scholarly journals Community oncologists’ perceptions and utilization of large-panel genomic tumor testing

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eric C. Anderson ◽  
Alexandra C. Hinton ◽  
Christine W. Lary ◽  
Anny T. H. R. Fenton ◽  
Andrey Antov ◽  
...  
Keyword(s):  
Perceived Barriers ◽  
Great Promise ◽  
Test Results ◽  
Regression Analyses ◽  
Clinical Value ◽  
Lower Confidence ◽  
Positive Attitudes ◽  
Community Oncology ◽  
Large Panel ◽  
Multivariable Regression

Abstract Purpose Large-panel genomic tumor testing (GTT) is an emerging technology with great promise but uncertain clinical value. Previous research has documented variability in academic oncologists’ perceptions and use of GTT, but little is known about community oncologists’ perceptions of GTT and how perceptions relate to clinicians' intentions to use GTT. Methods Community oncology physicians (N = 58) participating in a statewide initiative aimed at improving access to large-panel GTT completed surveys assessing their confidence in using GTT, attitudes regarding the value of GTT, perceptions of barriers to GTT implementation, and future intentions to use GTTs. Descriptive and multivariable regression analyses were conducted to characterize these perceptions and to explore the relationships between them. Results There was substantial variability in clinicians’ perceptions of GTT. Clinicians generally had moderate confidence in their ability to use GTT, but lower confidence in patients’ ability to understand test results and access targeted treatment. Clinicians had positive attitudes regarding the value of GTT. Clinicians’ future intentions to use GTT were associated with greater confidence in using GTT and greater perceived barriers to implementing GTT, but not with attitudes about the value of GTT. Conclusions Community oncologists’ perceptions of large-panel genomic tumor testing are variable, and their future intentions to use GTT are associated with both their confidence in and perceived barriers to its use, but not with their attitudes towards GTT. More research is needed to understand other factors that determine how oncologists perceive and use GTT in clinical practice.

scholarly journals Patients' Expectations of Benefits From Large-Panel Genomic Tumor Testing in Rural Community Oncology Practices

2021 ◽  
pp. 1554-1562
Author(s):  
Eric C. Anderson ◽  
John DiPalazzo ◽  
Emily Edelman ◽  
Petra Helbig ◽  
Kate Reed ◽  
...  
Keyword(s):  
Stage Iv ◽  
Clinical Value ◽  
High Expectations ◽  
Patients With Cancer ◽  
Positive Attitudes ◽  
Complex Patients ◽  
Community Oncology ◽  
Large Panel ◽  
Cancer Types ◽  
Lower Education

PURPOSE Large-panel genomic tumor testing (GTT) is an emerging technology that promises to make cancer treatment more precise. Because GTT is novel and complex, patients may have unrealistic expectations and limited knowledge of its benefits. These problems may limit the clinical value of GTT, but their prevalence and associated factors have not been explored. METHODS Patients with cancer enrolled in a large initiative to disseminate GTT in community oncology practices completed surveys assessing their expectations, knowledge, and attitudes about GTT. The study sample (N = 1,139) consisted of patients with a range of cancer types (22% gynecologic, 14% lung, 10% colon, 10% breast, and 46% other malignancies) and cancer stages (4% stage I, 3% stage II, 15% stage III, and 74% stage IV). Mean age was 64 years (standard deviation = 11); 668 (59%) were women; 71% had no college degree; 57% came from households with less than $50,000 US dollars household income; and 73% lived in a rural area. RESULTS Generally, patients had high expectations that they would benefit from GTT (M = 2.81 on 0-4 scale) and positive attitudes toward it (M = 2.98 on 0-4 scale). Patients also had relatively poor knowledge about GTT (48% correct answers on an objective test of GTT knowledge). Greater expectations for GTT were associated with lower knowledge (b = –0.46; P < .001), more positive attitudes (b = 0.40; P < .001), and lower education (b = –0.53; P < .001). CONCLUSION This research suggests patients have high expectations that they will benefit from GTT, which is associated with low knowledge, positive attitudes, and low education. More research is needed to understand the concordance between expectations and actual clinical outcomes.

Perceived Effectiveness of Random Testing for Alcohol and Drugs in the Australian Aviation Community

2012 ◽  
Vol 2 (2) ◽  
pp. 72-81
Author(s):  
Christina M. Rudin-Brown ◽  
Eve Mitsopoulos-Rubens ◽  
Michael G. Lenné
Keyword(s):  
Logistic Regression ◽  
Online Survey ◽  
Random Testing ◽  
Regression Analyses ◽  
Perceived Effectiveness ◽  
Student Pilots ◽  
Alcohol And Drugs ◽  
Positive Attitudes ◽  
One Year ◽  
Alcohol And Other Drugs

Random testing for alcohol and other drugs (AODs) in individuals who perform safety-sensitive activities as part of their aviation role was introduced in Australia in April 2009. One year later, an online survey (N = 2,226) was conducted to investigate attitudes, behaviors, and knowledge regarding random testing and to gauge perceptions regarding its effectiveness. Private, recreational, and student pilots were less likely than industry personnel to report being aware of the requirement (86.5% versus 97.1%), to have undergone testing (76.5% versus 96.1%), and to know of others who had undergone testing (39.9% versus 84.3%), and they had more positive attitudes toward random testing than industry personnel. However, logistic regression analyses indicated that random testing is more effective at deterring AOD use among industry personnel.

scholarly journals Influence on attitudes and lifestyle due to lockdown amidst COVID-19 pandemic: a perception-based analysis among Bangladeshi residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Md. Saiful Islam ◽  
Md. Asad Ullah ◽  
Ummay Soumayia Islam ◽  
Sahadat Hossain ◽  
Yusha Araf ◽  
...  
Keyword(s):  
Associated Factors ◽  
Formal Education ◽  
Rural Residence ◽  
Regression Analyses ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Positive Attitudes ◽  
The Mean ◽  
Structured Questionnaire

Abstract Background Countrywide lockdown or stay-at-home order has been implemented to slow down the transmission of emergent coronavirus. However, the influence on attitudes and lifestyle due to lockdown amidst the coronavirus disease 2019 (COVID-19) pandemic has been poorly understood. The present study aimed to investigate the influence on attitudes and lifestyle due to lockdown amidst the COVID-19 pandemic among Bangladeshi residents. Methods A cross-sectional survey carried out involving 1635 community dwellers across eight divisions in Bangladesh conducted from April 15, 2020 to May 10, 2020. A structured questionnaire incorporating socio-demographic, attitudes towards lockdown and adverse lifestyle amidst lockdown measures was employed to collect data using the Google Forms. Multiple regression analyses were executed to determine the associated factors of positive attitudes towards lockdown and adverse lifestyle. Results The mean scores of attitudes towards lockdown were 67.9 (SD = 8.4) out of 85 with an overall correct rate (positive attitudes) of 79.9%; whereas the mean scores of adverse lifestyle amidst lockdown were 16.1 (SD = 4.8) out of 34 with an overall rate of 47.4%. The factors associated with more positive attitudes towards lockdown included being female, divorced, higher educated, and students. Conversely, being male, having no formal education, and rural residence were associated factors of adverse lifestyle amidst the COVID-19 pandemic. Conclusions The findings reflect how the COVID-19 lockdown has preciously impacted the attitudes, and lifestyle of Bangladeshi citizens, which will contribute to promoting appropriate measures during a subsequent zonal or complete lockdown.

Vestibular assessment of a patient with myasthenia gravis: case report 

2020 ◽  
Vol 12 (3) ◽  
pp. 65-70
Author(s):  
Kenneth Chua ◽  
Sakumura J
Keyword(s):  
Myasthenia Gravis ◽  
Late Onset ◽  
Vestibular Function ◽  
Symptom Checklist ◽  
Test Results ◽  
Functional Impairments ◽  
Clinical Value ◽  
Vestibular Assessment ◽  
Vestibular Function Testing ◽  
Function Testing

Vestibular Assessment in patients with Myasthenia Gravis (MG) is challenging, as diagnostic evaluation requires good recording of eye movements. Reports on Vestibular Function Testing (VFT) in MG patients have been scant and it is arguable that VFT will have little clinical value in the MG population. A 75-year-old man, with late onset acquired autoimmune MG presented with dizziness for evaluation. He completed VFT with no significant abnormalities in all tests and was elated to have vestibular ruled out as a contributing factor to his dizziness and imbalance. However, his functional impairments were still addressed and managed regardless of the test results. MG is a heterogenous condition that may be well-controlled with treatment. Patients with dizziness can still be diagnostically evaluated to rule in or out a vestibular involvement and should not be precluded from VFT. Patients should also be assessed for their functional impairments and not based on symptom checklist and objective test results alone. Hence, patients with normal VFT results can still benefit from a hybrid of vestibular rehabilitation therapy (VRT) with focus on habituation.

scholarly journals Analysis of Changes in Cancer-Related Fatigue of Breast Cancer Patients Receiving an Integrative Medicine Program

2020 ◽  
Vol 19 ◽  
pp. 153473542096378
Author(s):  
Friedemann Schad ◽  
Anja Thronicke ◽  
Phillipp von Trott ◽  
Shiao Li Oei
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Integrative Medicine ◽  
Regression Analyses ◽  
Breast Cancer Patients ◽  
Point Change ◽  
Cancer Related Fatigue ◽  
Tumor Stages ◽  
Multivariable Regression ◽  
Integrative Medicine Program

Introduction: Cancer-related fatigue (CRF) occurs frequently in breast cancer patients. The aim of this real-world study was to analyze the longitudinal changes of CRF in breast cancer patients receiving an integrative medicine program, which includes the application of non-pharmacological interventions (NPIs) and Viscum album L. (VA) extracts. Methods: All data were collected from the clinical register of the Network Oncology of a German certified breast cancer center of the Gemeinschaftskrankenhaus Havelhöhe (GKH). Primary breast cancer patients, treated upon initial diagnosis with integrated NPIs, comprising art and exercise therapy, nursing interventions, and educational components, during their hospital stay, and who had answered the German Cancer-Fatigue Scale (CFS-D) questionnaire at first diagnosis and 12 months later, were included. The associations between NPIs and CFS-D changes were analyzed with adjusted multivariable regression analyses, considering received treatment regimens and demographic variables, using the software R. Results: 231 female breast cancer patients of all tumor stages were evaluated. While chemotherapy exhibited significant severe deterioration, add-on VA applications seem to partially mitigate this impairment on CRF. 36 separate multivariable regression analyses for all NPIs showed that in particular significant associations between CFS-D improvements and the interventions nursing compresses (6 point change; P = .0002; R² = 28%) or elaborate consultations and life review (ECLR) (4 point change; P = .0002; R² = 25%) were observed. Conclusions: Breast cancer patients benefit from a hospital-based integrative medicine program. To alleviate fatigue symptoms during oncological therapy, an expansion of this concept should be developed in the future.

scholarly journals Analytical Model for Predicting the UCS from P-Wave Velocity, Density, and Porosity on Saturated Limestone

2019 ◽  
Vol 9 (23) ◽  
pp. 5265 ◽  
Author(s):  
González ◽  
Saldaña ◽  
Arzúa
Keyword(s):  
Wave Velocity ◽  
Predictive Models ◽  
Laboratory Tests ◽  
Ultrasonic Pulse ◽  
P Wave ◽  
Test Results ◽  
Regression Analyses ◽  
P Wave Velocity ◽  
Dry Conditions ◽  
Engineering Projects

Rock mechanics and rock engineering projects require determining, among other parameters, the uniaxial compressive strength (UCS) of rock. For such a purpose, it is not uncommon to perform ultrasonic pulse laboratory tests. Many researchers have found experimental relationships between strength and P-wave velocity, but these relationships are based mainly on dry conditions and without considering any other physical or chemical characteristics of the studied rock. Specifically, for limestone, there are 11 correlations reported in the literature, eight of which are simple and the remaining three are multiple, and, among the latter, only two of them consider the saturation. In order to evaluate the combined effect of P-wave velocity, density, and porosity on the UCS of saturated limestone, simple and multiple regression analyses were carried out on the test results of 13 saturated limestone specimens to determine the parameters of both previously mentioned predictive models. The results showed that density is not correlated with strength.

A18 A simulation study of the number of events per variable recommended in multivariable regression analyses

1993 ◽  
Vol 14 (5) ◽  
pp. 406 ◽  
Author(s):  
Peter Peduzzi ◽  
John Concato ◽  
Alvan R. Feinstein ◽  
Theodore R. Halford
Keyword(s):  
Simulation Study ◽  
Regression Analyses ◽  
Multivariable Regression

Melanogenuria: laboratory evaluation of the qualitative Thormählen and ferric chloride tests and their clinical utility.

1988 ◽  
Vol 34 (3) ◽  
pp. 582-585 ◽  
Author(s):  
R E Scott ◽  
V L Ward ◽  
G F Grinstead ◽  
B S Stevens ◽  
D M Wilson
Keyword(s):  
No Value ◽  
Ferric Chloride ◽  
Clinical Utility ◽  
Clinical Performance ◽  
Laboratory Evaluation ◽  
Small Scale ◽  
Test Results ◽  
Clinical Value ◽  
Melanoma Patients ◽  
Layer Chromatography

Abstract Malignant melanoma, a disease that is increasing in occurrence and medical concern, is characterized by the excretion of melanogens. Two qualitative tests are recommended for melanogen detection, the Thormählen test and the ferric chloride test. We evaluated the laboratory and clinical performance of these tests by subsequently re-evaluating 201 urine samples that had been submitted for routine melanogen analysis. We used (a) Thormählen, (b) ferric chloride, (c) small-scale thin-layer chromatography, and (d) spectrophotometry. Nearly 30% of Thormählen test results were equivocal. The ferric chloride test was of no value in itself or in categorizing equivocal Thormählen results as positive or negative. The small-scale chromatography was irreproducible. Prompt scanning of the Thormählen reaction product was helpful in classifying equivocal results. History review of 121 histopathologically diagnosed melanoma patients indicated that these qualitative assays were of no clinical value in the diagnosis or monitoring of melanoma patients.

scholarly journals Laboratory automation impact on antimicrobial resistance

2019 ◽  
Vol 40 (2) ◽  
pp. 66
Author(s):  
Patrick R Murray
Keyword(s):  
Fundamental Problem ◽  
Test Methods ◽  
Rapid Diagnosis ◽  
Laboratory Automation ◽  
Test Results ◽  
Clinical Value ◽  
Bacterial Cultures ◽  
Identification Of Bacteria ◽  
Diagnostic Microbiology ◽  
Traditional Approaches

Antibiotic resistance in common bacterial pathogens, such as Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae, has significantly limited the therapeutic options available for management of infectious diseases. While the indiscriminant use of broad spectrum antibiotics is a significant contributing factor, a more fundamental problem exists. Diagnostic microbiology test results have historically been available too late to be useful. This is, in part, due to the nature of the test methods and in part due to workflow practices in the laboratory. Thus, patients remain on empiric treatments that are frequently ineffective or unnecessarily too broad spectrum1,2. Microscopy and bacterial cultures are mainstays in the microbiology lab, using techniques developed more than 100 years ago. Although microbiologists speak with pride about the ‘art' of their science, the clinical value of the diagnostic tests is frequently lost because of the delays in reporting results with these ‘traditional' approaches. Fortunately, the practice of clinical microbiology is undergoing a dramatic transformation with the introduction of molecular diagnostics, primarily for rapid diagnosis of infections caused by viruses and difficult to grow bacteria, MALDI-TOF mass spectrometry for identification of bacteria, mycobacteria and fungi, and automation of all practices in bacteriology.

Nonbeneficial Intensive Care: Misalignments Between Provider Assessments of Benefit and Use of Invasive Treatments

2019 ◽  
Vol 35 (12) ◽  
pp. 1411-1417 ◽  
Author(s):  
Christopher Hwe ◽  
Jennifer Parrish ◽  
Bryan Berry ◽  
Oleg Stens ◽  
Dong W. Chang
Keyword(s):  
Intensive Care ◽  
Public Hospital ◽  
Chart Review ◽  
Severity Of Illness ◽  
Venous Catheter ◽  
Regression Analyses ◽  
Clinical Factors ◽  
Central Venous ◽  
Factors Associated ◽  
Multivariable Regression

Background: The purpose of this study was to examine how frequently invasive intensive care unit (ICU) treatments are delivered to critically ill patients despite clinicians’ impressions that ICU care may be nonbeneficial. Methods: Patients admitted to the medical ICU of an academic public hospital were prospectively categorized according to guidelines from the Society of Critical Care Medicine which classifies patients based on severity of illness and likelihood of recovery (categories 1-4). Clinical data and use of ICU treatments in patients with high (category 1) and low (category 3) likelihoods of benefit were collected by chart review. Multivariable regression analyses examined associations between use of invasive treatments and patient categories, and clinical factors associated with receiving invasive ICU treatments despite low likelihood of benefit. Results: There were 533 patients (369 in category 1 and 164 in category 3) in the study. A total of 19.8%, 29.9%, and 28.9% of patient-days on mechanical ventilation, vasopressors, and renal replacement therapy, respectively, were delivered to patients who were considered unlikely to benefit from ICU treatments (category 3) and ultimately did not survive hospitalization. These patients also received 35.2% of cardiopulmonary resuscitation attempts and 22.6% of central venous catheter placements. Clinicians’ impressions of likelihood of benefit (category 1 vs 3) were not associated with odds of receiving invasive ICU treatments. Clinical characteristics associated with greater odds of receiving potentially nonbeneficial treatments included older age, presence of dementia or malignancy, and higher Acute Physiologic Assessment and Chronic Health Evaluation score. Conclusions: Invasive ICU treatments are frequently delivered to patients who are not expected to benefit from ICU care and die during hospitalization. These findings highlight the need to improve utilization of ICU services among patients with advanced medical illnesses.

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