Current patterns of care for patients with stage I testicular seminoma: Survey of U.S. radiation oncologists on treatment recommendations.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 418-418
Author(s):  
Timur Mitin ◽  
Aditya Jain ◽  
Catherine Degnin ◽  
Yiyi Chen ◽  
Arthur Hung ◽  
...  
Keyword(s):  
Best Practices ◽  
Compliance Rate ◽  
Clinical Work ◽  
Treatment Recommendations ◽  
Stage I ◽  
National Guidelines ◽  
Online Questionnaire ◽  
Chi Square ◽  
Testicular Seminoma ◽  
Radiation Oncologists

418 Background: Most men with Stage I testicular seminoma are cured with surgery alone, now a preferred strategy per national guidelines. The current pattern of practice among US radiation oncologists (RO) is unknown. Methods: We have surveyed practicing US RO via a short online questionnaire. Respondents’ characteristics, self-rated knowledge, perceived patient (pt) compliance rates with observation protocols and expected rate of infertility with and without adjuvant treatments were analyzed for association with treatment recommendations. Results: We received 353 responses from practicing US RO, of whom 23% consider themselves experts. Recommendations are summarized in the table. 34% believe that survival is jeopardized in case of recurrence on observation, but this belief does not impact the recommendation. Over 70% of respondents rate non-compliance with observation at > = 30%. Responders with a higher perceived non-compliance rate are more likely to recommend adjuvant therapy (Fisher’s exact p < 0.01). 52% routinely advise fertility assessment and/or sperm banking for pts who elect observation or chemotherapy, and 74% advise for pts undergoing RT. Respondents are more likely to recommend fertility assessment if they perceive a higher rate of infertility (Mantel-Haenszel Chi-square p < 0.01). 45% administer adjuvant RT in pts with elevated pre-orchiectomy alpha-fetoprotein levels. Conclusions: There is a dramatic uptake of observation as the recommended approach to pts with Stage I seminoma in US RO practices, despite a significant concern among practitioners about pt compliance. Further clinical work must establish best practices to minimize the effect on fertility, as well as guidelines for pts with Stage IS testicular seminoma. [Table: see text]

Current practice patterns surrounding fertility concerns in stage I seminoma patients: Survey of United States radiation oncologists.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 553-553
Author(s):  
Carl M Post ◽  
Aditya Jain ◽  
Catherine Degnin ◽  
Yiyi Chen ◽  
Michael Ellis Craycraft ◽  
...  
Keyword(s):  
Underlying Disease ◽  
Stage I ◽  
Trend Test ◽  
Online Questionnaire ◽  
Testicular Seminoma ◽  
Radiation Oncologists ◽  
Stage I Seminoma ◽  
Armitage Trend Test ◽  
Patterns Of Practice ◽  
Spearman’S Correlation

553 Background: Patients with testicular seminoma may face fertility issues because of their underlying disease as well as treatments they undergo. The current patterns of practice among US radiation oncologists aimed at assessing and preserving fertility in patients with Stage I seminoma are unknown. Methods: We surveyed practicing US radiation oncologists via an IRB-approved online questionnaire. Respondents’ characteristics, and perceived patient infertility rates were analyzed for association with treatment recommendations. Results: We received 353 responses, of whom one quarter (23%) consider themselves experts. A vast majority (84%) recommend observation as a default strategy. 52% routinely advise fertility assessment for patients prior to observation or chemotherapy, and 74% routinely do so prior to adjuvant RT. Nearly two-fifths believe that 10% and 30% of patients are infertile following orchiectomy. Thirty-seven and 22% believe infertility rates following para-aortic RT to be 30 and 50%, respectively. 80% routinely use clamshell scrotal shielding. Responders with higher perceived infertility rates are more likely to recommend fertility assessment/sperm banking (Fisher’s exact p<0.0001). Responders who routinely advised fertility assessment were more likely to use clamshell shielding (Cochran-Armitage trend test p = 0.0007). Clamshell use was positively correlated with higher perceived infertility rates following para-aortic RT (Spearman’s correlation coefficient = 0.006). Conclusions: Despite a clear knowledge of fertility issues in men diagnosed with seminoma, there is no universal adoption of fertility assessment among US radiation oncologists.

Patterns of prostate cancer management across Canadian prostate cancer treatment specialists.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 321-321
Author(s):  
Bobby Shayegan ◽  
Alan I. So ◽  
Shawn Malone ◽  
Sebastien J. Hotte ◽  
Antonio Finelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Treatment ◽  
Advanced Prostate Cancer ◽  
Patterns Of Care ◽  
Online Questionnaire ◽  
Prostate Cancer Treatment ◽  
Chi Square ◽  
Cancer Management ◽  
Radiation Oncologists ◽  
Medical Oncologists

321 Background: The Canadian GU Research Consortium (GURC) was recently established to bring comprehensive prostate cancer centres together to collaborate on research, education, and adoption of best practices. As an initial step to inform the work of the GURC, an electronic questionnaire was designed to assess management of advanced prostate cancer care in Canada and better understand patterns of care. Methods: A 59-item online questionnaire was developed by a multidisciplinary scientific committee to measure physician practices, patterns of care, treatment sequencing, and management of mCRPC. After pre-testing, the online questionnaire was sent to 93 urologists, uro-oncologists, medical oncologists, radiation oncologists, and general practitioner oncologists who are actively involved in the treatment of prostate cancer. Results: A total of 49 (53%) respondents completed the questionnaire between April 17, 2017 to May 17, 2017. Although all respondents indicated a role in initiating life-prolonging oral therapy for mCRPC and monitoring treatment and side effects, chemotherapy initiation was mainly a medical oncologist role compared to other specialties (p < 0.05, chi-square). Symptom management such as palliative care and end-of-life care were provided mainly by radiation oncologists (100%) and medical oncologists (81%) compared to urologists (33%) and uro-oncologists (50%), p < 0.05, chi-square). Patient mix varied across the disciplines. Urologist practices were composed primarily of non-metastatic prostate cancer patients (73%), as were radiation oncologist practices (77%), while uro-oncologist practices included both non-metastatic (58%) and metastatic (40%) patients. Medical oncologists practices were mainly (91%) metastatic patients. Referral patterns also varied by discipline. Conclusions: In Canada, prostate cancer treatment involves multiple disciplines providing a range of care at different points across the treatment continuum. We plan to do further research to better understand variation in practice and improve multidisciplinary coordination for patients with advanced prostate cancer.

scholarly journals On thin ice: barriers to adoption of surveillance for patients with stage I testicular seminoma. Survey of US radiation oncologists

2018 ◽  
Vol 44 (3) ◽  
pp. 452-460
Author(s):  
Aditya Jain ◽  
Catherine Degnin ◽  
Yiyi Chen ◽  
Mike Craycraft ◽  
Arthur Hung ◽  
...  
Keyword(s):  
Stage I ◽  
Barriers To Adoption ◽  
Testicular Seminoma ◽  
Radiation Oncologists

scholarly journals The perception of COVID-19 among Italian dental patients: an orthodontic point of view

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stefano Martina ◽  
Alessandra Amato ◽  
Paolo Faccioni ◽  
Alfredo Iandolo ◽  
Massimo Amato ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Point Of View ◽  
Dental Practice ◽  
Online Questionnaire ◽  
Chi Square ◽  
Dental Patients ◽  
Patient Health ◽  
Chi Square Test ◽  
Orthodontic Patients ◽  
Level Of Significance

Abstract Background The present study aimed to investigate the patients’ perception of the dental practice during the COVID-19 outbreak, and whether the pandemic will affect the attendance of orthodontic patients at the dental practice. An online questionnaire, including the Patient Health Questionnaire-4 (PHQ-4), was submitted to Italian dental patients with items about their perceived risks when going to the dentist, concerns about continuing orthodontic treatment, and the onset of temporomandibular disorders (TMD). Data were analyzed with a chi-square test and logistic regression analysis. The level of significance was set at P < 0.05. Results A total of 1566 subjects completed the survey, including 486 who were under orthodontic treatment or who had a child in orthodontic treatment. A total of 866 participants (55.3%) thought the risk of contracting the COVID-19 infection was higher in a dental practice; this perception was associated with gender (women more than man), age (over 60 years old) and high levels of distress (P<0.001). However, 894 patients (57.1%) felt comfortable going back to the dentist. Most of the orthodontic patients (84%) would continue their treatment. After the lockdown, there was a slight increase in the frequency of TMD pain (356 versus 334). Conclusions Most of the participants believed that the dental practice is a place at greater risk of contracting COVID-19, even if they continue to go to the dentist. Gender, age, and the level of distress were associated with the increase in the fear of going to the dentist due to COVID-19. Because of the pandemic, 16% of patients undergoing orthodontic treatment would not return to the dental practice to continue their orthodontic treatment after the lockdown. The prevalence of TMD pain in the population increased due to the pandemic.

scholarly journals Gastric Cancer Treatments and Survival Trends in the United States

2020 ◽  
Vol 28 (1) ◽  
pp. 138-151
Author(s):  
Kelly A. Stahl ◽  
Elizabeth J. Olecki ◽  
Matthew E. Dixon ◽  
June S. Peng ◽  
Madeline B. Torres ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Stage Iv ◽  
The United States ◽  
Current Treatment ◽  
Stage I ◽  
Stage Ii ◽  
Chi Square ◽  
Specific Guideline ◽  
Kaplan Meier

Gastric cancer is the third most common cause of cancer deaths worldwide. Despite evidence-based recommendation for treatment, the current treatment patterns for all stages of gastric cancer remain largely unexplored. This study investigates trends in the treatments and survival of gastric cancer. The National Cancer Database was used to identify gastric adenocarcinoma patients from 2004–2016. Chi-square tests were used to examine subgroup differences between disease stages: Stage I, II/III and IV. Multivariate analyses identified factors associated with the receipt of guideline concordant care. The Kaplan–Meier method was used to assess three-year overall survival. The final cohort included 108,150 patients: 23,584 Stage I, 40,216 Stage II/III, and 44,350 Stage IV. Stage specific guideline concordant care was received in only 73% of patients with Stage I disease and 51% of patients with Stage II/III disease. Patients who received guideline consistent care had significantly improved survival compared to those who did not. Overall, we found only moderate improvement in guideline adherence and three-year overall survival during the 13-year study time period. This study showed underutilization of stage specific guideline concordant care for stage I and II/III disease.

scholarly journals The Application and Development of Deep Learning in Radiotherapy: A Systematic Review

2021 ◽  
Vol 20 ◽  
pp. 153303382110163
Author(s):  
Danju Huang ◽  
Han Bai ◽  
Li Wang ◽  
Yu Hou ◽  
Lan Li ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Neural Networks ◽  
Decision Making ◽  
Deep Learning ◽  
Radiation Oncology ◽  
Clinical Work ◽  
Radiation Oncologists ◽  
Basic Concepts ◽  
Further Development

With the massive use of computers, the growth and explosion of data has greatly promoted the development of artificial intelligence (AI). The rise of deep learning (DL) algorithms, such as convolutional neural networks (CNN), has provided radiation oncologists with many promising tools that can simplify the complex radiotherapy process in the clinical work of radiation oncology, improve the accuracy and objectivity of diagnosis, and reduce the workload, thus enabling clinicians to spend more time on advanced decision-making tasks. As the development of DL gets closer to clinical practice, radiation oncologists will need to be more familiar with its principles to properly evaluate and use this powerful tool. In this paper, we explain the development and basic concepts of AI and discuss its application in radiation oncology based on different task categories of DL algorithms. This work clarifies the possibility of further development of DL in radiation oncology.

Attitude towards online classes among school and college going students during lockdown due to COVID-19 pandemic

2021 ◽  
Vol 8 (7) ◽  
pp. 3446
Author(s):  
Saurav Kumar ◽  
Shiv Prakash ◽  
Mona Srivastava
Keyword(s):  
Family Income ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Online Classes ◽  
Online Questionnaire ◽  
Chi Square ◽  
Cross Sectional ◽  
Academic Level ◽  
College Going ◽  
Significant Difference

Background: The aim of the study was to assess the attitude of the school and college-going students towards online classes. Methods: An online cross-sectional study was conducted on 228 school and college-going students fulfilling inclusion and exclusion criteria selected through purposive sampling methods. A semi-structured online questionnaire consisting of a socio-demographic questionnaire and Attitude towards online classes (ATOC) questionnaire was prepared by the researcher using Google form. The link of the questionnaire was sent to all the selected respondents through WhatsApp messages and emails. The data was analyzed using the IBM SPSS version 20 software. The reliability of the attitude questionnaire was assessed using Cronbach’s alpha test. The association between categorical variables was assessed using Chi-square tests. The comparison between variables was assessed using the students independent t-test.Results: More than half of the respondents (51.32%) were found with a positive attitude towards online classes. There was a significant association found between attitude towards online classes and socio-demographic variables such as age (p<0.05), academic level (p<0.05), and family income (p<0.01). The respondents who attended online classes (p<0.05), have technical knowledge (p<0.01), and got supported by their parents in the study (p<0.05) were found significantly high positive attitudes towards online classes. There was a significant difference found in the attitude of the respondents who faced psychological disturbances such as a decline in attention-concentration (p<0.05), irritation-anger (p<0.01), and tension (p<0.05) due to online classes.Conclusions: Although, online classes are more beneficial for the students and teachers in their academic activities during the lockdown period due to the COVID-19 pandemic but it can’t take place of traditional face-to-face classes. 

‘Watch policy’ in patients with suspected stage I testicular seminoma: CT as a sole staging and surveillance technique

1990 ◽  
Vol 42 (1) ◽  
pp. 40-41 ◽  
Author(s):  
M.J. Charig ◽  
A.C. Hindley ◽  
K. Lloyd ◽  
S.J. Golding
Keyword(s):  
Stage I ◽  
Testicular Seminoma

scholarly journals Adherence to Vaccine Requirements among Hajj Pilgrims in Saudi Arabia, 2017-2019

2021 ◽  
Vol 3 (2) ◽  
pp. 86-97
Author(s):  
Adel Alotaibi ◽  
Sami S Almudarra ◽  
Homoud S Algarni ◽  
Yasser Bakhsh ◽  
Zahir Mohamed Elamin Dafaalla ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Infectious Diseases ◽  
Yellow Fever ◽  
Vaccine Coverage ◽  
Compliance Rate ◽  
Adherence Rate ◽  
P Value ◽  
Chi Square ◽  
Surveillance Network ◽  
Polio Vaccination

Hajj pilgrims must have certain vaccines for pilgrimage; these requirements aim to reduce the spread of infectious diseases. This study analyzed the trends in vaccine adherence for meningitis, yellow fever, and polio from January 2017- December 2019. These trends can help in guiding future policymaking to prevent outbreaks during Hajj and similar mass gatherings. We analyzed data using descriptive statistics for Hajj pilgrims and Hajj seasonal workers arriving in Saudi Arabia over three years (2017–2019). Health Control Centers (HCCs) collected data at points-of-entry (PoE) and entered it into Saudi Arabia’s Health Electronic Surveillance Network (HESN). We reviewed HESN data to collect information on total passengers arriving per country and the number of passengers vaccinated for: meningococcal meningitis, poliomyelitis, and yellow fever. We compared data to identify the difference in vaccination by region.  We used chi-square tests to assess differences in compliance rate among these travelers by year and country of origin. The number of participating countries increased from 113 to 132. Meningitis vaccine coverage increased by 5% from 2017–2019. The increase was not statistically significant. Asia had the lowest overall adherence rate (83%). Yellow fever adherence decreased significantly using a difference of mean adherence between 2017 and 2019 (p-value 0.01). Polio vaccination adherence decreased by 5% from 2017 to 2019; this was not significant (p-value = 0.08). The vaccine coverage increased for meningitis and decreased for yellow fever and polio. Less than 100% vaccine adherence among Hajj travelers creates the potential for the spread of infectious diseases. Proof of vaccination should be required in submitted visa applications. Countries of origin and Saudi Arabia must work together to ensure that all Hajjis are adequately vaccinated before departure.

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