurse (RN).Primary and secondary outcome measuresUptake, acceptance, engagement and attrition factors of participants who obtained PrEP through PrEP-RN.Findings69% of participants who were eligible attended their intake PrEP-RN visit. 66% were retained in care. Half of participants continued PrEP and half were lost to follow-up. We found no significant differences in the uptake, acceptance, engagement and attrition factors of participants who accessed PrEP-RN regarding reason for referral, age, ethnicity, sexual orientation, annual income, education attainted, insurance status, if they have a primary care provider, presence or absence of depression or anxiety and evidence of newly acquired STI during the study period.ConclusionsNurse-led PrEP is an appropriate strategy for PrEP delivery.

Download Full-text

Can delirium research activity impact on routine delirium recognition? A prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-023386 ◽

2018 ◽

Vol 8 (10) ◽

pp. e023386 ◽

Cited By ~ 2

Author(s):

Carly Welch ◽

Thomas A Jackson

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

University Teaching ◽

Secondary Outcome ◽

Research Activity ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Improve Patient ◽

Discharge Summaries

ObjectiveTo assess if ongoing delirium research activity within an acute admissions unit impacts on prevalent delirium recognition.DesignProspective cohort study.SettingSingle-site tertiary university teaching hospital.Participants125 patients with delirium, as diagnosed by an expert using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition reference criteria, were recruited to a prospective cohort study investigating use of informant tools to detect unrecognised dementia. This study evaluated recognition of delirium and documentation of delirium by medical staff.InterventionsThe main study followed an observational design; the intervention discussed was the implementation of this study itself.Primary and secondary outcome measuresThe primary outcome was recognition of delirium by the admitting medical team prior to study diagnosis. Secondary outcomes included recording of or description of delirium in discharge summaries, and factors which may be associated with unrecognised delirium.ResultsDelirium recognition improved between the first half (48%) and second half (71%) of recruitment (p=0.01). There was no difference in recording of delirium or description of delirium in the text of discharge summaries.ConclusionDelirium research activity can improve recognition of delirium. This has the potential to improve patient outcomes.

Download Full-text

Meniscal tear outcome Study (METRO Study): a study protocol for a multicentre prospective cohort study exploring the factors which affect outcomes in patients with a meniscal tear

BMJ Open ◽

10.1136/bmjopen-2020-038681 ◽

2020 ◽

Vol 10 (7) ◽

pp. e038681

Author(s):

Imran Ahmed ◽

Mike Bowes ◽

Charles E Hutchinson ◽

Nicholas Parsons ◽

Sophie Staniszewska ◽

...

Keyword(s):

Cohort Study ◽

Research Ethics ◽

Outcome Measures ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Meniscal Tear ◽

Ethics Committee ◽

Secondary Outcome ◽

Research Ethics Committee ◽

Baseline Characteristics

IntroductionThis study is designed to explore the baseline characteristics of patients under 55 years of age with a meniscal tear, and to describe the relationship between the baseline characteristics and patient-reported outcome measures (PROMs) over 12 months. Research has highlighted the need for a trial to investigate the effectiveness of arthroscopic meniscectomy in younger patients. Before this trial, we need to understand the patient population in greater detail.Methods and analysisThis is a multicentre prospective cohort study. Participants aged between 18 and 55 years with an MRI confirmed meniscal tear are eligible for inclusion. Baseline characteristics including age, body mass index, gender, PROMs duration of symptoms and MRI will be collected. The primary outcome measure is the Western Ontario Meniscal Evaluation Tool at 12 months. Secondary outcome measures will include PROMs such as EQ5D, Knee Injury and Osteoarthritis Outcome Score and patient global impression of change score at 3, 6 and 12 months.Ethics and disseminationThe study obtained approval from the National Research Ethics Committee West Midlands—Black Country research ethics committee (19/WM/0079) on 12 April 2019. The study is sponsored by the University of Warwick. The results will be disseminated via peer-reviewed publication.Trial registration numberUHCW R&D Reference: IA428119. University of Warwick Sponsor ID: SC.08/18–19

Download Full-text

Vitamin Supplement Use During Breast Cancer Treatment and Survival: A Prospective Cohort Study

Breast Diseases A Year Book Quarterly ◽

10.1016/j.breastdis.2011.10.004 ◽

2011 ◽

Vol 22 (4) ◽

pp. 401-402

Author(s):

L.M. Hernandez

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Cancer Treatment ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Breast Cancer Treatment ◽

Vitamin Supplement ◽

Supplement Use

Download Full-text

Psychometric validation of the Breast Cancer Treatment Outcome Scale (BCTOS-12): a prospective cohort study

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-019-05362-y ◽

2019 ◽

Vol 300 (6) ◽

pp. 1679-1686

Author(s):

Manuel Feißt ◽

Jörg Heil ◽

Ilona Stolpner ◽

Alexandra von Au ◽

Christoph Domschke ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Treatment Outcome ◽

Cancer Treatment ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Breast Cancer Treatment ◽

Psychometric Validation

Download Full-text

Determining universal processes related to best outcome in emergency abdominal surgery: a multicentre, international, prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2014-006239 ◽

2014 ◽

Vol 4 (10) ◽

pp. e006239 ◽

Cited By ~ 7

Author(s):

Aneel Bhangu ◽

J Edward Fitzgerald ◽

Stuart Fergusson ◽

Chetan Khatri ◽

Hampus Holmer ◽

...

Keyword(s):

Cohort Study ◽

Abdominal Surgery ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Outcome Measure ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Perioperative Mortality ◽

Acute Surgery ◽

Emergency Abdominal Surgery

IntroductionEmergency abdominal surgery outcomes represent an internationally important marker of healthcare quality and capacity. In this study, a novel approach to investigating global surgical outcomes is proposed, involving collaborative methodology using ‘snapshot’ clinical data collection over a 2-week period. The primary aim is to identify internationally relevant, modifiable surgical practices (in terms of modifiable process, equipment and clinical management) associated with best care for emergency abdominal surgery.Methods and analysisThis is a multicentre, international, prospective cohort study. Any hospital in the world performing acute surgery can participate, and any patient undergoing emergency intraperitoneal surgery is eligible to enter the study. Centres will collect observational data on patients for a 14-day period during a 5-month window and required data points will be limited to ensure practicality for collaborators collecting data. The primary outcome measure is the 24 h perioperative mortality, with 30-day perioperative mortality as a secondary outcome measure. During registration, participants will undertake a survey of available resources and capacity based on the WHO Tool for Situational Analysis.Ethics and disseminationThe study will not affect clinical care and has therefore been classified as an audit by the South East Scotland Research Ethics Service in Edinburgh, Scotland. Baseline outcome measurement in relation to emergency abdominal surgery has not yet been undertaken at an international level and will provide a useful indicator of surgical capacity and the modifiable factors that influence this. This novel methodological approach will facilitate delivery of a multicentre study at a global level, in addition to building international audit and research capacity.Trial registration numberThe study has been registered with ClinicalTrials.gov (Identifier: NCT02179112).

Download Full-text

Functional status decline in older patients with breast and colorectal cancer after cancer treatment: A prospective cohort study

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2017.01.003 ◽

2017 ◽

Vol 8 (3) ◽

pp. 176-184 ◽

Cited By ~ 22

Author(s):

Doris van Abbema ◽

Arnée van Vuuren ◽

Franchette van den Berkmortel ◽

Marjan van den Akker ◽

Laura Deckx ◽

...

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Cancer Treatment ◽

Functional Status ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Older Patients ◽

After Cancer

Download Full-text

Could listening to music during pregnancy be protective against postnatal depression and poor wellbeing post birth? Longitudinal associations from a preliminary prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2017-021251 ◽

2018 ◽

Vol 8 (7) ◽

pp. e021251 ◽

Cited By ~ 3

Author(s):

Daisy Fancourt ◽

Rosie Perkins

Keyword(s):

Mental Health ◽

Cohort Study ◽

Prospective Cohort Study ◽

Postnatal Depression ◽

Prospective Cohort ◽

Depression Scale ◽

Well Being ◽

Secondary Outcome ◽

Confounding Variables ◽

Mental Well Being

ObjectivesThis study explored whether listening to music during pregnancy is longitudinally associated with lower symptoms of postnatal depression and higher well-being in mothers post birth.DesignProspective cohort study.ParticipantsWe analysed data from 395 new mothers aged over 18 who provided data in the third trimester of pregnancy and 3 and 6 months later (0–3 and 4–6 months post birth).Primary and secondary outcome measuresPostnatal depression was measured using the Edinburgh Postnatal Depression Scale, and well-being was measured using the Short Warwick-Edinburgh Mental Well-being Scale. Our exposure was listening to music and was categorised as ‘rarely; a couple of times a week; every day <1 hour; every day 1–2 hours; every day 3–5 hours; every day 5+hrs’. Multivariable linear regression analyses were carried out to explore the effects of listening to music during pregnancy on depression and well-being post birth, adjusted for baseline mental health and potential confounding variables.ResultsListening during pregnancy is associated with higher levels of well-being (β=0.40, SE=0.15, 95% CI 0.10 to 0.70) and reduced symptoms of postnatal depression (β=−0.39, SE=0.19, 95% CI −0.76 to −0.03) in the first 3 months post birth. However, effects disappear by 4–6 months post birth. These results appear to be particularly found among women with lower levels of well-being and high levels of depression at baseline.ConclusionsListening to music could be recommended as a way of supporting mental health and well-being in pregnant women, in particular those who demonstrate low well-being or symptoms of postnatal depression.

Download Full-text

End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study

10.21203/rs.3.rs-33924/v4 ◽

2020 ◽

Author(s):

Kevin Ki-Wai Ho ◽

Lawrence Chun-Man Lau ◽

Wai Wang Chau ◽

Queena Poon ◽

Kwong-Yin Chung ◽

...

Keyword(s):

Cohort Study ◽

Muscle Strength ◽

Outcome Measures ◽

Prospective Cohort Study ◽

Knee Arthroplasty ◽

Prospective Cohort ◽

Functional Improvement ◽

Secondary Outcome ◽

End Stage

Abstract Background: Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a one-year post-operative period.Methods: This prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were quality of life (QOL) measurements for pain, psychological and physical health.Results: Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects was comparable (67.89±7.07 vs. 67.92±6.85; p=0.99), but sarcopenic subjects had a lower body mass index (BMI) (25.64±2.64 vs. 28.57±4.04; p=0.01). There was a statistically significant improvement in walking speed (10.24±5.35 vs. 7.69±2.68, p<0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (19.31±5.92 vs. 18.98±6.37 vs. 19.36±7.66; p=0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27±15.98 vs. 20.65±15.24 vs. 16.65±18.13) and SF12v2 (PCS: 33.06±8.55 vs. 38.96±8.01 vs. 40.67±7.93) revealed progressive significant improvement (both comparisons p≤0.01). Further analysis with the IPAQ also found increased engagement of high-intensity activities.Conclusions: This study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon, but both sarcopenic and non-sarcopenic OA patients achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects.

Download Full-text