Cancer patient satisfaction with telehealth: Survey results from a large NCI-designated cancer institute.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1579-1579
Author(s):  
Divya Natesan ◽  
Donna Niedzwiecki ◽  
Taofik Oyekunle ◽  
Aviva Emmons ◽  
Yousuf Zafar ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Cancer Patient ◽  
Trend Test ◽  
Full Time ◽  
Patient Demographics ◽  
Time Table ◽  
Clinic Site ◽  
Survey Results ◽  
Armitage Trend Test ◽  
Over Time

1579 Background: Telehealth (TH) utilization for patients at our cancer institute increased in 2020 in response to the COVID-19 pandemic, however oncology-specific TH patient satisfaction is unknown. Methods: Monthly TH utilization at a single large NCI-designated institute from 3/1/2020-11/30/2020 was reviewed. Utilization was calculated as chargeable TH visits (new video, established video, phone) as a proportion of all consult/follow up visits. Patient satisfaction surveys for oncology TH visits for MD/PA/NP providers were reviewed from 4/1/2020-11/30/2020. Surveys were sent after every TH visit, unless the patient had a prior visit in the past 3 months. Percent (%) top box score (TBS) was defined as proportion of responses in the highest possible response category (i.e. very good). % TBS was reported for 14 survey items in 4 domains: technology, access, care provider (CP), and overall assessment. Satisfaction was assessed over time and according to patient factors: generation, gender, insurance type, employment status, and clinic site. The Cochrane-Armitage trend test was used to compare proportions of TBS responses across monthly time points. Results: TH comprised 21% (22,055/103,461) of all encounters in the study period. TH use increased from 9% in 3/2020 to a peak of 47% in 4/2020. In 11/2020, TH use was 18%. 28.0% (2,286/8,173) of TH patient surveys were returned. Multiple patient satisfaction metrics were improved over time (Table). Patients had higher satisfaction with phone compared to video visits with regards to technology (86% vs 76%) and access (80% vs 72%). Millennials (born 1981-1995) had higher satisfaction with access to TH (87%) compared to Gen X (1965-1980) (77%), Baby Boomer (1946-1964) (74%), and Silent Generation (1928-1945) (72%), however all generations had similar levels of satisfaction with technology (range 77-80%). Disabled patients had higher overall satisfaction of TH (82%) versus those working full time or retired (71%). Patients with commercial insurance had worse overall satisfaction of TH compared to other insurance types (65% vs 72%). Patients with encounters in genitourinary, thoracic, and endocrine oncology clinics had the highest levels of overall satisfaction (75%) compared to other clinics (69%). There were no observed differences in TH satisfaction according to gender. Conclusions: TH cancer patient satisfaction is high and has improved over time, however satisfaction differs by patient demographics. Further data are needed to best select patients appropriate for TH.[Table: see text]

Abstract W MP106: Temporal Trends in Stroke Investigations and Their Effect on Management

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Vivian T Ng ◽  
Ahmed M Bayoumi ◽  
Jiming Fang ◽  
Kirsteen R Burton ◽  
Melissa Stamplecoski ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Temporal Trends ◽  
Trend Test ◽  
Carotid Revascularization ◽  
Stroke Registry ◽  
Armitage Trend Test ◽  
Suspected Stroke ◽  
One Year ◽  
The Cost ◽  
Over Time

Background: Current guidelines recommend that patients with suspected stroke undergo neuroimaging to confirm the diagnosis and that those with ischemic stroke or TIA receive carotid imaging and cardiac investigations to determine stroke etiology. It is not known how rates of investigations have changed over time, and if those trends have led to changes in medical or surgical management. We used a clinical stroke registry to evaluate temporal trends in stroke investigations in Ontario, Canada. Methods: We used the Ontario Stroke Registry to identify patients who presented with stroke and TIA to 11 stroke centers between 2003 and 2012. The primary outcome was the proportion of patients who received CT, MRI, CTA, MRA, carotid doppler, and echocardiography in each year. Secondary outcomes were (1) the total number of neuroimaging procedures per patient; (2) the proportion of patients with ischemic stroke/TIA prescribed antithrombotics at discharge; and (3) the proportion who had carotid revascularization. The characteristics of study participants, rates of investigations and interventions, and test for trends over one year intervals were completed using a Cochran-Armitage trend test. Results: The study sample included 42,738 patients. From 2003 to 2012, the proportion receiving any type of neuroimaging increased from 96% to 99%, those receiving an MRI increased from 10% to 49%, those receiving carotid imaging increased from 62% to 88% and those receiving echocardiography increased from 52% to 70% (P<0.0001 for all comparisons). The total number of neuroimaging procedures per patient also increased, from a median of 1 in 2003 to 3 in 2011 (P<0.0001), and with almost 40% undergoing three or more neuroimaging procedures in 2011. In those with ischemic stroke or TIA, rates of antithrombotic therapy increased from 83% to 91%, as did the rate of carotid endarterectomy, from 0.7% to 0.8%. (P< 0.009). Conclusions: Rates of neuroimaging, carotid imaging and cardiac investigations after stroke have markedly increased over time. It is uncertain whether the increased rates of MRI and neuroimaging per patient are associated with improved outcomes. Further research is needed to evaluate the cost-effectiveness of current patterns of investigations following stroke.

scholarly journals P068: Patient satisfaction following educational ultrasounds in the emergency department

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S101
Author(s):  
P. Kapur ◽  
M. Betz ◽  
J. Chenkin ◽  
C. Brick
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Negative Experiences ◽  
Patient Demographics ◽  
Included Patient ◽  
Survey Results ◽  
Age Range ◽  
Do So

Introduction: Development of point-of-care ultrasound (POCUS) image-generating skills requires residents to practice on patients awaiting care in the emergency department (ED) for unrelated reasons. While patients are almost universally agreeable to the scans, there is the possibility that they feel pressured to do so and may have negative experiences that go unreported. The objective of this study was to determine the self-reported patient satisfaction and identify any concerns after educational ultrasounds performed in the ED. Methods: We conducted a survey of patients at a single academic ED. Patients were eligible for enrollment if they had volunteered for an ultrasound when study personnel were available. The survey was administered by a representative from the Patient Affairs Department who advised the patients that the results would remain anonymous and would have no impact on their care. The survey included patient demographics, questions about the consent process, communication by the trainee, adverse reactions and patient satisfaction. The primary outcome was the overall satisfaction level reported by the volunteer patients on a 5-point Likert scale. Secondary outcomes included identification of any discomfort or concerns about the process as expressed by patients. Simple descriptive statistics were used to report survey results. Results: Ninety-nine patients fully completed the questionnaire. Fifty (50%) were women. The age range was 18 to 99 years. Satisfaction among volunteers was high, with 94% of respondents giving a rating of 4 or 5 (five being an excellent experience). No patients gave a negative rating (1 or 2). Three (3%) patients felt “somewhat” pressured to volunteer. A majority of patients (72%) experienced no discomfort during the scan however 16% experienced some physical discomfort. Comments indicated that too much pressure applied with the ultrasound probe or cold ultrasound gel were the main sources of discomfort. Despite some discomfort 95 (95%) patients stated they would likely volunteer again if asked in the future. Conclusion: ED patients volunteering as models for residents learning POCUS expressed generally positive perceptions of their experience. While only a small minority of patients experienced some discomfort or felt pressured into participating, it is important to ensure that patients have a process to communicate any concerns about educational ultrasounds in the ED.

Changes in the setting of first consults to palliative and supportive care over a 7-year period.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 86-86
Author(s):  
Bernard Lobato Prado ◽  
Ali Haider ◽  
Syed M. Naqvi ◽  
Roberto Carmagnani Pestana ◽  
Janet L. Williams ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Hematologic Malignancies ◽  
Outpatient Setting ◽  
Annual Number ◽  
Trend Test ◽  
Hematologic Cancer ◽  
Inpatient Settings ◽  
Armitage Trend Test ◽  
Changes Over Time ◽  
Over Time

86 Background: Optimal benefits from palliative cancer care (PC) are achieved when first consults (PC1) occur early, ideally in the outpatient setting. Late PC1, such as those occurring in the intensive care unit (ICU), limit the benefits of PC and are a poor indicator of the integration of PC and oncology. Our aim was to determine the proportion of PC1 over time in three clinical settings: outpatient clinic (OPC), ICU, and inpatient non-ICU (IP). We also examined patients’ demographic and clinical characteristics and the timing of PC access (from PC1 to death or last contact) by the setting of PC1. Methods: We evaluated consecutive administrative/billing records to ascertain the annual number of PC1 and its distribution across settings from 2011 to 2017. ICU PC1 (n = 309) and a random sample of an equal number of OPC and IP PC1 were reviewed to retrieve patients’ demographics, clinical characteristics, and date of death/last contact. The Cochran-Armitage trend test was used to determine trend differences in the proportion of PC1 among settings. Results: The total annual number of PC1 increased by 58% from 2011 (n = 2286) to 2017 (n = 3615). We found a significant decreasing trend in the proportion of PC1 at the ICU (from 2.3% in 2011 to 1% in 2017, p < 0.001). There were no significant changes over time in the proportion of PC1 at OPC versus inpatient settings (p = 0.2). Hematologic cancer patients were more likely to have a PC1 at the ICU (p < .001). PC1 at ICU accessed PC much later, median survival (95% CI) after PC1 in months: OPC= 7.7 (6.3 - 9.7); IP= 3.4, (2.4 - 4.5), ICU= 0.1 (0.1, 0.1), p < .01). Conclusions: Over time, the total annual number of PC1 has increased and the proportion of PC1 at ICU, a very late clinical setting, is decreasing. Further efforts are needed to promote early PC referrals for patients with hematologic malignancies.

scholarly journals Temporal trends in clozapine use at time of discharge among people with schizophrenia at two public psychiatric hospitals in Taiwan, 2006–2017

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ching-Hua Lin ◽  
Hung-Yu Chan ◽  
Chun-Chi Hsu ◽  
Feng-Chua Chen
Keyword(s):  
Temporal Trends ◽  
Psychiatric Hospitals ◽  
Trend Test ◽  
Anticholinergic Medication ◽  
Clozapine Treatment ◽  
Augmentation Strategy ◽  
Hospital Stays ◽  
Treatment Changes ◽  
Armitage Trend Test ◽  
Over Time

Abstract Clozapine treatment remains the gold standard for treatment-resistant schizophrenia. This study aimed to describe temporal trends in clozapine use at discharge among patients with schizophrenia at two of the largest public psychiatric hospitals in Taiwan over a twelve-year period. Patients with schizophrenia discharged from the two study hospitals between 2006 and 2017 (n = 24,101) were included in the analysis. Antipsychotic augmentation was defined as concomitant use of a second antipsychotic as augmentation to clozapine treatment. Changes in the rate of clozapine use and antipsychotic augmentation at discharge over time were analyzed using the Cochran-Armitage trend test. Patients discharged on clozapine had significantly longer hospital stays than other patients. The rate of clozapine use at discharge increased from 13.8% to 20.0% over time (Z = 6.88, p < .0001). Concomitant use of anticholinergic medication was more common in patients receiving antipsychotic augmentation than clozapine antipsychotic monotherapy. Among patients discharged on clozapine, the rate of augmentation with a second antipsychotic increased from 19.1% to 36.2% over time (Z = 6.58, p < .0001). Among patients receiving antipsychotic augmentation, use of another second-generation antipsychotic as the augmentation agent grew from 32.6% to 65.5% over time (Z = 8.90, p < .0001). The increase in clozapine use was accompanied by an increase in concomitant use of a second antipsychotic as augmentation during the study period. Further studies are warranted to clarify the risk/benefit of this augmentation strategy. Clozapine may still be underutilized, and educational programs are needed to promote clinical use of clozapine.

THE DEVELOPMENT OF A COMMUNITY OF INQUIRY OVER TIME IN AN ONLINE COURSE: UNDERSTANDING THE PROGRESSION AND INTEGRATION OF SOCIAL, COGNITIVE AND TEACHING PRESENCE

2008 ◽  
Vol 12 (3) ◽  
Author(s):  
Zehra Akyol ◽  
D. Randy Garrison
Keyword(s):  
Social Presence ◽  
Community Of Inquiry ◽  
Social Cognitive ◽  
Cognitive Presence ◽  
Teaching Presence ◽  
Significant Relationships ◽  
Survey Results ◽  
Community Of Inquiry Framework ◽  
Discussion Postings ◽  
Over Time

The purpose of this study was to explore the dynamics of an online educational experience through the lens of the Community of Inquiry framework. Transcript analysis of online discussion postings and the Community of Inquiry survey were applied in order to understand the progression and integration of each of the Community of Inquiry presences. The results indicated significant change in teaching and social presence categories over time. Moreover, survey results yielded significant relationships among teaching presence, cognitive presence and social presence, and students’ perceived learning and satisfaction in the course.

scholarly journals Using Telemedicine to Pre-Screen Sports Medicine Patients in the Ambulatory Setting Reduces Wait Times and Maximizes Provider-Patient Interaction

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0041
Author(s):  
Alfred Atanda ◽  
Kathryn Leyden ◽  
Medical Student
Keyword(s):  
Patient Satisfaction ◽  
Knee Pain ◽  
Sports Medicine ◽  
Clinic Visit ◽  
Background Information ◽  
Full Time ◽  
Visit Time ◽  
Medicine Clinic ◽  
Exam Room ◽  
Room Time

Objectives: Gathering of background information during a clinic visit can be time-consuming. Some medical specialties have workflows that pre-screen patients ahead of time to minimize delays. Having background information ahead of time may decrease delays and ensure that the visit is focused on physical examination, diagnosis, and treatment. We have used telemedicine to treat established patients to reduce cost and resource utilization, while maintaining high levels of patient satisfaction. It is conceivable that telemedicine could also be used to pre-screen new patients prior to their in-person clinic visit. The goal of the current study was to evaluate whether utilizing telemedicine to pre-screen new patients to our sports medicine clinic would reduce time in the exam room waiting and being seen, and overall clinic times. Methods: From June 2018 through August 2018, we utilized videoconferencing telemedicine to pre-screen all new patients to a pediatric sports medicine clinic with a chief diagnosis of knee pain. Visits were performed by full-time telemedicine pediatricians who were provided appropriate training and an intake form describing which questions should be asked. All visits utilized the American Well software platform (Boston, USA) and were performed on the patient’s personal device. During the subsequent in-person visit, the overall timing of the visit was recorded including: time checked in, time waiting in waiting room, time waiting in exam room, time spent with provider, and time-checked out, were all recorded. Similar time points were recorded for matched control patients that did not undergo telemedicine pre-screening and were seen in the traditional manner. Inclusion criteria included: being brand new to the practice and unilateral knee pain. Results: There were eight pre-screened patients and ten control patients in this cohort. Compared to controls, pre-screened patients spent less time in the exam room (19 min vs. 31 min), higher percentage of the exam room time with the provider (58% vs. 34%), higher percentage of the overall visit time with the provider (29% vs. 19.5%), and less time for the overall visit (39 min vs. 52 min). Conclusion: Pre-screening patients to obtain background information can decrease exam room waiting time and overall visit time and maximize time during the visit spent with the provider. In addition, it could potentially be used to increase throughput through the clinic and improve patient satisfaction scores.

scholarly journals 241 Trends in the percentage of modified live, killed, and combination respiratory viral vaccines administered to beef calves offered for sale in summer video auctions from 2000 through 2018

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 9-10
Author(s):  
Maggie J Smith ◽  
Mike E King ◽  
Karol E Fike ◽  
Esther D McCabe ◽  
Glenn M Rogers ◽  
...  
Keyword(s):  
Trend Test ◽  
Fort Worth ◽  
Single Gender ◽  
Beef Calves ◽  
Vaccine Type ◽  
Viral Vaccine ◽  
Viral Vaccines ◽  
Dramatic Shift ◽  
Armitage Trend Test

Abstract The objective of this study was to identify trends in the percentage of type of respiratory viral vaccines administered to lots of beef calves offered for sale in summer video auctions from 2000 through 2018. There were 59,762 lots of single-gender beef calves (7,167,352 total calves) offered for sale in 145 summer video auctions during these years. Information describing calf lots was obtained from the auction service (Superior Livestock Auction, Fort Worth, TX) which included named vaccines administered to the lot. Named 4- or 5-way respiratory viral vaccines were classified into three groups based on the type of antigens they contained: all modified live antigens (MLV), all killed antigens (KILLED), and a combination of modified live and killed antigens (COMBO). The Cochran-Armitage Trend Test was used to quantify the significance of a trend in the usage of each respiratory viral vaccine type. There was an increase (P &lt; 0.0001) in the percentage of MLV vaccines given to beef calf lots from 2000 (39.7%) through 2018 (88.9%). At the same time, the percentages of both KILLED and COMBO vaccines administered to lots of beef calves declined (P &lt; 0.0001 and P &lt; 0.0001, respectively). In 2000, 31.2% and 29.1% of the total respiratory viral vaccines given to beef calf lots were KILLED or COMBO vaccines, respectively. By 2018, only 4.7% of respiratory viral vaccines were KILLED, and only 6.4% were COMBO vaccines. This dramatic shift indicates an industry trend towards increasing MLV vaccine utilization compared with declining usage of KILLED and COMBO vaccines. This trend may be a result of MLV vaccine approval for use in calves nursing pregnant cows.

Increased prevalence of psychosis in patients who get admitted with atrial fibrillation with worse outcomes

2017 ◽  
Vol 41 (S1) ◽  
pp. S575-S576
Author(s):  
Z. Mansuri ◽  
S. Patel ◽  
P. Patel ◽  
O. Jayeola ◽  
A. Das ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Admissions ◽  
Temporal Trends ◽  
International Classification Of Diseases ◽  
Trend Test ◽  
Classification Of Diseases ◽  
Competing Interest ◽  
Armitage Trend Test ◽  
The Impact

ObjectiveTo determine trends and impact on outcomes of atrial fibrillation (AF) in patients with pre-existing psychosis.BackgroundWhile post-AF psychosis has been extensively studied, contemporary studies including temporal trends on the impact of pre-AF psychosis on AF and post-AF outcomes are largely lacking.MethodsWe used Nationwide Inpatient Sample (NIS) from the healthcare cost and utilization project (HCUP) from year's 2002–2012. We identified AF and psychosis as primary and secondary diagnosis respectively using validated international classification of diseases, 9th revision, and Clinical Modification (ICD-9-CM) codes, and used Cochrane–Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).ResultsWe analyzed total of 3.887.827AF hospital admissions from 2002–2012 of which 1.76% had psychosis. Proportion of hospitalizations with psychosis increased from 5.23% to 14.28% (P trend < 0.001). Utilization of atrial-cardioversion was lower in patients with psychosis (0.76%v vs. 5.79%, P < 0.001). In-hospital mortality was higher in patients with Psychosis (aOR 1.206; 95%CI 1.003–1.449; P < 0.001) and discharge to specialty care was significantly higher (aOR 4.173; 95%CI 3.934–4.427; P < 0.001). The median length of hospitalization (3.13 vs. 2.14 days; P < 0.001) and median cost of hospitalization (16.457 vs. 13.172; P < 0.001) was also higher in hospitalizations with psychosis.ConclusionsOur study displayed an increasing proportion of patients with Psychosis admitted due to AF with higher mortality and extremely higher morbidity post-AF, and significantly less utilization of atrial-cardioversion. There is a need to explore reasons behind this disparity to improve post-AF outcomes in this vulnerable population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Power comparison of Cochran-Armitage trend test against allelic and genotypic tests in large-scale case-control genetic association studies

2016 ◽  
Vol 27 (9) ◽  
pp. 2657-2673 ◽  
Author(s):  
Mathieu Emily
Keyword(s):  
Large Scale ◽  
Association Studies ◽  
Disease Model ◽  
Trend Test ◽  
Genome Wide Association Studies ◽  
Power Functions ◽  
Power Comparison ◽  
Powerful Test ◽  
Armitage Trend Test ◽  
Mode Of Inheritance

The Cochran-Armitage trend test (CA) has become a standard procedure for association testing in large-scale genome-wide association studies (GWAS). However, when the disease model is unknown, there is no consensus on the most powerful test to be used between CA, allelic, and genotypic tests. In this article, we tackle the question of whether CA is best suited to single-locus scanning in GWAS and propose a power comparison of CA against allelic and genotypic tests. Our approach relies on the evaluation of the Taylor decompositions of non-centrality parameters, thus allowing an analytical comparison of the power functions of the tests. Compared to simulation-based comparison, our approach offers the advantage of simultaneously accounting for the multidimensionality of the set of features involved in power functions. Although power for CA depends on the sample size, the case-to-control ratio and the minor allelic frequency (MAF), our results first show that it is largely influenced by the mode of inheritance and a deviation from Hardy–Weinberg Equilibrium (HWE). Furthermore, when compared to other tests, CA is shown to be the most powerful test under a multiplicative disease model or when the single-nucleotide polymorphism largely deviates from HWE. In all other situations, CA lacks in power and differences can be substantial, especially for the recessive mode of inheritance. Finally, our results are illustrated by the comparison of the performances of the statistics in two genome scans.

What Happens to Patient Satisfaction and Behavioral Intentions Over Time?

2001 ◽  
Vol 23 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Thomas L. Powers ◽  
Dawn Bendall-Lyon
Keyword(s):  
Patient Satisfaction ◽  
Behavioral Intentions ◽  
Over Time
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