scholarly journals Improving radiologic communication in oncology: a single-centre experience with structured reporting for cancer patients

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Tim Frederik Weber ◽  
Manuela Spurny ◽  
Felix Christian Hasse ◽  
Oliver Sedlaczek ◽  
Georg Martin Haag ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Structured Reporting ◽  
First Year ◽  
Questionnaire Item ◽  
Software Application ◽  
Report Quality ◽  
Anticancer Treatment ◽  
Structured Reports ◽  
Item Scores

Abstract Objectives Our aim was to develop a structured reporting concept (structured oncology report, SOR) for general follow-up assessment of cancer patients in clinical routine. Furthermore, we analysed the report quality of SOR compared to conventional reports (CR) as assessed by referring oncologists. Methods SOR was designed to provide standardised layout, tabulated tumour burden documentation and standardised conclusion using uniform terminology. A software application for reporting was programmed to ensure consistency of layout and vocabulary and to facilitate utilisation of SOR. Report quality was analysed for 25 SOR and 25 CR retrospectively by 6 medical oncologists using a 7-point scale (score 1 representing the best score) for 6 questionnaire items addressing different elements of report quality and overall satisfaction. A score of ≤ 3 was defined as a positive rating. Results In the first year after full implementation, 7471 imaging examinations were reported using SOR. The proportion of SOR in relation to all oncology reports increased from 49 to 95% within a few months. Report quality scores were better for SOR for each questionnaire item (p < 0.001 each). Averaged over all questionnaire item scores were 1.98 ± 1.22 for SOR and 3.05 ± 1.93 for CR (p < 0.001). The overall satisfaction score was 2.15 ± 1.32 for SOR and 3.39 ± 2.08 for CR (p < 0.001). The proportion of positive ratings was higher for SOR (89% versus 67%; p < 0.001). Conclusions Department-wide structured reporting for follow-up imaging performed for assessment of anticancer treatment efficacy is feasible using a dedicated software application. Satisfaction of referring oncologist with report quality is superior for structured reports.

The outcome of outpatient palliative care service at Yonsei Cancer Center, a tertiary cancer center in Korea.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 131-131
Author(s):  
Si Won Lee ◽  
Hye Jin Choi
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Group Performance ◽  
Care Service ◽  
Symptom Control ◽  
Palliative Care Service ◽  
Cancer Center ◽  
Anticancer Treatment ◽  
Tertiary Cancer Center

131 Background: The importance of palliative care in cancer patients continues to be emphasized and studies are proving its importance. Several studies proved the improvement of quality of life in advanced cancer patients. The efficacy of symptom control based on outpatient palliative care service has not yet been reported in Korea. The objective of this study is to review the outcome of outpatient palliative care service at Yonsei Cancer Center, a tertiary cancer center in Korea. Methods: We retrospectively reviewed 155 cancer patients who used outpatient clinic at Yonsei Cancer Center in Korea between April 2014 and December 2014. Symptom severity was measured by modified Korean version of Edmonton Symptom Assessment System. Twelve symptoms were assessed: pain, fatigue, nausea, depression, anxiety, drowsiness, dyspnea, sleep disorder, anorexia, constipation, wellbeing, financial distress. Higher score means worse symptom. ESAS scores at baseline and follow-up assessments were analyzed. Results: The 155 patients had following characteristics: female 52.3%, median age 65 years (range 58-75), Hepatobiliary-pancreatic cancer and lung cancer patients accounted for the largest portion (n = 37, 23.9%; n = 36, 23.2% respectively). Most patients were Eastern Cooperative Oncology Group performance status 1 (n = 28, 18.1%) or 2 (n = 24, 15.5%). Ninety-two (59.4%) patients were referred to the palliative care team after anti-cancer treatments were all finished. Overall the symptoms did not change significantly from baseline to 2 consecutive follow up assessment except anorexia ( p value = 0.0195). Patients who were on active anticancer treatment had tendency of higher ESAS score than those finished with the anticancer treatment. However, all symptoms except nausea were not statistically significant. Conclusions: Most patients in this study did not have severe symptom scores that would show the differences of the symptom changes. Nevertheless, although not statistically significant, we found that patients on active anticancer treatment had higher symptom burden than those who were finished with the anticancer treatment. More meticulous symptom management is necessary to improve the symptom control.

Development of the functional capacity screening tool (FCST): A brief instrument to identify functional capacity deficits in anemic cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8593-8593
Author(s):  
D. Cella ◽  
H. Viswanathan ◽  
R. D. Hays ◽  
T. Mendoza ◽  
K. Stein ◽  
...  
Keyword(s):  
Construct Validity ◽  
Cancer Patients ◽  
Functional Capacity ◽  
Screening Tool ◽  
Self Report ◽  
Step Test ◽  
Open Label ◽  
New Instrument ◽  
Item Scores

8593 Background: Existing fatigue measures are long and often difficult to incorporate in practice. The objective of this study was to develop a short tool (Functional Capacity Screening Tool [FCST]) to identify functional capacity deficits related to fatigue in anemic cancer patients (pts) using self-report and performance-based measures of functional capacity. Methods: Data were obtained from a multicenter, open-label, single-arm study of darbepoetin alfa therapy (3.0 μg/kg every 2 weeks) in cancer pts (n=1558) who were ≥ 18 years of age with nonmyeloid malignancies receiving cyclic chemotherapy and anemia (hemoglobin [Hb] ≤ 11 g/dL). The Modified Harvard Step Test (MHST) was used as a performance-based measure of functional capacity to assess adjusted VO2max. Pts who contributed data for the development of FCST completed the following: MHST, baseline and ≥ 1 follow-up Hb measurement, baseline and ≥ 1 follow-up Functional Assessment of Cancer Therapy-Fatigue (FACT-F), and fatigue assessed within 3 days of MHST. Items from FACT-F, Brief Fatigue Inventory (BFI), Fatigue Symptom Inventory (FSI) and Medical Outcomes Study physical functioning scale were tested for inclusion in the FCST. Individual item scores were transformed to a 100-point scale. Item selection was based on identifying best predictors of adjusted VO2max, Hb, and global FACT-F scores using linear regression and the r-square selection method. FCST scores were calculated by summating item scores and dividing by number of items. Results: Data from401 pts contributed to the development of the FCST. Eight items were identified for the FCST with a Cronbach’s coefficient alpha of 0.92. Construct validity was supported by correlations of FCST with FSI (r = 0.80, P < .0001) and BFI (r = 0.86, P < .0001). Correlations between FCST and energy (r = 0.75, P < .0001), productivity (r = 0.72, P < .0001), and Hb (r = 0.24, P < .0001) further supported construct validity. Conclusions: FCST holds promise as a short screening tool for identifying functional capacity deficits in cancer pts. This new instrument was reliable, easy to score, and completed quickly by pts, making it suitable for incorporation in clinical practice. Further validation is required in different cancer populations. [Table: see text]

Job Loss and Re-Employment of Cancer Patients in Korean Employees: A Nationwide Retrospective Cohort Study

2008 ◽  
Vol 26 (8) ◽  
pp. 1302-1309 ◽  
Author(s):  
Jae-Hyun Park ◽  
Eun-Cheol Park ◽  
Jong-Hyock Park ◽  
Sung-Gyeong Kim ◽  
Sang-Yi Lee
Keyword(s):  
Cancer Patients ◽  
Job Loss ◽  
Cancer Site ◽  
First Year ◽  
Factors Affecting ◽  
Younger Age ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Diagnosis Of Cancer

Purpose The aim of this study was to investigate whether a diagnosis of cancer has an impact on the cancer patients’ job loss and re-employment and to identify the factors affecting job loss and re-employment during 6 years of follow-up of Korean employees with cancer. Patients and Methods All employees except for the self-employed in Korea who were diagnosed with cancer during the 2001 calendar year (n = 5,396) were identified as the first baseline patients and were followed every 3 months over 6 years to estimate the time taken to job loss. Patients who lost their job within the first year after a diagnosis of cancer (n = 1,398) were identified as the second baseline patients and were followed up over 5 years to estimate the time taken to re-employment using the National Health Insurance claims data. Patient demographic, socioeconomic, and clinical variables were investigated as factors that affected job loss and re-employment. Results Among the first baseline cancer patients, 47.0% lost their job, and among the second baseline patients, 30.5% were re-employed over 69 to 72 months of follow-up. Female sex, younger age and older age, company employee, lower income, blood cancer, and brain and CNS, lung, and liver cancer were significant predictors of early job loss or delayed re-employment. Conclusion The diagnosis of cancer affects cancer patients’ employment status differently according to different factors: sex, age, type of job, income, and cancer site. Efforts should be made to support re-employment and reduce unnecessary work cessation and disparity between different demographic and socioeconomic groups of cancer survivors.

scholarly journals Evolution of Health-Related Quality of Life in Breast Cancer Patients during the First Year of Follow-Up

2013 ◽  
Vol 16 (1) ◽  
pp. 104 ◽  
Author(s):  
David Moro-Valdezate ◽  
Salvador Peiró ◽  
Elvira Buch-Villa ◽  
Antonio Caballero-Gárate ◽  
M. Dolores Morales-Monsalve ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
First Year ◽  
Health Related Quality ◽  
Breast Cancer Patients ◽  
Related Quality ◽  
Health Related

Anti-Müllerian hormone (AMH) as a marker of ovarian reserve and premature ovarian insufficiency (POI) in children and women with cancer: A systematic review.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24057-e24057
Author(s):  
David A. Cameron ◽  
Richard Anderson ◽  
Florian Clatot ◽  
Isabelle Demeestere ◽  
Matteo Lambertini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Ovarian Reserve ◽  
Post Treatment ◽  
Cancer Type ◽  
Partial Recovery ◽  
Pediatric Cancer Patients ◽  
Before And After ◽  
Anticancer Treatment ◽  
Pre Treatment

e24057 Background: Female patients undergoing anticancer treatment are at elevated risk of ovarian damage including development of POI. AMH is a key serum biomarker of ovarian reserve. However, its role to identify risk of POI in cancer patients prior to and after treatment is less well understood. Methods: A systematic literature search for AMH in women with cancer was conducted up to 30 August 2020, with formal bias assessment. We aimed at evaluating AMH as a biomarker of ovarian reserve and POI before and after anticancer treatment. Exploratory subgroups were based on age, cancer type and length of follow-up. Results: : Eighty publications (including 7,708 patients) were included in this analysis. All papers reporting AMH before and after treatment reported a large reduction in AMH following treatment, in both adult and paediatric populations. Effect sizes varied depending on the treatment and diagnosis, but ranged from 42% to below the limit of detection, and many reported declines of ≥90%. A majority (25/34, 74%) of studies also reported at least partial recovery of AMH at follow-up. Pre-treatment AMH correlated with post-treatment levels in all studies and younger patient age with higher post-treatment AMH in 21/29 (72%) studies. In 18/32 (58%) publications, oligo/amenorrhea correlated with lower post-treatment AMH. No studies reported correlations between post-treatment AMH and pregnancy, although pregnancy was reported in some patients with low or undetectable AMH. 70% of publications found that within-study variations in treatment (estimated by chemotherapy or radiotherapy type, dosage, duration and/or number of cycles) correlated with AMH reductions and degree of recovery, indicating its potential value as a marker of gonadotoxicity. In women with breast cancer, recovery of AMH was reported in some patients in 10/18 publications; however, AMH levels showed no recovery in many patients receiving alkylating agents or cyclophosphamide-based chemotherapies. In lymphoma, patients receiving ABVD-based regimens had at least partial post-treatment recovery of AMH at follow-up compared with those receiving cyclophosphamide-containing regimens. 16/20 (80%) publications in pediatric cancer patients showed significant reductions in AMH compared with pre-treatment levels or controls. The diagnostic value of post-treatment AMH for POI was supported in 5/5 (100%) studies. AMH levels measured 1–2 years after treatment appeared to be equally reliable at indicating longer-term menstrual outcomes as studies with longer followup. Conclusions: AMH levels were strongly impacted by anticancer treatment, with recovery in some women determined by treatment regimen, age, and pretreatment AMH level. There was evidence for its role in diagnosis of POI, nut further studies are required to clarify its value to assist in patient management.

scholarly journals Are hypothalamic- pituitary (HP) axis deficiencies after whole brain radiotherapy (WBRT) of relevance for adult cancer patients? – a systematic review of the literature

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
P. Mehta ◽  
F. B. Fahlbusch ◽  
D. Rades ◽  
S. M. Schmid ◽  
J. Gebauer ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Nasopharyngeal Cancer ◽  
Whole Brain Radiotherapy ◽  
Cochrane Library ◽  
First Year ◽  
Cranial Radiotherapy ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Pubmed Database

Abstract Background Cranial radiotherapy (cRT) can induce hormonal deficiencies as a consequence of significant doses to the hypothalamic-pituitary (HP) axis. In contrast to profound endocrinological follow-up data from survivors of childhood cancer treated with cRT, little knowledge exists for adult cancer patients. Methods A systematic search of the literature was conducted using the PubMed database and the Cochrane library offering the basis for our debate of the relevance of HP axis impairment after cRT in adult cancer patients. Against the background of potential relevance for patients receiving whole brain radiotherapy (WBRT), a particular focus was set on the temporal onset of hypopituitarism and the radiation dose to the HP axis. Results Twenty-eight original papers with a total of 1728 patients met the inclusion criteria. Radiation doses to the HP area ranged from 4 to 97 Gray (Gy). Hypopituitarism incidences ranged from 20 to 93% for adult patients with nasopharyngeal cancer or non-pituitary brain tumors. No study focused particularly on hypopituitarism after WBRT. The onset of hypopituitarism occurred as early as within the first year following cRT (range: 3 months to 25.6 years). However, since most studies started follow-up evaluation only several years after cRT, early onset of hypopituitarism might have gone unnoticed. Conclusion Hypopituitarism occurs frequently after cRT in adult cancer patients. Despite the general conception that it develops only after several years, onset of endocrine sequelae can occur within the first year after cRT without a clear threshold. This finding is worth debating particularly in respect of treatment options for patients with brain metastases and favorable survival prognoses.

Health outcomes and resource utilization associated with postsurgical opioid use among cancer patients undergoing curative-intent surgery.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6515-6515
Author(s):  
Na Lin ◽  
Yuan Xu ◽  
Winson Y. Cheung ◽  
May Lynn Quan
Keyword(s):  
Cancer Patients ◽  
Resource Use ◽  
First Year ◽  
Opioid Overdose ◽  
Health Resource ◽  
Opioid Use ◽  
Curative Intent ◽  
Opioid Prescription ◽  
Opioid Users

6515 Background: To date, it remains unclear whether new persistent post-surgical opioid use is associated with subsequent opioid overdose, higher mortality and greater consumption of healthcare resources among cancer patients. To fill this gap, a population-based cohort study by applying real-world data has been performed to compare the long-term outcomes and healthcare resource use between new persistent and non-persistent opioid users among cancer patients after curative-intent surgery. Methods: This retrospective cohort study included all adult cancer patients with solid tumours who received curative-intent surgery in Alberta between 2011 and 2015, with a follow-up period until December 31, 2019. Patients who had multiple tumors, or had a follow-up < 6 months, or > 30 days of hospitalization were excluded. A new persistent post-surgical opioid user was defined as a patient who was opioid-naïve before surgery (no opioid prescription filled prior to the surgery) and subsequently filled at least one opioid prescription between 60 and 180 days after surgery. The outcomes (opioid overdose and mortality within 3 years) and health resource use (emergency department visits and hospitalization within the first year) after surgery were evaluated by applying multivariable logistic and Cox regressions. Results: A total of 19,219 patients received curative-intent surgery with a median follow-up of 47 months, of which 1,530 (8.0%) were identified as postoperative new persistent opioid users. Compared with the non-persistent group, a higher rate of opioid overdose (OR = 1.81, 95% CI: 1.49-2.2) within 3 years of surgery has been observed for new persistent opioid users, who were also associated with a greater likelihood of being hospitalized (OR = 2.52, 95% CI: 2.21-2.87) and visiting an emergency room (OR = 2.0, 95% CI: 1.78-2.24) within the first year after surgery. A higher overall (HR = 1.37, 95% CI: 1.2-1.57) and non-cancer caused mortality (HR = 1.39, 95% CI: 1.18-1.65) has also been detected for new persistent opioid users during the study follow-up period. Conclusions: For cancer patients undergoing curative-intent surgery, reducing new persistent opioid use is imperative to improve subsequent outcomes and health resource utilization.

scholarly journals Evaluation of optimal education level to implement structured reporting into ultrasound training

2020 ◽  
Vol 22 (4) ◽  
pp. 445
Author(s):  
Benjamin Philipp Ernst ◽  
Sebastian Strieth ◽  
Julian Künzel ◽  
Mohamed Hodeib ◽  
Fabian Katzer ◽  
...  
Keyword(s):  
Medical School ◽  
User Satisfaction ◽  
Information Loss ◽  
Structured Reporting ◽  
Free Text ◽  
Time Efficiency ◽  
Report Quality ◽  
Structured Reports ◽  
Junior Residents

Aims: Reporting of head and neck ultrasound (HNU) has been outlined to be a major obstacle during ultrasound training due to a lack of standardized structure, content and terminology. Consequently, overall report quality differs significantly between various examiners posing a severe risk factor for information loss and miscommunication. Therefore, the present study’s purpose is to compare the overall quality of free text reports (FTR) and structured reports (SR) of HNU at various stages of training in order to determine the optimal educational level to implement SR.Material and methods: Typical pathologies in HNU were reported upon using SR and FTR by medical students, junior residents and senior residents. The reports were assessed for overall quality, time efficiency and readability. Additionally, user satisfaction was determined using a questionnaire.Results: SRs exhibited a significantly superior report quality (93.1% vs. 45.6%, p<0.001) at all training levels. Overall time efficiency was significantly better for SRs, especially at the stages of medical school and early residency (89.4 s vs. 160.2 s., p<0.001). Using structured reporting also increased user satisfaction significantly (VAS 8.6 vs. 3.9, p<0.001).Conclusions: Implementing structured reporting of HNU results in a superior report quality at all training stages. Greatest benefits for time efficiency are achieved by implementation during medical school. Therefore, structured reporting of HNU should be implemented early on in the training of HNU.

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