scholarly journals Access to systemic anti-cancer therapies for women with secondary breast cancer—protocol for a mixed methods systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sally Anne Pearson ◽  
Sally Taylor ◽  
Antonia Marsden ◽  
Janelle Yorke
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Mixed Methods ◽  
Contextual Factors ◽  
Cochrane Library ◽  
Evidence Based ◽  
Cancer Therapies ◽  
Anti Cancer ◽  
Unwarranted Variation ◽  
Secondary Breast Cancer

Abstract Background It is well recognised that access and receipt of appropriate guideline recommended treatment with systemic anti-cancer therapies for secondary breast cancer is a key determinant in overall survival. Where there is disparity in access this may result in unwarranted variation and disparity in outcomes. Individual, clinical and wider contextual factors have been associated with these disparities, however this remains poorly understood for women with secondary breast cancer. The purpose of the review is to examine individual, clinical and contextual factors which influence access to evidence-based systemic anti-cancer therapies for women with secondary breast cancer. This will include barriers and facilitators for access and receipt of treatment and an exploration of women and clinicians experience and perspectives on access. Methods A mixed methods approach with a segregated design will be used to examine and explore factors which influence access to systemic anti-cancer therapies for women with secondary breast cancer. Electronic databases to be searched from January 2000 onwards will be EBSCO CINAHL Plus, Ovid MEDLINE, Ovid EMBASE, PsychINFO and the Cochrane Library and JBI database. This will include NHS Evidence which will be searched for unpublished studies and gray literature. Title and abstract citations and full-text articles will be screened by the author and second reviewer. Data will be extracted by the author and validated by the second reviewer. An overarching synthesis will be produced which brings together quantitative and qualitative findings. Methodological quality and risk of bias will be assessed using the Mixed Methods Appraisal Tool. Discussion Understanding individual, clinical and wider contextual factors associated with access and receipt of systemic anti-cancer therapies for secondary breast cancer is a complex phenomenon. These will be examined to determine any association with access. Review findings will be used to guide future research in this area and the development of an evidence-based service level intervention designed to address unwarranted variation in access based upon the Medical Research Council (MRC) approach to the development, implementation and evaluation of complex interventions. Systematic review registration The review protocol has been registered in PROSPERO CRD42020196490.

scholarly journals Access to Systemic Anti-cancer Therapies for Women With Secondary Breast Cancer - Protocol for a Mixed Methods Systematic Review

2020 ◽  
Author(s):  
Sally Anne Pearson ◽  
Sally Taylor ◽  
Antonia Marsden ◽  
Janelle Yorke
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Mixed Methods ◽  
Data Extraction ◽  
Contextual Factors ◽  
Cancer Therapies ◽  
Factors Associated ◽  
Anti Cancer ◽  
Unwarranted Variation ◽  
Secondary Breast Cancer

Abstract Background:It is well recognised that access and receipt of appropriate guideline recommended treatment with systemic anti-cancer therapies for secondary breast cancer is a key determinant in overall survival. Where there is disparity in access this may result in unwarranted variation and disparity in outcomes. Individual, clinical and wider contextual factors have been associated with these disparities, however this remains poorly understood for women with secondary breast cancer. The purpose of the review is to address this gap by bringing together the available quantitative and qualitative evidence to examine factors associated with access to systemic anti-cancer therapies for women with secondary breast cancer and explore barriers and facilitators in relation to women and clinicians experience of access.Methods: A mixed methods approach with a segregated design will be used to examine and explore factors which influence access to systemic anti-cancer therapies for women with secondary breast cancer. Quantitative and qualitative appraisal, analysis and syntheses will be conducted discretely prior to final integration of findings. The review will use a comprehensive search strategy to search published and gray literature. Titles and abstracts will be screened against the eligibility criteria and full text articles will be retrieved for all records that meet the inclusion criteria. A data extraction tool will be developed, piloted and refined prior to full data extraction. Methodological quality and risk of bias will be assessed using the Mixed Methods Appraisal Tool. Discussion:Understanding individual, clinical and wider contextual factors associated with access and receipt of systemic anti-cancer therapies for secondary breast cancer is a complex phenomenon. These will be examined to determine any association with access. Review findings will be used to guide future research in this area and the development of an evidence-based service level intervention designed to address unwarranted variation in access based upon the Medical Research Council (MRC) approach to the development, implementation and evaluation of complex interventions.Systematic review registration:The review protocol has been registered in PROSPERO CRD42020196490

scholarly journals SOCIODEMOGRAPHIC AND GEOGRAPHICAL VARIATION IN ACCESS TO SYSTEMIC ANTI-CANCER THERAPIES FOR WOMEN WITH ADVANCED BREAST CANCER: A SYSTEMATIC REVIEW

The Breast ◽  
2021 ◽  
Vol 59 ◽  
pp. S40-S41
Author(s):  
Sally Anne Pearson ◽  
Sally Taylor ◽  
Antonia Marsden ◽  
Jessica Dalton O’Reilly ◽  
Sacha Howell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Advanced Breast Cancer ◽  
Geographical Variation ◽  
Advanced Breast ◽  
Cancer Therapies ◽  
Anti Cancer

scholarly journals Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Elizabeth A. McGuier ◽  
David J. Kolko ◽  
Mary Lou Klem ◽  
Jamie Feldman ◽  
Grace Kinkler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Human Service ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Implementation Outcomes ◽  
Services Implementation ◽  
Team Functioning

Abstract Background Healthcare and human services increasingly rely on teams of individuals to deliver services. Implementation of evidence-based practices and other innovations in these settings requires teams to work together to change processes and behaviors. Accordingly, team functioning may be a key determinant of implementation outcomes. This systematic review will identify and summarize empirical research examining associations between team functioning and implementation outcomes in healthcare and human service settings. Methods We will conduct a comprehensive search of bibliographic databases (e.g., MEDLINE, PsycINFO, CINAHL, ERIC) for articles published from January 2000 or later. We will include peer-reviewed empirical articles and conference abstracts using quantitative, qualitative, or mixed methods. We will include experimental or observational studies that report on the implementation of an innovation in a healthcare or human service setting and examine associations between team functioning and implementation outcomes. Implementation outcomes of interest are acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. Two reviewers will independently screen all titles/abstracts, review full-text articles, and extract data from included articles. We will use the Mixed Methods Appraisal Tool to assess methodological quality/bias and conduct a narrative synthesis without meta-analysis. Discussion Understanding how team functioning influences implementation outcomes will contribute to our understanding of team-level barriers and facilitators of change. The results of this systematic review will inform efforts to implement evidence-based practices in team-based service settings. Systematic review registration PROSPERO CRD42020220168

Prevascularized, Co-Culture Model for Breast Cancer Drug Development

2012 ◽  
Author(s):  
Lauren Marshall ◽  
Isabel Löwstedt ◽  
Paul Gatenholm ◽  
Joel Berry
Keyword(s):  
Breast Cancer ◽  
Drug Development ◽  
Three Dimensional ◽  
Human Tumor ◽  
3D Models ◽  
Cancer Drug ◽  
Cancer Therapies ◽  
Anti Cancer

The objective of this study was to create 3D engineered tissue models to accelerate identification of safe and efficacious breast cancer drug therapies. It is expected that this platform will dramatically reduce the time and costs associated with development and regulatory approval of anti-cancer therapies, currently a multi-billion dollar endeavor [1]. Existing two-dimensional (2D) in vitro and in vivo animal studies required for identification of effective cancer therapies account for much of the high costs of anti-cancer medications and health insurance premiums borne by patients, many of whom cannot afford it. An emerging paradigm in pharmaceutical drug development is the use of three-dimensional (3D) cell/biomaterial models that will accurately screen novel therapeutic compounds, repurpose existing compounds and terminate ineffective ones. In particular, identification of effective chemotherapies for breast cancer are anticipated to occur more quickly in 3D in vitro models than 2D in vitro environments and in vivo animal models, neither of which accurately mimic natural human tumor environments [2]. Moreover, these 3D models can be multi-cellular and designed with extracellular matrix (ECM) function and mechanical properties similar to that of natural in vivo cancer environments [3].

scholarly journals Does Exercise Have a Preventive Effect on Secondary Lymphedema in Breast Cancer Patients Following Local Treatment - A Systematic Review

Breast Care ◽  
2018 ◽  
Vol 13 (5) ◽  
pp. 380-385 ◽  
Author(s):  
Freerk T. Baumann ◽  
Alexandra Reike ◽  
Michael Hallek ◽  
Joachim Wiskemann ◽  
Vanessa Reimer
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Strength Training ◽  
Local Treatment ◽  
Exercise Group ◽  
Current Data ◽  
Cochrane Library ◽  
Breast Cancer Patients ◽  
Preventive Effect ◽  
Secondary Lymphedema

Background: Secondary lymphedema (SL) is a possible side effect of breast cancer treatment. Current data describe a positive influence of exercise on upper lymphedema. This systematic review evaluates studies examining a potential preventive effect of exercise on SL incidence. Methods: A systematic literature search of PubMed, LIVIVO, and the Cochrane Library was performed. Results: 8 randomized controlled trials were included in the review. 3 studies investigated the effect of strength training, and 5 the effect of combined exercise therapy. 5 studies included participants without lymphedema at study entry, and 3 studies included both patients with and without lymphedema. The partly significant results showed that progressive strength training as well as combined dynamic exercise therapies consisting of physiotherapy, physical therapy, and/or kinesiotherapy are safe and can prevent SL. Onset as well as diagnosis of lymphedema were significantly decreased in 5 studies in the exercise group. Conclusion: All 8 studies included indicate a potential preventive effect of exercise on SL; however, further research is needed.

scholarly journals Barriers and facilitators to implementing clinical imaging guidelines by healthcare professionals using theoretical domains framework: a mixed-methods systematic review protocol

BJR|Open ◽  
2021 ◽  
Vol 3 (1) ◽  
pp. 20210004
Author(s):  
Harriet Nalubega Kisembo ◽  
Ritah Nassanga ◽  
Faith Ameda Ameda ◽  
Moses Ocan ◽  
Alison A Kinengyere ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Systematic Reviews ◽  
Financial Incentives ◽  
Healthcare Professionals ◽  
Information Source ◽  
Theoretical Domains Framework ◽  
Barriers And Facilitators ◽  
Cochrane Library ◽  
Clinical Imaging

Objectives: To identify, categorize, and develop an aggregated synthesis of evidence using the theoretical domains framework (TDF) on barriers and facilitators that influence implementation of clinical imaging guidelines (CIGs) by healthcare professionals (HCPs) in diagnostic imaging Methods: The protocol will be guided by the Joanna Briggs Institute Reviewers’ Manual 2014. Methodology for JBI Mixed Methods Systematic Reviews and will adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA-P). Information source will include databases (MEDLINE, EMBASE and The Cochrane Library), internet search (https://www.google.com/scholar), experts’ opinion, professional societies/organizations websites and government bodies strategies/recommendations, and reference lists of included studies. Articles of any study design published in English from 1990 to date, having investigated factors operating as barriers and/or facilitators to the implementation CIGs by HCPs will be eligible. Selecting, appraising, and extracting data from the included studies will be independently performed by at least two reviewers using validated tools and Rayyan – Systematic Review web application. Disagreements will be resolved by consensus and a third reviewer as a tie breaker. The aggregated studies will be synthesized using thematic analysis guided by TDF. Results: Identified barriers will be defined a priori and mapped into 7 TDF domains including knowledge, awareness, effectiveness, time, litigationand financial incentives Conclusion: The results will provide an insight into a theory-based approach to predict behavior-related determinants for implementing CIGs and develop strategies/interventions to target the elicited behaviors. Recommendations will be made if the level of evidence is sufficient Advances in knowledge: Resource-constrained settings that are in the process of adopting CIGs may opt for this strategy to predict in advance likely impediments to achieving the goal of CIG implementation and develop tailored interventions during the planning phase. Systematic review Registration: PROSPERO ID = CRD42020136372 (https://www.crd.york.ac.uk/PROSPERO).

scholarly journals Terapia Física Descongestiva no tratamento do linfedema secundário ao câncer de mama: uma revisão sistemática / Decongestive Physical Therapy in the treatment of secondary breast cancer lymphedema: a systematic review

2020 ◽  
Vol 14 (53) ◽  
pp. 330-340
Author(s):  
Marilange Araújo de Almeida Souza ◽  
Aline Marques Piloto ◽  
Rosana Porto Cirqueira
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Physical Therapy ◽  
Cáncer De Mama ◽  
Secondary Breast Cancer ◽  
De Medicina

Resumo: O linfedema secundário é disfunção linfática crônica caraterizado como uma consequência do processo cirúrgico do câncer de mama que pode ser tratado por procedimento cirúrgico ou conservador. O objetivo foi realizar uma revisão sistemática da literatura sobre a utilização da terapia física descongestiva no tratamento do linfedema secundário e seus efeitos na redução do linfedema. Trata-se de uma revisão sistemática de literatura com artigos publicados nas bases de dados do Scientific Eletronic Library Online, Biblioteca Nacional de Medicina, Literatura Latino-Americana e Google Acadêmico, nos anos de 2010 a 2019. Foram selecionados 10 estudos que demonstraram efeitos positivos da terapia física descongestiva no tratamento do linfedema secundário e seus efeitos benefícios na redução do linfedema. A revisão sistemática comprovou os terapia física descongestiva é uma aliada no tratamento conservador do linfedema secundário de câncer de m

scholarly journals Effects of Exercise on Cardiac Function Outcomes in Women Receiving Anthracycline or Trastuzumab Treatment for Breast Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (18) ◽  
pp. 8336
Author(s):  
Pedro Antunes ◽  
Dulce Esteves ◽  
Célia Nunes ◽  
Anabela Amarelo ◽  
José Fonseca-Moutinho ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cardiac Function ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cochrane Library ◽  
Circulating Biomarkers ◽  
Ventricular Ejection Fraction ◽  
Secondary Outcomes

Background: we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of exercise training on cardiac function and circulating biomarkers outcomes among women with breast cancer (BC) receiving anthracycline or trastuzumab-containing therapy. Methods: PubMed, EMBASE, Cochrane Library, Web of Science and Scopus were searched. The primary outcome was change on left ventricular ejection fraction (LVEF). Secondary outcomes included diastolic function, strain imaging and circulating biomarkers. Results: Four RCTs were included, of those three were conducted during anthracycline and one during trastuzumab, involving 161 patients. All trials provided absolute change in LVEF (%) after a short to medium-term of treatment exposure (≤6 months). Pooled data revealed no differences in LVEF in the exercise group versus control [mean difference (MD): 2.07%; 95% CI: −0.17 to 4.34]. Similar results were observed by pooling data from the three RCTs conducted during anthracycline. Data from trials that implemented interventions with ≥36 exercise sessions (n = 3) showed a significant effect in preventing LVEF decline favoring the exercise (MD: 3.25%; 95% CI: 1.20 to 5.31). No significant changes were observed on secondary outcomes. Conclusions: exercise appears to have a beneficial effect in mitigating LVEF decline and this effect was significant for interventions with ≥36 exercise sessions.

Return to Play After Hip Arthroscopy: A Systematic Review and Meta-analysis

2018 ◽  
Vol 46 (11) ◽  
pp. 2780-2788 ◽  
Author(s):  
Michaela O’Connor ◽  
Anas A. Minkara ◽  
Robert W. Westermann ◽  
James Rosneck ◽  
T. Sean Lynch
Keyword(s):  
Systematic Review ◽  
Hip Arthroscopy ◽  
Meta Analysis ◽  
Return To Play ◽  
Sufficient Evidence ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Evidence Based ◽  
Rehabilitation Protocols ◽  
The Mean

Background: The use of arthroscopic treatment for intra-articular hip pathology has demonstrated improved patient-reported outcomes (PROs) with a lower rate of complications, reoperation, and patient morbidity as compared with traditional methods. Although the use of this minimally invasive approach has increased in prevalence, no evidence-based return-to-play (RTP) criteria have been developed to ensure an athlete’s preparedness for sporting activities. Purpose: To determine if there exists sufficient evidence in the literature to support an RTP protocol and functional assessment after hip arthroscopy, as well as to assess the mean rate and duration of RTP. Study Design: Systematic review and meta-analysis. Methods: The search terms “hip arthroscopy,” “return to play,” and 10 related terms were searched in PubMed, Cochrane Library, Scopus, and Web of Science, yielding 263 articles. After screening, 22 articles were included. RTP timeline, rehabilitation protocols, and conditional criteria measures were assessed with previously established criteria. Pooled estimates were calculated for RTP rate and duration, and weighted mean scores were determined for PROs. Results: A total of 1296 patients with 1442 total hips were identified. Although 54.5% (12 of 22) of studies did not provide a guideline for RTP duration after hip arthroscopy, 36.4% (8 of 22) recommended a duration of 4 months, while 9.1% (2 of 22) recommended 3 months. The most frequently described postoperative rehabilitation protocols were weightbearing guidelines (15 studies) and passive motion exercises (9 studies). Only 2 studies satisfied the criteria for a sufficient RTP protocol, and 3 provided a specific replicable test for RTP. The mean RTP duration was 7.4 months (95% CI, 6.1-8.8 months), and the return rate was 84.6% (95% CI, 80.4%-88.8%; P = .008) at a mean ± SD follow-up of 25.8 ± 2.4 months. Mean modified Harris Hip Score (mHHS) improved from 63.1 to 84.1 postoperatively (+33.3%), while Non-arthritic Hip Score improved from 61.7 to 86.8 (+40.7%). A lower preoperative mHHS was significantly associated with a higher postoperative improvement ( r = −0.95, P = .0003). Conclusion: Significant variability exists in RTP protocols among institutions owing to a lack of standardization. Despite a high overall rate of RTP and improvement in PROs after hip arthroscopy, the majority of rehabilitation protocols are not evidence based and rely on expert opinion. No validated functional test currently exists to assess RTP.

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