Perceived provider barriers to collecting and documenting a complete family history in a statewide oncology consortium.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 221-221
Author(s):  
Shayna Weiner ◽  
Erika Amini ◽  
Erika Koeppe ◽  
Ken Resnicow ◽  
Elena Martinez Stoffel ◽  
...  
Keyword(s):  
Family History ◽  
Patient Specific ◽  
Patient Knowledge ◽  
Complete Family ◽  
Patients With Cancer ◽  
The Family ◽  
Provider Barriers ◽  
Cancer Syndromes ◽  
Specific Barriers

221 Background: A complete family history is essential in identifying patients who may benefit from genetic evaluation for hereditary cancer syndromes. Fewer than 40% of patients with cancer have a complete family history documented in their medical record. As part of a larger study of patient- and provider-focused interventions for increasing genetic testing, we conducted a survey of provider barriers to collecting and documenting a complete family history in a statewide, physician-led quality consortium of nearly all medical and gynecologic oncologists in Michigan. Methods: A novel survey instrument was created by adapting existing literature and clinician input. Surveys were mailed to medical and gynecologic oncologists with follow up electronic surveys sent to non-respondents. Questions addressed patient-specific barriers as well as known constraints faced by oncologists. Each barrier was rated from low to high using a 10-point Likert scale. Descriptive statistics, including mean scores and standard deviations (SD), were calculated. Results: Of 317 surveys sent, 194 (61.2%) were returned. Oncologists rated constraints on their time lower than lack of patient knowledge and understanding of their family history and its importance as a barrier. Open-ended responses indicated that the processes of collecting a family history (e.g. templates for collecting family history that omit age at diagnosis) and patients being overwhelmed at the time of consultation also interfered with collecting a complete family history. Conclusions: Oncologists perceive patient knowledge of their family history, including the ages of affected family members, and understanding of its importance as barriers to completion and documentation of a family history. Explaining the importance of the family history to patients, prompting new patients to provide their family history, and improving the process, including the timing of collection, may increase the proportion of oncology patients who have a complete family history collected and documented.[Table: see text]

scholarly journals 22-year longitudinal study of repetitive colonoscopy in patients with a family history of colorectal cancer

2013 ◽  
Vol 95 (8) ◽  
pp. 586-590 ◽  
Author(s):  
JK Randall ◽  
CS Good ◽  
JM Gilbert
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
British Society ◽  
Degree Relative ◽  
Surveillance Programme ◽  
Patients With Cancer ◽  
Significant Pathology ◽  
History Of

Introduction We report the outcomes of a long-term surveillance programme for individuals with a family history of colorectal cancer. Methods The details of patients undergoing a colonoscopy having been referred on the basis of family history of colorectal cancer were entered prospectively into a database. Further colonoscopy was arranged on the basis of the findings. The outcomes assessed included incidence of cancer and adenoma identification at initial and subsequent colonoscopy. Results The records of 2,293 patients (917 men; median patient age: 51 years) were entered over 22 years, giving data on 3,982 colonoscopies. Eight adverse events (0.2%) were recorded. Twenty-seven cancers were found at first colonoscopy and thirteen developed during the follow-up period. There were significantly more cancers identified in those with more than one first-degree relative with cancer than in other groups (p=0.01). The number of adenomas identified at subsequent surveillance colonoscopies remained constant with between 9.3% and 12.0% of patients having adenomas that were removed. Two-thirds (68%) of patients with cancer and three-quarters (77%) with adenomas fell outside the British Society of Gastroenterology (BSG) 2006 guidelines. Conclusions Repeated colonoscopy continues to yield significant pathology including new cancers. These continue to occur despite removal of adenomas at prior colonoscopies. The majority of patients with cancers and adenomas fell outside the BSG 2006 guidelines; more would have fallen outside the 2010 guidelines.

Abstract 200: Risk Factors Positively Associated with Annual Growth Rate of Brain Aneurysms

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Aichi Chien ◽  
Michelle Hildebrandt ◽  
Rashida Callender ◽  
Yuanqing Ye
Keyword(s):  
Risk Factors ◽  
Growth Rate ◽  
Family History ◽  
Positive Family History ◽  
High Growth ◽  
Aneurysm Rupture ◽  
Patient Specific ◽  
Annual Growth Rate ◽  
Aneurysm Growth

Introduction: Previous studies have shown that unruptured intracranial aneurysm (UIA) growth and rupture are strongly associated with each other, with an increasing number of aneurysms followed clinically, especially UIA smaller than 7 mm. Hypothesis: Patient-specific and aneurysm-specific clinical and demographic features can predict growth and growth rates of UIA. Methods: We studied a cohort of 293 individuals diagnosed with a total of 409 intracranial aneurysms followed for an average of 27.4 months. Associations with aneurysm growth and growth rate were identified for both patient- and aneurysm-specific variables. Growth was defined as a size increase greater than 0.6 mm, with growth rate (mm/year) determined from the change in size of the aneurysm between the first and last measurement. Results: Mean initial size at diagnosis was significantly associated with risk of growth (OR: 1.09, 95% CI: 1.01-1.18, p=0.036), as was diagnosis of multiple aneurysms (OR: 2.01, 95% CI: 1.00-4.04, p=0.048) and having a positive family history (OR: 4.25, 95% CI: 1.18-15.3, p=0.041). Diagnosis of coronary artery disease (CAD) (p<0.001), diabetes (p=0.041), and gender (p=0.014) were significant for growth rate. Differences were observed for aneurysms located in different vessels, with an increased occurrence of growth at M-Bifurcation (p=0.015 vs. other MCA sites) and a high growth rate for those located in the BA trunk (p=0.0033 vs. other VABA sites). Conclusions: This analysis takes advantage of a large longitudinal cohort with multiple follow-up measurements to provide further insight regarding the characteristics of UIA growth behavior. While our data further confirm that aneurysm rupture and growth share a similar set of risk factors (size, multiplicity and family history), we additionally that found patients with CAD or diabetes had a higher aneurysm growth rate, and therefore might require more frequent follow up.

scholarly journals Risk reducing mastectomy in patients with brca mutation: initial experience

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Sabas Carlos Vieira ◽  
Danilo Rafael da Silva Fontinele ◽  
Ana Lúcia Nascimento Araújo
Keyword(s):  
Breast Cancer ◽  
Brca Mutation ◽  
Immediate Reconstruction ◽  
Patients With Cancer ◽  
The Family ◽  
The Mean ◽  
Contralateral Mastectomy ◽  
Risk Reducing

Introduction: There are no randomized studies that assess the role of risk-reducing mastectomy in decreasing the mortality of mutated patients; however, major prospective studies show a decrease in the incidence of breast cancer. The absolute reduction in the risk of breast cancer ranges from 2% to 7%, but the reduction of the risk of developing breast cancer is higher than 90%. The increasing mortality caused by contralateral breast cancer in the mutated patient is 1.7%, in 10 years, and 6.8%, in 20 years. Objectives: To analyze the cases of risk-reducing mastectomy in patients with BRCA mutation. Method: This is a retrospective study. We included all patients who had positive BRCA mutation test, assisted from 1999 to 2019. The study was approved by the Research Ethics Committee of Universidade Federal do Piauí, report n. 2.817.502. Results: We studied 23 patients who had a mutation in the BRCA gene, being 15 (65.2%) in BRCA 1, and 8 (34.8%) in BRCA 2. All participants were female, with mean age of 46 years, and mean of three cases of cancer in the family. Seven (30.4%) risk-reducing bilateral or contralateral mastectomy procedures were performed. The mean age at the performance of surgery was 38 years. There were six cases of previous breast carcinoma in one of the breasts, and one patient who had not been diagnosed with breast cancer. All of them were submitted to immediate reconstruction with inclusion of a silicone prosthesis. Laparoscopic bilateral salpingo-oophorectomy was performed in three patients. The histological type in the six patients with cancer was invasive carcinoma of no special type, being four triple negatives. Neoadjuvant chemotherapy was performed in four cases; in 6 cases, the mutation was in BRCA1. All patients remain without complains and free of disease, with mean follow-up of 29.5 months. Twelve (52.1%) patients are being followed-up with mammography, resonance and annual clinical examination, and did not accept risk-reducing mastectomy or salpingo-oophorectomy. Conclusions: Risk-reducing mastectomy was performed in 30.4% of the patients with deleterious mutation of BRCA. The main mutation was BRCA, and in 85.7% of the cases, the patient presented with previous breast cancer in one of the breasts.

Familial prostatic adenocarcinoma in the A.U.S.L territory of Imola

1996 ◽  
Vol 63 (1_suppl) ◽  
pp. 7-12
Author(s):  
G. Vagliani ◽  
A. Perrone ◽  
G. Salvi ◽  
G. Misuriello ◽  
A. Di Silverio ◽  
...  
Keyword(s):  
Family History ◽  
Working Conditions ◽  
Prostatic Carcinoma ◽  
Positive Family History ◽  
Benign Prostatic Hypertrophy ◽  
Next Of Kin ◽  
Healthy Men ◽  
Patients With Cancer ◽  
The Family ◽  
Civil Status

From 1987 to 1992, over 6,000 men aged between 50 and 79 years underwent mass screening for early diagnosis of prostatic carcinoma. They were also given an “epidemiological” questionnaire drawn up by a Urologist, which included information regarding civil status, fertility, working conditions, eating and smoking habits as well as tumours in the family. With regard to the latter, it appeared that 11% of patients with cancer have a positive family history against 2.2% in healthy men and 1.8% in individuals with benign prostatic hypertrophy. In order to investigate this aspect, 46 next of kin (brothers, sons) of patients with prostatic carcinoma (mean age 60 years, range 44–76) were enrolled in the study and subjected to DRE, TRUS and PSA assay. Patients with an alteration of one or more of the above-mentioned parameters (6 patients) underwent an echoguided biopsy (of nodule or normal). Only one (aged 52 years, PSA 12.1, DRE negative, TRUS small hypoechogenic area, prostatic volume 80 cc) had grade 2 PIN. Prostatectomy performed on the patient in another hospital showed that he had fibromyo-glandular hyperplasia. Results are discussed and compared with those reported in literature.

Spontaneous Haemophilia in a Female

1960 ◽  
Vol 04 (03) ◽  
pp. 369-375 ◽  
Author(s):  
E. H Braun ◽  
David B. Stollar
Keyword(s):  
Family History ◽  
Bleeding Time ◽  
Dental Extraction ◽  
White Girl ◽  
Complete Family ◽  
Normal Limits ◽  
Sex Chromatin ◽  
History Of ◽  
Generation Test

SummaryA case of haemophilia in a young white girl is described. There was a history of bleeding from birth. The thromboplastin generation test was grossly abnormal and A. H. G. levels were below 1%. Bleeding time and capillary morphology was within normal limits. Dental extraction after transfusion caused almost uncontrollable haemorrhage.A complete family history was obtained for four generations. There was no case of a “bleeder” amongst these.The girl’s apparent sex was confirmed by sex chromatin studies.

Antithrombin III Alger: A New Homozygous AT III Variant

1986 ◽  
Vol 55 (02) ◽  
pp. 218-221 ◽  
Author(s):  
A M Fischer ◽  
P Cornu ◽  
C Sternberg ◽  
F Mériane ◽  
M D Dautzenberg ◽  
...  
Keyword(s):  
Family History ◽  
Antithrombin Iii ◽  
Antigen Concentration ◽  
Crossed Immunoelectrophoresis ◽  
The Family ◽  
At Iii ◽  
Molecular Abnormality ◽  
Slow Moving ◽  
Cofactor Activity ◽  
Plasma Heparin

SummaryA qualitative abnormality of antithrombin III (AT III) was found in the plasma of a 41-year old patient. The plasmatic AT III antigen concentration was 130% and the progressive anti-F IIa and anti-F Xa activities were normal (105% and 137%). The plasma heparin cofactor activity was less than 10%, when measured by F Ila or F Xa inhibition. Crossed immunoelectrophoresis of AT III in the presence of heparin revealed in the plasma an abnormal slow-moving peak. When tested by affinity chromatography on heparin Sepharose, this abnormal AT III did not bind to heparin. Among the investigated relatives, 5 subjects had normal AT III levels, whatever the test used, the nine others having reduced levels of antithrombin heparin cofactor activity (45-61%) but normal levels of immunoreactive AT III (97-122%). Consanguinity was found in the family history. We therefore considered our patient as homozygous for an AT III molecular abnormality affecting the binding site for heparin.

The Dupont family: collectors, dealers and naturalists in nineteenth-century Paris

2016 ◽  
Vol 43 (2) ◽  
pp. 191-207 ◽  
Author(s):  
Richard Mearns ◽  
Laurent Chevrier ◽  
Christophe Gouraud
Keyword(s):  
Nineteenth Century ◽  
Family History ◽  
Natural History ◽  
North Africa ◽  
Special Interest ◽  
Early Life ◽  
Anatomical Models ◽  
The Family ◽  
Small Collection

In the early part of the nineteenth century the Dupont brothers ran separate natural history businesses in Paris. Relatively little is known about their early life but an investigation into the family history at Bayeux corrects Léonard Dupont's year of birth from 1795 to 1796. In 1818 Léonard joined Joseph Ritchie's expedition to North Africa to assist in collecting and preparing the discoveries but he did not get beyond Tripoli. After 15 months he came back to Paris with a small collection from Libya and Provence, and returned to Provence in 1821. While operating as a dealer-naturalist in Paris he published Traité de taxidermie (1823, 1827), developed a special interest in foreign birds and became well known for his anatomical models in coloured wax. Henry Dupont sold a range of natural history material and with his particular passion for beetles formed one of the finest collections in Europe; his best known publication is Monographie des Trachydérides (1836–1840). Because the brothers had overlapping interests and were rarely referred to by their forenames there has been confusion between them and the various eponyms that commemorate them. Although probably true, it would be an over-simplification to state that birds of this era named for Dupont refer to Léonard Dupont, insects to Henry Dupont, and molluscs to their mother.

scholarly journals The Family Psychoeducation Fidelity Scale: Psychometric Properties

2020 ◽  
Vol 47 (6) ◽  
pp. 894-900 ◽  
Author(s):  
I. Joa ◽  
J. O. Johannessen ◽  
K. S. Heiervang ◽  
A. A. Sviland ◽  
H. A. Nordin ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Internal Consistency ◽  
Interrater Reliability ◽  
Review Process ◽  
Trial Registration ◽  
Family Psychoeducation ◽  
Time Points ◽  
The Family ◽  
Fidelity Scale

Abstract This study examined psychometric properties and feasibility of the Family Psychoeducation (FPE) Fidelity Scale. Fidelity assessors conducted reviews using the FPE fidelity scale four times over 18 months at five sites in Norway. After completing fidelity reviews, assessors rated feasibility of the fidelity review process. The FPE fidelity scale showed excellent interrater reliability (.99), interrater item agreement (88%), and internal consistency (mean = .84 across four time points). By the 18-month follow-up, all five sites increased fidelity and three reached adequate fidelity. Fidelity assessors rated feasibility as excellent. The FPE fidelity scale has good psychometric properties and is feasible for evaluating the implementation of FPE programs. Trial registration ClinicalTrials.gov Identifier: NCT03271242.

scholarly journals Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

2021 ◽  
pp. 219256822098227
Author(s):  
Max J. Scheyerer ◽  
Ulrich J. A. Spiegl ◽  
Sebastian Grueninger ◽  
Frank Hartmann ◽  
Sebastian Katscher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Treatment Failure ◽  
Patient Specific ◽  
Mineral Density ◽  
Radiographic Findings ◽  
Specific Risk ◽  
Fracture Development ◽  
Predict Treatment Failure

Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

Sign in / Sign up

Export Citation Format

Share Document