Implementing value assessment in oncology practice: A single-center experience

2018 ◽  
Vol 25 (4) ◽  
pp. 947-953
Author(s):  
Katherine Saunders ◽  
Mary S Mably ◽  
Sara S Shull ◽  
Heather Jones ◽  
Ticiana A Leal ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Checkpoint Inhibitors ◽  
The United States ◽  
Cancer Center ◽  
Value Assessment ◽  
Disease States ◽  
Single Center Experience ◽  
Challenges And Opportunities ◽  
Oncology Practice ◽  
Line Setting

Cancer treatment costs in the United States are rising. Evidence suggests that increased costs do not always correlate with improved outcomes. Several organizations have developed tools and frameworks to assess cancer treatment value; however, many centers have reported difficulty in implementing these tools and effectively incorporating value-based decision making into clinical practice. After evaluating existing frameworks, the Carbone Cancer Center at UW Health set out to create a value-based tool that could be used to inform the decisions of clinicians and patients. This tool was piloted in metastatic or advanced non-small cell lung cancer, specifically in the second-line setting to assess the value of immune checkpoint inhibitors nivolumab, atezolizumab, and pembrolizumab. The results of the pilot suggest that atezolizumab is the best value of the three agents in this patient population. Challenges and opportunities for improvement that were identified during the pilot process have helped refine the tool for use in a variety of disease states within oncology.

Quality Oncology Practice Initiative (QOPI): Preliminary results from a Brazilian academic public oncology service.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16568-e16568
Author(s):  
Daniel Iracema Cubero ◽  
Felipe Melo Cruz ◽  
Suelen Patricia dos Santos Martins ◽  
Joao Glasberg ◽  
Thomas Giollo Rivelli ◽  
...  
Keyword(s):  
Latin American ◽  
Electronic Record ◽  
The United States ◽  
Cancer Center ◽  
Self Assessment ◽  
School Of Medicine ◽  
Care Processes ◽  
Patient Consent ◽  
Voluntary Program ◽  
Oncology Practice

e16568 Background: The Quality Oncology Practice Initiative (QOPI) is a voluntary program developed by ASCO to aid oncology practices in quality self-assessment and continuous improvement of patient records. It consists of a cyclical, semiannual measurement of the adequacy of several care processes pertaining to some important aspects of patient care. Few academic cancer centers have been QOPI participants in the United States and there aren’t reports to our knowledge of any Latin American Cancer Center adopting this strategy. Methods: This study shows the pilot initiative to implement the QOPI at the ABC School of Medicine, Discipline of Oncology, a large public academic cancer center of Santo André, São Paulo, Brazil. Results: From January 2008 to December 2010, we consecutive selected 37 patients with gastric cancer, 40 with breast cancer, 33 with lung cancer and 40 colorectal cancer. The table below shows the first round of the core QOPI. Conclusions: There are several opportunities for improvement such as assessing and recording of pain and analgesic use, documentation patient consent and of the intent of chemotherapy and providing patients with their chemotherapy summaries. Our current electronic record will be modified to reflect the aforementioned needs in order to improve our results in the following rounds of QOPI program. [Table: see text]

Expanding Role of Positron Emission Tomography in Cancer of the Uterine Cervix

2006 ◽  
Vol 4 (5) ◽  
pp. 463-469 ◽  
Author(s):  
Joseph G. Rajendran ◽  
Benjamin E. Greer
Keyword(s):  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Molecular Imaging ◽  
The United States ◽  
Emission Tomography ◽  
Cancer Center ◽  
Cellular Functions ◽  
Positron Emission ◽  
Oncology Practice

Molecular imaging through positron emission tomography (PET) is playing a very important role in the management of several different cancers. Its noninvasive nature and ability to study biologic function are ideal for oncology practice. PET is establishing itself in staging, guiding therapy, and follow-up of patients with cervical cancer. The emergence and widespread availability of combined PET/computed tomography technology has further consolidated the role of molecular scanning in managing these patients. This technology is now accessible to every cancer center in the United States and is also available in most countries. Although it is approved for staging patients with cervical cancer, its use in other clinical management situations is being evaluated. The real power of molecular imaging will be to predict treatment response and guide therapy and applications of novel PET tracers for studying complex cellular functions that characterize the tumor for individualized treatment approaches. Although PET technology is beyond the reach of many developing countries, the experience gained in major centers would help devise more effective and simpler treatments that can be introduced.

scholarly journals Advances and Controversies With Checkpoint Inhibitors in Bladder Cancer

2021 ◽  
Vol 15 ◽  
pp. 117955492110449
Author(s):  
Logan P Rhea ◽  
Jeanny B Aragon-Ching
Keyword(s):  
Bladder Cancer ◽  
Checkpoint Inhibitors ◽  
Phase Iii ◽  
First Line ◽  
Disease States ◽  
Metastatic Setting ◽  
Phase Iii Trials ◽  
Line Setting ◽  
Almost All ◽  
Confirmatory Phase

Immune checkpoint inhibitors have revolutionized the treatment of bladder urothelial cancers and have wide application in almost all disease states. Although several drugs have initially been shown to be beneficial in the second-line metastatic setting, there are still ongoing controversies and debate, including voluntary withdrawals of durvalumab and atezolizumab, along with the approval of agents in the first-line setting in the cisplatin-ineligible state based on inconsistent confirmatory phase III trials. As novel immunotherapy drugs are discovered and studied in various phases of clinical trials, these agents will continue to change the treatment landscape for bladder cancer patients. This review will discuss current available evidence and information and key pivotal trials using checkpoint inhibitors in bladder cancer.

scholarly journals Considerations for Managing Patients With Hematologic Malignancy During the COVID-19 Pandemic: The Seattle Strategy

2020 ◽  
Vol 16 (9) ◽  
pp. 571-578 ◽  
Author(s):  
Mary-Elizabeth M. Percival ◽  
Ryan C. Lynch ◽  
Anna B. Halpern ◽  
Mazyar Shadman ◽  
Ryan D. Cassaday ◽  
...  
Keyword(s):  
Hematologic Malignancy ◽  
Hematologic Malignancies ◽  
The United States ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Clinical Practices ◽  
General Management ◽  
Disease States ◽  
Potential Risks ◽  
The University

In January 2020, the first documented patient in the United States infected with severe acute respiratory syndrome coronavirus 2 was diagnosed in Washington State. Since that time, community spread of coronavirus disease 2019 (COVID-19) in the state has changed the practice of oncologic care at our comprehensive cancer center in Seattle. At the Seattle Cancer Care Alliance, the primary oncology clinic for the University of Washington/Fred Hutchinson Cancer Consortium, our specialists who manage adult patients with hematologic malignancies have rapidly adjusted clinical practices to mitigate the potential risks of COVID-19 to our patients. We suggest that our general management decisions and modifications in Seattle are broadly applicable to patients with hematologic malignancies. Despite a rapidly changing environment that necessitates opinion-based care, we provide recommendations that are based on best available data from clinical trials and collective knowledge of disease states.

Psychological benefits of theater-depicting cancer treatment.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 203-203
Author(s):  
Samantha Carlson ◽  
Becky Jones ◽  
Linda Grossheim ◽  
Joseph Mirro
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Family Members ◽  
The United States ◽  
Cancer Center ◽  
Emotional Impact ◽  
Therapeutic Effects ◽  
Continuous Variables

203 Background: The number of cancer survivors in the United States is increasing and estimated to exceed 13 million. Consequently, the quality of life of these patients and their family members has become a high priority. The best interventions to decrease distress, improve coping and quality of life for survivors are poorly understood but are becoming an important focus of research. We therefore, undertook a prospective pilot study using a questionnaire to measure the emotional impact of a play depicting cancer treatment on cancer survivors and their family members. This research project was reviewed and approved by the West Michigan Cancer Center Institutional Review Board (IRB). Methods: The emotional feelings and perceived levels of coping were measured and compared before and after the play. Statistical analyses of responses included chi-square and t-tests for continuous variables, or Fisher’s test or Wilcoxon’s test where parametric assumptions were not met. Results: A total of 60 survivors and 49 family members completed the research questionnaire. The most promising finding was that a majority of survivors and family members 51.0% (n = 50) felt they were coping better (p < 0.0001) after the play. Of the survivors, 73.0% said the play reflected their experiences and 78.0% felt it was helpful dealing with their emotions. Overall, 94.0% of those attending the play requested additional theater performances. Conclusions: Our preliminary data demonstrates that theater depicting cancer treatment has a strong emotional impact and potential therapeutic effects for cancer survivors and family members. Increased feelings of coping with the diagnosis occurred following the play. Attendees also felt less alone (59.5%) and more hopeful (53.4%) after the play.

scholarly journals Immuno-Oncology Medicines: Policy Implications and Economic Considerations

2019 ◽  
Vol 10 (3) ◽  
pp. 9
Author(s):  
Georges Adunlin ◽  
Jenny Dong ◽  
Maisha Kelly Freeman
Keyword(s):  
Cancer Immunotherapy ◽  
Checkpoint Inhibitors ◽  
The United States ◽  
Policy Implications ◽  
Cancer Therapies ◽  
Value Assessment ◽  
Factors Affecting ◽  
Innovative Drugs ◽  
The Impact ◽  
Economic Considerations

Significant progress has taken place in the field of cancer immunotherapy in recent years. Cancer immunotherapy, particularly immune checkpoint inhibitors, have shown rather dramatic results and are believed to have completely transformed the field of oncology. However, these transformational therapies are more expensive than previous cancer therapies. As more cancer immunotherapy agents are being developed, with some already being marketed, it is important to consider how economic constraints will shape health policy and value assessment related to these agents. A number of strategies have been suggested to alleviate the price burden and the ensuing concerns about the sustainability of publicly funded healthcare systems. Among these strategies, value-based pricing (VBP) for innovative drugs dominates the headlines in the field of oncology. The specifics of how VBP may be implemented in the United States is still unclear. Nonetheless, policy reform and economic considerations will have to be incorporated into the planning of VBP. The objective of this paper is multifold: (i) to identify the factors affecting the impact of cancer immunotherapy on healthcare cost; (ii) to critically appraise current approaches used to assess the value of novel cancer therapies; (iii) to assess the methodological challenges associated with the economic evaluation of cancer immunotherapy. As the health care system in the U.S transitions toward a value-based model, the need for a formal value assessment framework is warranted in cancer immunotherapy.   Article Type: Review

Convective Storms and the Insurance Industry: Challenges and Opportunities

2020 ◽  
Author(s):  
Kirsten D. Orwig
Keyword(s):  
United States ◽  
Tropical Cyclones ◽  
Insurance Industry ◽  
Property Values ◽  
Construction Materials ◽  
The United States ◽  
Building Code ◽  
Convective Storms ◽  
Challenges And Opportunities ◽  
Insured Loss

Convective storms affect countries worldwide, with billions in losses and dozens of fatalities every year. They are now the key insured loss driver in the United States, even after considering the losses sustained by tropical cyclones in 2017. Since 2008, total insured losses from convective storms have exceeded $10 billion per year. Additionally, these losses continue to increase year over year. Key loss drivers include increased population, buildings, vehicles, and property values. However, other loss drivers relate to construction materials and practices, as well as building code adoption and enforcement. The increasing loss trends pose a number of challenges for the insurance industry and broader society. These challenges are discussed, and some recommendations are presented.

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