A feasibility study of a new smartphone application for patients with cancer.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 211-211
Author(s):  
Atsuko Kitano ◽  
Chikako Shimizu ◽  
Yosuke Uchitomi ◽  
Narikazu Boku ◽  
Jun Ohi ◽  
...  
Keyword(s):  
Medical Oncology ◽  
Japanese Version ◽  
Smartphone Application ◽  
Assessment System ◽  
Cancer Center ◽  
Cancer Type ◽  
Breast Cancer Patients ◽  
Active User ◽  
Number Of Patients ◽  
User Rate

211 Background: Smartphone-applications have been used for self-care, but not all applications have a sufficient level of efficacy. We evaluated the feasibility of a new smartphone application (the App) which has two main functions—diary function and SNS function—and investigated the characteristics of active users. Methods: Patients who visited the Breast and Medical Oncology or GI Medical Oncology divisions at National Cancer Center Hospital were recruited between March and April in 2016. Participants could use the App for 28 days. Web-based survey was performed before and 28 days after using the App. The primary endpoint was Daily Active User (DAU) rate (the number of daily log-in user divided by the number of patients who completed installation). A mean DAU rate higher than 20% was predetermined as feasible. The secondary endpoints were daily diary function user rate, daily SNS function user rate, and overall user rate and change of Edmonton Symptom Assessment System Revised Japanese version (ESAS-r-j) before and after the App use. “Active user” was defined as a participant who used the AppeWe more than median active days for diary or SNS function. Duration of App use was counted from the date of installation to the date of last use, and overall user rate was calculated by Kaplan Meier method. Results: One-hundred and four patients (96%) completed the App installation and answered the first survey. All patients were followed for 28 days. The mean DAU rate was 50.9%. Active diary function user rate was 53% and active SNS function user rate was 40%. Overall user rate was 87.5%. Diary function was used more frequently by male patients than female, and non-breast cancer patients. SNS function was used more frequently by unemployed patients than others, and by patients younger than 40 y/o. We could evaluate the change of ESAS-r-j score in 80 patients who answered the second survey. There was a significant improvement of depression score among patients who were single and who had metastatic disease. Conclusions: The App was considered feasible. Gender, cancer type, job status, and age may influence the behavior of the App use. The App may improve patients’ psychological symptoms, but further investigations are warranted to reveal the clinical utility of the App.

Time to adjuvant chemotherapy (AC) in stage III colon cancer at a community cancer center: A quality improvement initiative.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17503-e17503
Author(s):  
Arun Partridge ◽  
Mark Rother ◽  
Katherine Enright ◽  
Leonard Kaizer ◽  
Jeffrey A. Myers ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Median Time ◽  
Medical Oncology ◽  
Stage Iii ◽  
Patient Specific ◽  
Cancer Center ◽  
Time Interval ◽  
Stage Iii Colon Cancer ◽  
Number Of Patients ◽  
Modifiable Factors

e17503 Background: The standard of care for stage III colon cancer remains 5FU based AC. In clinical trial settings, this begins within 56 days of surgery. Recently a meta-analysis suggested that delays to starting chemotherapy are associated with inferior outcomes and the goal should be to commence AC as soon as feasible. Our objective was to assess the time to starting AC for referred patients to our center and to identify modifiable factors which may be improve upon to reduce delays. Methods: All patients referred to our center with stage III colon cancer who received at least 1 cycle of intravenous AC between Jan.1, 2010 and Dec.31, 2010 were identified. Patient characteristics and time intervals between surgery, Medical Oncology referral, Medical Oncology consultation and initiation of AC were assessed. Results: The total number of patients is 43. Median time to initiation of AC from surgery was 60 days with a range of 29-118 days. Only 32% of patients commenced AC within 56 days of surgery. The intervals of time from surgery to Medical Oncology referral and Medical Oncology consultation to initiation of AC were similar with a median of 25 and 26 days respectively. The median time interval from Medical Oncology referral to Medical Oncology consultation was only 9 days. The bulk of the interval for initiation of AC after seeing a Medical Oncologist was for placement of central intravenous (CIV) devices which took a median of 19 days. Conclusions: The majority of our patients do not start AC within an accepted timeframe. Most of the delay is related to the interval taken to request a consultation to Medical Oncology by the surgeon and to Medical Oncology access to CIV devices. Educational programs geared to referring surgeons which stress the importance of timely AC can help and are being initiated. Further options such as pre booking CIV devices and colon cancer patient-specific nurse navigators to try and streamline the processes and reduce their delays are being explored. [Table: see text]

Promoting quality breast cancer care: Psychosocial distress screening

2013 ◽  
Vol 12 (1) ◽  
pp. 75-80 ◽  
Author(s):  
M. Tish Knobf ◽  
Maureen Major-Campos ◽  
Anees Chagpar ◽  
Andrea Seigerman ◽  
Ruth Mccorkle
Keyword(s):  
Administrative Support ◽  
Medical Oncology ◽  
Surgical Oncology ◽  
Psychosocial Distress ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Distress Screening ◽  
Two Phase ◽  
Breast Center ◽  
Number Of Patients

AbstractObjective:To evaluate the feasibility of implementing psychosocial distress screening in a breast center of a comprehensive cancer center, using a model of structure (personnel, resources), process (screening), and outcome (number of patients screened, number referred).Methods:The first step in the project was to establish administrative support, educate and engage breast center staff, identify stakeholders and persons with expertise in the conduct of evidence based initiatives. A two-phase implementation approach was agreed upon with Phase I being screening of new patients in surgical oncology and Phase II being screening women in medical oncology.Results:A total of 173 patients were screened. The new patients screened in surgical oncology reported higher average distress scores compared to patients in medical oncology (5.7 vs. 4.0). However, a greater number of patients in medical oncology reported scores >4 compared to the new patients screened in surgery (54% vs. 35%). Psychological distress was the most commonly reported distress for patients in surgery. In contrast, 60% of scores >4 in medical oncology were symptom related, managed by the nurse or physician.Significance of results:Nurse led implementation of psychosocial distress screening is feasible, addressing this important quality indicator of patient-centered care.

Clinical trials networks and enrollment of historically underrepresented populations in medical oncology trials

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20598-e20598
Author(s):  
J. L. Berkowitz ◽  
A. Fernandez ◽  
R. A. Dichmann ◽  
K. A. Kennedy ◽  
B. DiCarlo
Keyword(s):  
Clinical Trials ◽  
Medical Oncology ◽  
Cancer Center ◽  
Underrepresented Populations ◽  
Oncology Research ◽  
Academic Center ◽  
Clinical Investigations ◽  
Number Of Patients ◽  
Bony Metastases ◽  
Two Populations

e20598 Background: Oncology research is limited by the very low number of patients accrued into clinical trials. Clinical trials networks may help to overcome this limitation by allowing investigations designed through academic centers to be available to patients seen in community practices that are far from these centers. This allows for increased accrual and access for these patients while potentially increasing the pace of progress in clinical oncology research. Methods: In this study, we attempted to determine the effect that clinical trials networks can have on the accrual of cancer patients into clinical investigations. We retrospectively analyzed the records from 2002–2008 of a private practice located over 150 miles from an academic center for accrual into trials. This practice is a member of a clinical trials network affiliated with a major academic cancer center. Accrued patients were divided into subgroups based upon type of malignancy, ethnicity and whether or not they were elderly. In addition, from 2007–2008, the percentage of patients accrued into trials relative to the total number treated onsite was calculated and compared to national averages. Results: In this period, a total of 139 patients at this practice were accrued into clinical trials. By malignancy, they were as follows: breast 36%, colorectal 22%, lung 13%, prostate 8.4%, gastric and lymphoma each 3.0%, pancreatic 1.8%, melanoma 1.2% and ovarian 0.6%. The other 18 patients were in trials for either chemotherapy related anemia 7.8% or bony metastases 3.0%. Of the 139 patients, 45% were elderly and 16% were Hispanic, both markedly higher than national averages. For 2007–2008, 12% of patients that received on site treatment were accrued on to trials. For lung, colorectal, and breast cancer, the number of patients on trial as a percentage of all treated onsite were also higher than the national averages. Conclusions: Clinical trial networks allow a higher percentage of total patients to be accrued than the national average and greatly enhance the potential for both minority and elderly enrollment, two populations that have been historically underrepresented in major clinical trials. It may also help to accelerate the progress of medical oncology research towards better treatments for all patients. No significant financial relationships to disclose.

scholarly journals The 10-Year Incidence Trend of Common Cancers at a Referral Hospital in Tehran, Iran From 2007 to 2016

2019 ◽  
Vol 4 (3) ◽  
pp. 80-85
Author(s):  
Hormoz Sanaeinasab ◽  
Esmat Davoudi Monfared ◽  
Ali-Akbar Karimi Zarchi ◽  
Mohsen Saffari ◽  
Abdowreza Delavari
Keyword(s):  
Cancer Patients ◽  
Linear Trend ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Cancer Center ◽  
P Value ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Almost All

Background: Common cancers such as colon, breast, and lung cancer are increasing in developing countries. Objective: This study was conducted to determine 10-year trends and changes in common cancers in patients from a referral hospital in Tehran, Iran. Methods: This cross-sectional study investigated a study population comprising colon, stomach, lung, prostate, and breast cancer patients registered at the cancer center of a referral hospital in Tehran, Iran from April 1, 2007 to the end of March, 2016 (n=4472). Inclusion criteria were a definitive diagnosis of cancer and an age between 15 and 75 years. Data was entered into SPSS (version 18) software and analyzed using the Time Series analysis and Scatter IO graph. Results: Significant correlations (P value <0.001) were seen between age increases in patients and the increasing number of patients in any type of cancer. With almost all of the five studied cancers, incidence increased with aging (P value <0.001). The incremental linear trend in the age of patients with lung (P value = 0.008) and colon (P value = 0.004) cancers and the decreasing trend in the age of prostate cancer patients (P value = 0.001) were statistically significant. Conclusion: The incidence of cancer has increased over the past 10 years in both genders and ages. It is suggested that future studies should address the causes and factors behind the increasing incidence of common cancers.

Prevalence and predictors of online patient access to electronic medical records among patients with cancer.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 35-35
Author(s):  
Andrew L Laccetti ◽  
Jingsheng Yan ◽  
Jennifer Cai ◽  
Samantha Gates ◽  
Yang Xie ◽  
...  
Keyword(s):  
Medical Center ◽  
Medical Advice ◽  
Cancer Center ◽  
Cancer Type ◽  
Patient Portal ◽  
Patient Access ◽  
Test Results ◽  
Number Of Patients ◽  
Patient Reported ◽  
The Impact

35 Background: Although the impact of patient access to health records and providers has not been well studied in cancer populations, these applications are now widely employed at cancer centers nationwide. Understanding implications of this practice in cancer patients is critical as patient-reported symptoms may be more likely to represent medical emergencies and test results may be more likely to represent major clinical developments. Methods: Retrospective analysis of enrollment in and use of MyChart, an internet-based patient portal for the EPIC electronic medical record, among patients seen at the Harold C. Simmons Cancer Center at UT Southwestern Medical Center. Predictors of MyChart use were analyzed through univariate and multivariate regression models. Results: A total of 6,495 patients enrolled in MyChart (2006-2012). Mean age was 60 ± 13 years, and 67% were female. The number of patients enrolling per year increased more than five-fold - 181 in 2006 to 1,146 in 2012. The total number of MyChart log-ins was 707,746. Per patient, median total log-ins was 57 (range 1-10,347). In a multivariate model, increased MyChart use was associated with male gender (p=0.01) and with cancer type (p<0.001), with highest rates among patients with genitourinary and upper aerodigestive malignancies. The most common MyChart activities were review of laboratory and radiology results (35%), communicating with providers (34%) [including messaging (29%) and medical advice request (5%)], and appointment scheduling/canceling (18%). Eighty-nine percent of log-ins occurred Monday-Friday. Login-times were 8a-5p (72%), 5p-11p (17%), and 11p-8a (11%). Approximately 32% of messaging (40% of medical advice requests) occurred outside clinic hours. Conclusions: Patient use of an internet-based patient health portal at an NCI-designated cancer center increased dramatically in recent years. The most common activities were viewing of test results and messaging with providers. A substantial proportion of messaging, particularly advice requests, occurred outside clinic hours. Further study of this technology is needed to understand its impact on patient safety, patient/provider satisfaction, and quality of care.

Decrease of oncological patients’ hospital visits during Covid-19 pandemic: The experience of a tertiary Romanian center.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13607-e13607
Author(s):  
Cristina Crisan ◽  
Calin Ioan Cainap ◽  
Andrada Larisa Deac ◽  
Andrei Dan Havasi ◽  
Ovidiu Balacescu ◽  
...  
Keyword(s):  
Medical Oncology ◽  
Cancer Center ◽  
Significant Drop ◽  
Surgical Interventions ◽  
Oncological Patients ◽  
Number Of Patients ◽  
Mri Scans ◽  
Outpatient Departments ◽  
Pathology Reports ◽  
The Impact

e13607 Background: The outbreak of COVID-19 pandemic has changed the provision of medical services worldwide. Oncological patients continued receiving specialty treatments. We assess the impact of the pandemic on the oncological patients' visits to a tertiary cancer center. Methods: We analyzed registrations from the administrative data system of in and outpatients in all departments of the Cluj-Napoca Oncology Institute, during March-October 2020, compared to the same 7-month period of the previous year. Results: The decrease during March-October 2020 was of 40.2% for new referrals overall (with the most significant drop in April, of 80%), of 52.5% for medical oncology inpatients, 39% for pediatric oncology department inpatients, 69% for radiotherapy inpatients, 34.9% for surgical interventions and 31% decrease of issued pathology reports. The decrease was less important for outpatients: only 10% for medical oncology outpatient department, 33% for radiotherapy, and 27% for breast cancer unit outpatients. Imaging investigations were only slightly influenced by the pandemic (reduction of 5% for MRI scans, 19% for mammograms, whereas performed CT scans were even more after the outbreak of COVID-19). Conclusions: Our results show a decrease in the number of patients during the period after the outbreak of the COVID-19 pandemic, more for inpatients and less significant for outpatient departments, probably because of the internal circuits reorganization but also because of healthcare measures taken nationally and locally to limit the spread of the pandemic. Keywords: COVID-19, pandemic, oncology referrals, disruption.

The impact of COVID-19 on delivery of systemic anti-cancer treatment in urological cancer patients: A comparison with 2019 data from Guy’s Cancer Center.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17057-e17057
Author(s):  
Christina Karampera ◽  
Muhammad Khan ◽  
Beth Russell ◽  
Charlotte Moss ◽  
Maria J Monroy-Iglesias ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Severe Pneumonia ◽  
Patient Characteristics ◽  
Cancer Center ◽  
Cancer Type ◽  
Urological Cancer ◽  
Cancer Services ◽  
Number Of Patients ◽  
The Uk ◽  
The Impact

e17057 Background: The provision of cancer services has been strongly impacted by the outbreak of SARS-CoV-2. Our Cancer Centre in South-East London treats approximately 8,800 patients annually and is one of the largest Comprehensive Cancer Centres in the UK. When dealing with the second wave of COVID-19, it is important to further evaluate the safety of cancer treatments whilst balancing the risks of COVID-19 infection and complications. Here, we report on the patient/tumour characteristics of those patients undergoing SACT for a urological cancer diagnosis during the first wave, so as to help establish clinical guidelines for the management of these patients in a SARS-CoV-2 epidemic. Methods: All urological cancer patients receiving at least one SACT between 1st March- 31st May 2020 (COVID-19 period) were compared to the same timeframe in 2019. SARS-CoV2 infection was defined as a positive RT-PCR test; patients with symptoms or radiological changes alone were excluded. As part of Guy’s Cancer Cohort, we collected information on demographics, and cancer type, stage, and treatment. Results: A total of 455 patients (305 prostate, 102 renal, 38 bladder, and 10 testicular) received SACT in 2020 as compared to 535 (353 prostate, 129 renal, 37 bladder, and 15 testicular) in 2019 (15% overall decline). Patient characteristics in terms of demographics were fairly comparable, with 10% female patients in 2019 and 9% in 2020; 49% aged 70+ vs 45%; and 77% in the low socio-economic category vs 78%. There was an increase in patients with stage 4 (89% vs 95% in 2020) and a slight change in distribution of SACT types (2019 vs 2020): chemotherapy (18% vs 14%), immunotherapy (7% vs 10%), biological or targeted (63% vs 66%), combination of biological/targeted (6% vs 5%), other combinations (5% vs 5%). The proportion of SACT delivered as part of radical treatment declined from 3% to 0.2% in 2020. A total of 5 patients (1%) developed COVID-19 (2 prostate, 2 renal, and 1 bladder). All were male and aged 60+; three had 2+ comorbidities. One patient was on immunotherapy and four on biological or targeted treatment. Four patients had severe pneumonia and one died of their COVID-19 (bladder cancer). Conclusions: Whilst there was a decline of number of patients receiving SACT during COVID-19, we were still able to provide a safe high-quality urological cancer SACT pathway during the peak of the COVID-19 pandemic, with very few COVID-19 positive patients. In a next step we will evaluate oncological outcomes at 6 months follow-up

scholarly journals Complementary and Alternative Medicine Use in Breast Cancer Patients at a Medical Center in Taiwan: A Cross-Sectional Study

2020 ◽  
Vol 19 ◽  
pp. 153473542098391
Author(s):  
Chieh-Ying Chin ◽  
Yung-Hsiang Chen ◽  
Shin-Chung Wu ◽  
Chien-Ting Liu ◽  
Yun-Fang Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Cancer Patients ◽  
Medical Center ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Cam Use ◽  
Complementary And Alternative

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.

scholarly journals Bayesian adaptive design of early-phase clinical trials for precision medicine based on cancer biomarkers

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Shinjo Yada
Keyword(s):  
Neural Network ◽  
Clinical Trials ◽  
Precision Medicine ◽  
Early Phase ◽  
Patient Specific ◽  
Specific Gene ◽  
Cancer Type ◽  
Background Characteristics ◽  
Number Of Patients ◽  
Early Phase Clinical Trials

Abstract Cancer tissue samples obtained via biopsy or surgery were examined for specific gene mutations by genetic testing to inform treatment. Precision medicine, which considers not only the cancer type and location, but also the genetic information, environment, and lifestyle of each patient, can be applied for disease prevention and treatment in individual patients. The number of patient-specific characteristics, including biomarkers, has been increasing with time; these characteristics are highly correlated with outcomes. The number of patients at the beginning of early-phase clinical trials is often limited. Moreover, it is challenging to estimate parameters of models that include baseline characteristics as covariates such as biomarkers. To overcome these issues and promote personalized medicine, we propose a dose-finding method that considers patient background characteristics, including biomarkers, using a model for phase I/II oncology trials. We built a Bayesian neural network with input variables of dose, biomarkers, and interactions between dose and biomarkers and output variables of efficacy outcomes for each patient. We trained the neural network to select the optimal dose based on all background characteristics of a patient. Simulation analysis showed that the probability of selecting the desirable dose was higher using the proposed method than that using the naïve method.

scholarly journals CanAssist Breast Impacting Clinical Treatment Decisions in Early-Stage HR+ Breast Cancer Patients: Indian Scenario

2019 ◽  
Author(s):  
Satish Sankaran ◽  
Jyoti Bajpai Dikshit ◽  
Chandra Prakash SV ◽  
SE Mallikarjuna ◽  
SP Somashekhar ◽  
...  
Keyword(s):  
High Risk ◽  
Early Stage ◽  
Risk Groups ◽  
Treatment Decisions ◽  
Low Risk ◽  
Not Given ◽  
Breast Cancer Patients ◽  
Number Of Patients ◽  
Risk Of Cancer ◽  
The Impact

AbstractCanAssist Breast (CAB) has thus far been validated on a retrospective cohort of 1123 patients who are mostly Indians. Distant metastasis–free survival (DMFS) of more than 95% was observed with significant separation (P < 0.0001) between low-risk and high-risk groups. In this study, we demonstrate the usefulness of CAB in guiding physicians to assess risk of cancer recurrence and to make informed treatment decisions for patients. Of more than 500 patients who have undergone CAB test, detailed analysis of 455 patients who were treated based on CAB-based risk predictions by more than 140 doctors across India is presented here. Majority of patients tested had node negative, T2, and grade 2 disease. Age and luminal subtypes did not affect the performance of CAB. On comparison with Adjuvant! Online (AOL), CAB categorized twice the number of patients into low risk indicating potential of overtreatment by AOL-based risk categorization. We assessed the impact of CAB testing on treatment decisions for 254 patients and observed that 92% low-risk patients were not given chemotherapy. Overall, we observed that 88% patients were either given or not given chemotherapy based on whether they were stratified as high risk or low risk for distant recurrence respectively. Based on these results, we conclude that CAB has been accepted by physicians to make treatment planning and provides a cost-effective alternative to other similar multigene prognostic tests currently available.

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