Quality and value of subspecialty reinterpretation of outside thoracic CT scans of patients referred to a tertiary cancer center.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 265-265
Author(s):  
Brett W. Carter ◽  
Jeremy J. Erasmus ◽  
Mylene Truong ◽  
Reginald F. Munden ◽  
Jo-Anne O. Shepard ◽  
...  
Keyword(s):  
Poor Quality ◽  
Chest Ct ◽  
Ct Scans ◽  
Cancer Center ◽  
Management Change ◽  
Nccn Guidelines ◽  
Radiology Reports ◽  
The Impact ◽  
Tertiary Cancer Center

265 Background: At tertiary cancer centers, physicians frequently request reinterpretation of imaging studies performed at outside institutions. The purposes of this study were to determine the quality of outside computed tomography (CT) scans of the chest and compare the accuracy of accompanying radiology reports from outside institutions and our multidisciplinary cancer center. Methods: Two thoracic radiologists graded the quality of 59 outside chest CT scans and generated independent reports for 52 of the scans. A third thoracic radiologist scored the outside reports and reinterpretations for quality. Fisher’s exact tests were used to compare the frequency with which crucial items appeared in outside reports and reinterpretations. Next, two outside thoracic radiologists identified discrepancies between outside reports and reinterpretations (first radiologist) and determined whether the outside report or reinterpretation was more accurate in each case (second radiologist). Finally, the impact of discrepancies on management was evaluated, largely based on NCCN guidelines. Results: Of the 59 outside CT scans, 35 (59%) were of poor quality. Reinterpretations were more likely than outside reports to include information about lymph nodes, adrenal and liver metastasis, tumor nodules, and tumor texture. In 19 of 52 cases (37%), discrepancies were identified between outside reports and reinterpretations. In 17 of these cases, the reinterpretation was superior; in 2 cases, the reinterpretation and outside report were of equal quality. Among these 17 cases, reinterpretation allowed staging in nine cases that could not be staged with information from the outside reports; resulted in upstaging without management change in one case and upstaging with management change in four cases among the five cases with staging information present in both sets of reports; and revealed a significant omission (2 cases) or error (1 case) that changed management in three cases. In total, reinterpretation resulted in significant changes to 16 of 52 (31%) of CT scans. Conclusions: Subspecialty reinterpretation of chest CT scans can substantially improve clinical management.

scholarly journals Adherence to and Implementation of ASCO Antiemetic Guidelines in Routine Practice in a Tertiary Cancer Center in India

2017 ◽  
Vol 13 (6) ◽  
pp. e574-e581 ◽  
Author(s):  
Vijay M. Patil ◽  
Vanita Noronha ◽  
Amit Joshi ◽  
Anant Ramaswamy ◽  
Sudeep Gupta ◽  
...  
Keyword(s):  
Cancer Center ◽  
Adherence Rate ◽  
Routine Practice ◽  
Adherence To Guidelines ◽  
Outpatient Chemotherapy ◽  
Antiemetic Guidelines ◽  
Check System ◽  
The Impact ◽  
Tertiary Cancer Center

Background: Nonadherence of antiemetic prescriptions to evidence-based antiemetic guidelines is associated with an increased proportion of chemotherapy-induced nausea and vomiting. The current project was carried out to improve the quality of antiemetic prescriptions at our institute. Methods: We initially performed a retrospective analysis of 1,211 consecutive antiemetic prescription records of adult patients with solid tumors who received outpatient chemotherapy regimens. The antiemetic prescription records were classified as either ASCO-guideline adherent or nonadherent, and the impact on emesis was studied. These data were used to educate clinicians regarding the importance of adherence to guidelines. We then revised our antiemetic prescription policies and made their use mandatory. In addition, a double-check system was introduced to ensure implementation. A reaudit was performed to study the impact of these interventions. Results: ASCO-guideline–adherent prescriptions in the initial part of our study were associated with a lower rate of vomiting (6.6% v 21.9%; P < .001), emergency visits (2.6% v 5.8%; P = .006), and hospitalization for emesis (0.9% v 4.9%; P < .001). The proportion of prescriptions classified as ASCO-guideline adherent in the initial audit and the reaudit were 63.6% and 98.5%, respectively ( P < .001). The proportion of patients for whom antiemetic prescriptions were overused was significantly lower on the reaudit (41.3% v 68.3% before the interventions; P = .001). Conclusion: Mandatory, semirigid corrective steps as carried out in this audit led to an improvement in antiemetic-guideline adherence rate.

Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ quality of life: An Arabic version of the Functional Living Index-Emesis

2021 ◽  
pp. 107815522199844
Author(s):  
Abdullah M Alhammad ◽  
Nora Alkhudair ◽  
Rawan Alzaidi ◽  
Latifa S Almosabhi ◽  
Mohammad H Aljawadi
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Arabic Language ◽  
Nausea And Vomiting ◽  
Cancer Center ◽  
Arabic Version ◽  
Patient Reported ◽  
Arabic Speaking ◽  
The Impact

Introduction Chemotherapy-induced nausea and vomiting is a serious complication of cancer treatment that compromises patients’ quality of life and treatment adherence, which necessitates regular assessment. Therefore, there is a need to assess patient-reported nausea and vomiting using a validated scale among Arabic speaking cancer patient population. The objective of this study was to translate and validate the Functional Living Index-Emesis (FLIE) instrument in Arabic, a patient-reported outcome measure designed to assess the influence of chemotherapy-induced nausea and vomiting on patients’ quality of life. Methods Linguistic validation of an Arabic-language version was performed. The instrument was administered to cancer patients undergoing chemotherapy in a tertiary hospital's cancer center in Saudi Arabia. Results One-hundred cancer patients who received chemotherapy were enrolled. The participants’ mean age was 53.3 ± 14.9 years, and 50% were female. Half of the participants had a history of nausea and vomiting with previous chemotherapy. The Cronbach coefficient alpha for the FLIE was 0.9606 and 0.9736 for nausea and vomiting domains, respectively, which indicated an excellent reliability for the Arabic FLIE. The mean FLIE score was 110.9 ± 23.5, indicating no or minimal impact on daily life (NIDL). Conclusions The Arabic FLIE is a valid and reliable tool among the Arabic-speaking cancer population. Thus, the Arabic version of the FLIE will be a useful tool to assess the quality of life among Arabic speaking patients receiving chemotherapy. Additionally, the translated instrument will be a useful tool for future research studies to explore new antiemetic treatments among cancer patients.

scholarly journals Quality of care in the free maternal healthcare era in sub-Saharan Africa: a scoping review of providers’ and managers’ perceptions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monica Ansu-Mensah ◽  
Frederick Inkum Danquah ◽  
Vitalis Bawontuo ◽  
Peter Ansu-Mensah ◽  
Tahiru Mohammed ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Research Question ◽  
Healthcare Providers ◽  
Poor Quality ◽  
Sub Saharan Africa ◽  
Healthcare Financing ◽  
Maternal Healthcare ◽  
Sub Saharan ◽  
The Impact

Abstract Background Free maternal healthcare financing schemes play an essential role in the quality of services rendered to clients during antenatal care in sub-Saharan Africa (SSA). However, healthcare managers’ and providers’ perceptions of the healthcare financing scheme may influence the quality of care. This scoping review mapped evidence on managers’ and providers’ perspectives of free maternal healthcare and the quality of care in SSA. Methods We used Askey and O’Malley’s framework as a guide to conduct this review. To address the research question, we searched PubMed, CINAHL through EBSCOhost, ScienceDirect, Web of Science, and Google Scholar with no date limitation to May 2019 using keywords, Boolean terms, and Medical Subject Heading terms to retrieve relevant articles. Both abstract and full articles screening were conducted independently by two reviewers using the inclusion and exclusion criteria as a guide. All significant data were extracted, organized into themes, and a summary of the findings reported narratively. Results In all, 15 out of 390 articles met the inclusion criteria. These 15 studies were conducted in nine countries. That is, Ghana (4), Kenya (3), and Nigeria (2), Burkina Faso (1), Burundi (1), Niger (1), Sierra Leone (1), Tanzania (1), and Uganda (1). Of the 15 included studies, 14 reported poor quality of maternal healthcare from managers’ and providers’ perspectives. Factors contributing to the perception of poor maternal healthcare included: late reimbursement of funds, heavy workload of providers, lack of essential drugs and stock-out of medical supplies, lack of policy definition, out-of-pocket payment, and inequitable distribution of staff. Conclusion This study established evidence of existing literature on the quality of care based on healthcare providers’ and managers’ perspectives though very limited. This study indicates healthcare providers and managers perceive the quality of maternal healthcare under the free financing policy as poor. Nonetheless, the free maternal care policy is very much needed towards achieving universal health, and all efforts to sustain and improve the quality of care under it must be encouraged. Therefore, more research is needed to better understand the impact of their perceived poor quality of care on maternal health outcomes.

scholarly journals Scoping review of mental health in prisons through the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046547
Author(s):  
Luke Johnson ◽  
Kerry Gutridge ◽  
Julie Parkes ◽  
Anjana Roy ◽  
Emma Plugge
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Grey Literature ◽  
Well Being ◽  
Health Impact ◽  
Poor Quality ◽  
Eligibility Criteria ◽  
Prison Staff ◽  
The Impact

ObjectiveTo examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.DesignScoping review.Data sourcesPubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.Eligibility criteria for selection of studiesAll papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.ResultsOf 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.ConclusionsIt is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.

scholarly journals Impact of the severity of restrictive spirometric pattern on nutrition, physical activity, and quality of life: results from a nationally representative database

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sung Jun Chung ◽  
Hwan Il Kim ◽  
Bumhee Yang ◽  
Taehee Kim ◽  
Yun Su Sim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
General Health ◽  
Multivariable Analysis ◽  
Caloric Intake ◽  
Health Problems ◽  
Poor Quality ◽  
Five Dimensions ◽  
The Impact

AbstractThe general disease burden associated with the restrictive spirometric pattern (RSP) is substantial. However, the impact of RSP by its severity on general health problems and quality of life has not been well elucidated. This study aimed to analyse nutrition, physical activity, and quality of life in subjects who participated in the Korea National Health and Nutrition Examination Survey 2007–2016 according to severity of RSP. Participants were classified as subjects with normal spirometry, those with mild-to-moderate RSP, and those with severe RSP. Poor quality of life was defined as 25th percentile value on the EuroQoL five dimensions (Eq5D) questionnaire index, i.e., 0.90. This study included 23,615 subjects composed of 20,742 with normal spirometry, 2758 with mild-to-moderate RSP, and 115 with severe RSP. The subjects with severe RSP were more likely to have attained lower education levels, had a lower total caloric intake, had less physical activity, had experienced a higher prevalence of comorbidities, and poorer quality of life than those with normal spirometry (P < 0.001 for all). In multivariable analysis, subjects with a mild-to-moderate RSP and severe RSP were more likely to show decreased total calories (coefficient for change in calorie = − 56.6 kcal and − 286.7 kcal, respectively) than those with normal spirometry; subjects with mild-to-moderate RSP and those with severe RSP were 1.26 times and 1.96 times more likely, respectively, to have a poorer quality of life than those with normal spirometry. Additionally, subjects with mild-to-moderate RSP and those with severe RSP were 0.84 times and 0.36 times less likely, respectively, to have high-intensity physical activity than those with normal spirometry in univariable analysis. The trends of a poorer quality of life and physical activity were only significant in the male subgroups. In conclusion, our study revealed that the severity of general health problems and quality of life reductions are correlated with the severity of RSP, especially in males.

Depressive and Bipolar Disorders

2017 ◽  
Author(s):  
Antoine Douaihy ◽  
Matthew Conlon ◽  
Maria Ferrara
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Sexual Behaviors ◽  
Depressive Disorders ◽  
Bipolar Disorders ◽  
Poor Quality ◽  
Persons Living With Hiv ◽  
The Impact ◽  
Hiv Aids

Depressive disorders are highly prevalent among persons living with HIV/AIDS. Depressive disorders significantly negatively affects adherence to antiretroviral therapy and HIV viral suppression and is associated with poor quality of life and major impairment in overall functioning. This chapter reviews the prevalence, risk factors, assessment and diagnosis of depressive and bipolar disorders. It also examines the impact of depression on sexual behaviors, adherence to antiretroviral therapy, quality of life, and mortality. This chapter also includes a comprehensive discussion of treatment approaches and considerations for HIV-infected individuals with depressive disorders. Furthermore, it reviews the bipolar disorder spectrum in HIV/AIDS as well as other psychiatric disorders co-occurring with depressive disorders.

Quality of life of young patients with recurrent respiratory papillomatosis

2017 ◽  
Vol 131 (5) ◽  
pp. 425-428 ◽  
Author(s):  
B B Montaño-Velázquez ◽  
J Nolasco-Renero ◽  
J E Parada-Bañuelos ◽  
F Garcia-Vázquez ◽  
S Flores-Medina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Human Papillomavirus ◽  
Otitis Media ◽  
Young Patients ◽  
Chronic Otitis Media ◽  
Poor Quality ◽  
Recurrent Respiratory Papillomatosis ◽  
Assess Quality ◽  
The Impact

AbstractObjective:To assess quality of life of children and teenagers with recurrent respiratory papillomatosis, according to the evidence of infection by human papillomavirus types 6 and 11, compared with healthy volunteers and patients with chronic otitis media.Method:Participants and their parents completed the Pediatric Quality of Life Inventory 4.0.Results:Patients with recurrent respiratory papillomatosis and their parents reported lower quality of life than healthy subjects (p < 0.01), but similar quality of life to patients with chronic otitis media. Those with human papillomavirus type 11 showed the lowest scores among all participants (p < 0.05).Conclusion:Young Mexican patients with recurrent respiratory papillomatosis and their parents perceive a poor quality of life, and they may experience limitations in interactions with their peers. Infection by human papillomavirus type 11 may increase the impact of the disease on quality of life.

What Is the Impact on Quality of Life of Various Treatments in Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome? Rethinking the Goals

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2112-2112 ◽  
Author(s):  
Sara M. Tinsley ◽  
Brent J Small ◽  
Jeffrey E Lancet ◽  
Susan C McMillan ◽  
Rami S. Komrokji ◽  
...  
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Supportive Care ◽  
Myeloid Leukemia ◽  
Research Funding ◽  
Intensive Therapy ◽  
Cancer Center ◽  
Pathology Report ◽  
The Impact

Abstract Introduction: Treatment decisions are difficult for older patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS). Few studies address the impact of treatment on QOL. Both AML and high-risk MDS occur most frequently in the sixth and seventh decades of life, and are associated with a poor prognosis with median survival of one year or less. A primary goal of treatment is to improve quality of life (QOL) because cure is improbable. This was a longitudinal cohort study to compare QOL between groups receiving intensive therapy, non-intensive therapy, and supportive care. The sample consisted of 85 patients 60 years of age and older diagnosed high risk MDS and AML recruited from Moffitt Cancer Center from 12/2013 until 4/2015. Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) was used to measure QOL. Study aims were to: 1) To compare the difference in QOL scores measured by the Functional Assessment of Cancer Therapy-Leukemia version for intensive chemotherapy, non-intensive therapy and supportive care within 7 days of new treatment, or decision to pursue supportive care, and one month or later; 2) To determine QOL predictors of AML and high risk MDS from age, comorbidity, fatigue, and diagnosis; 3) To test the moderating effect of treatment with age, comorbidity, and fatigue on QOL. See figure 1. Methods: Recruitment of 85 patients with high risk MDS and AML occurred at the time of appointments in the Hematology Clinic or during admission to Moffitt Cancer Center for induction chemotherapy. Inclusion criteria included patients 60 years of age and older with confirmed diagnosis of high-risk MDS or AML based on bone marrow pathology report. High-risk MDS and AML were treatedas one group. Patients were able to read, write, and speak English, were orientedto person, place, and time, and werewilling to participate. Quality of life was assessedat the time of enrollment and within at least one month of enrollment using the FACT-Leu. Fatigue was measuredusing the Brief Fatigue Inventory, a one page, nine-item questionnaire, which measures fatigue on a scale of zero to ten, with zero indicating no fatigue, and ten representing the worst fatigue that a person can imagine. Measurement of number of comorbidities was performedat the time of enrollment using the Charlson comorbidity index. Baseline information obtained on all subjects included age, as measured by date of birth, and diagnosis from pathology report including chromosome analysis. Demographic data collected included gender, marital status, level of education, income level, religious ceremony attendance on a scale of zero to four, and designation of intensive, non-intensive, or supportive care treatment. Results: The first aim, a comparison of QOL scores from week 1 to week 4, was analyzed with repeated measures analysis of variance (ANOVA). The supportive care group was not included in the analysis because of low accrual. Results indicated that there was a significant group by time interaction (with p=.040). Follow up tests revealed that the intensive treatment group had a significant improvement in their QOL scores at 1 month post treatment (p=.020). The second aim, evaluation of predictors of QOL was conducted using Pearson's correlations with age, comorbidity, fatigue, and diagnosis with significant correlations found between fatigue and QOL (r=-.693, p< .001). These findings identify an important relationship between fatigue and QOL. This was a negative correlation, showing that as fatigue increased QOL decreased. The third aim was explored using regression with Hayes (2013) application for moderation analysis. Scores for QOL for age, comorbidity, and fatigue were not moderated by treatment. Conclusions: These findings suggest that the most intensive treatment approach improves QOL. In addition, fatigue is a significant predictor of QOL. As fatigue increased, QOL scores decreased. Additional studies with a larger, more diverse sample are needed to explore the relationship between treatment approaches and QOL. In addition, intervention studies can be developed in AML and high risk MDS focused on fatigue management. It is anticipated that the results of this study will be used to inform patients and health care providers when making decisions concerning treatment based on QOL outcomes. Figure 1. Figure 1. Figure 2. Figure 2. Disclosures Lancet: Seattle Genetics: Consultancy; Pfizer: Research Funding; Boehringer-Ingelheim: Consultancy; Kalo-Bios: Consultancy; Amgen: Consultancy; Celgene: Consultancy, Research Funding. Komrokji:Celgene: Consultancy, Research Funding; Incite: Consultancy; Novartis: Speakers Bureau; GSK: Research Funding. List:Celgene Corporation: Honoraria, Research Funding.

FEATURES OF FORMATION AND MANAGEMENT OF STAFF QUALITY IN GERMANY AND RUSSIA

2017 ◽  
Vol 6 (2) ◽  
pp. 22-28
Author(s):  
Кудайберген ◽  
Pirimkul Kudaybergen
Keyword(s):  
Russian Federation ◽  
Social Protection ◽  
Poor Quality ◽  
Metro Station ◽  
The Russian Federation ◽  
The Impact

The article reveals peculiarities of the German and Russian staff, the tradition of quality of formation personnel in Germany and the Russian Federation. The impact reveals social protection, promotion, and the inevitability of punishment on the quality of the German staff. For example, compare the quality of the metro station and staff in Moscow and Dortmund, there is shown the differences in the activities of personnel in Germany and Russia. The origins and reasons for the relatively poor quality of Russian personnel are settled.

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