Feasibility of using data collected through the St. Jude Pediatric Oncology Facility integrated local evaluation (PrOFILE) tool to determine previously defined levels of pediatric hematology-oncology care.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13530-e13530
Author(s):  
Aniekan Udoko ◽  
Pedro Mazotti-Roso ◽  
Enrico Suriano ◽  
Fernando Silva-Perez ◽  
Heather Forrest ◽  
...  

e13530 Background: Pediatric hematology and oncology (PHO) facilities are not all equally equipped to diagnose and treat the full range of childhood cancers. Proposed facility tier models have been published to facilitate the context-based adaptation of PHO diagnostic and treatment guidelines. However, a tool to assist facilities in identifying their level of PHO care does not exist. We assessed the feasibility of using the St. Jude Pediatric Oncology Facility Integrated Local Evaluation (PrOFILE) tool to identify (1) facility levels as defined by the International Society of Pediatric Oncology (SIOP) and the Lancet Oncology Commission (LOC) for sustainable care for children with cancer, and (2) treatment strata in the Adapted Resource and Implementation Application (ARIA) Guide. Methods: This study employed a multi-step mapping approach. We mapped the 1,279 PrOFILE tool variables to the nine SIOP service lines, ten LOC domains, and ten ARIA resource groups. Mapping was performed by two teams and carried out in two different rounds. The first round aimed to define if an indicator was fully or partially covered by PrOFILE. Multiple PrOFILE variables could be assigned to each concept to meet its content specificity. Various cut-offs were applied when necessary to assign mutually exclusive responses to each tier. The second round consisted of expert validation for each indicator previously identified. Results: Most (97%) of SIOP’s indicators were partially or fully covered in the PrOFILE tool (Table). Radiation therapy tools and appointment scheduling and call back system could not be mapped. Of the LOC indicators, 89% were covered (Table). Pathology technical staff, chemotherapy complexity (low, moderate, and high), lymph node biopsy, organ preservation, liver transplantation, intensity-modulated radiotherapy, and research infrastructure could not be mapped. Finally, 77% of the indicators used by the ARIA Guide were covered (Table). The ophthalmology resource group could not be fully mapped. Conclusions: This exercise demonstrates the feasibility of using PrOFILE tool variables to identify facility PHO care levels as defined by SIOP and LOC. The tool also contains most of the variables necessary to apply the ARIA Guide to diagnose, treat, and manage childhood cancer. Future PrOFILE versions will address concepts that are not covered or are partially covered in its current version.[Table: see text]

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 165s-165s
Author(s):  
G. Muftakhova ◽  
K. Kirgizov ◽  
G. Serik ◽  
S. Kogan ◽  
S. Varfolomeeva

Background and context: International cooperation is a key factor in the success of multicenter studies and educational projects, especially in LMICs. Aim: To describe projects of The National Society of Pediatric Hematologists and Oncologists (NSPHO) in the international collaboration. Strategy/Tactics: NSPHO international projects: optimization of care for children with cancer in Commonwealth of Independent States (CIS) and developing relationship with international organizations such as UICC, SIOP (Asian region). Unique feature is that these projects based on collaboration between healthcare professionals and governments with support of leading institutions. Program/Policy process: Program based on online and off-line meetings and courses. CIS project (in collaboration with WHO and St. Jude Children's Research Hospital) based on series of scientific and organizational meetings (online/off-line). Aim of this work is to organize a community of pediatric hematologists/oncologists of the region and prepare unique projects to improve the outcomes of treatment of pediatric cancer cases. Next meeting under the auspices if WHO will be held in Moscow in April 2018 (participants from 10 countries). The objectives of this meeting are to describe current situation of pediatric oncology care in the region, identify regional gaps in pediatric oncology care, and create collaborative project proposals to address identified gaps in care to improve pediatric cancer outcomes in the region. NSPHO working close with SIOP Asia: SIOP Asia Congress was organized in Moscow in 2016. Second project is developing of Directory of Asian Societies and Foundations in the field of pediatric hematology and oncology. Russian-Vietnamese collaborative group in pediatric hematology and oncology was formed in November 2017 in Vietnam. Second meeting of this group is planned for April 2018. Outcomes: More than 5 collaborative projects will be discussed such as CIS cancer registries, collaborative multicentre protocols, educational outreach projects, etc. As the deliverables the plan to publish a special report as well as a resolution to the Ministries of Health of CIS region. SIOP Asia Congress in Moscow was one of the most successful, attracted 1000 participants from 40 different countries attended. New relations were started. Directory of Asian Societies and Foundations in the field of pediatric hematology and oncology includes information on more than 40 organizations. Printed version will be presented at SIOP 2018 Congress in Kyoto. Several collaborative projects discussed in Russian-Vietnamese group. A “memorandum of understanding” was signed as a part of this meeting. It was decided to continue a series of scientific meetings as a part of collaboration. What was learned: Only active international collaboration supported by healthcare professionals and governments could lead to strong improvement of outcomes of pediatric cancer care in all countries worldwide.


2014 ◽  
Vol 104 (4) ◽  
pp. 422-425 ◽  
Author(s):  
Dominic J. Roda ◽  
Brian Albano ◽  
Bharti Rathore ◽  
Linda Zhou

Merkel cell carcinoma is a rare, often fatal, neuroendocrine cutaneous malignancy with a highly variable clinical presentation. Due to the rapid progression of the disease, early detection and treatment is vital to survival. Here, we report the case of a 45-year-old woman whose podiatrist noticed an unusual lesion on her lower left leg and referred her to a dermatologist for work-up. A diagnostic excisional biopsy confirmed the diagnosis and was followed by treatment that included wide local excision of the primary lesion with subsequent chemotherapy and radiation. At the time of diagnosis, sentinel lymph node biopsy was positive. Due to the increasing prevalence of Merkel cell carcinoma in the past decade and its propensity to present on the lower extremity, podiatric physicians need to be aware of the clinical presentation and treatment guidelines for this elusive disease.


Author(s):  
Mary Beth Arensberg ◽  
Beth Besecker ◽  
Laura Weldishofer ◽  
Susan Drawert

AbstractThe Oncology Care Model (OCM) is a US Centers for Medicare & Medicaid Services (CMS) specialty model implemented in 2016, to provide higher quality, more highly coordinated oncology care at the same or lower costs. Under the OCM, oncology clinics enter into payment arrangements that include financial and performance accountability for patients receiving chemotherapy treatment. In addition, OCM clinics commit to providing enhanced services to Medicare beneficiaries, including care coordination, navigation, and following national treatment guidelines. Nutrition is a component of best-practice cancer care, yet it may not be addressed by OCM providers even though up to 80% of patients with cancer develop malnutrition and poor nutrition has a profound impact on cancer treatment and survivorship. Only about half of US ambulatory oncology settings screen for malnutrition, registered dietitian nutritionists (RDNs) are not routinely employed by oncology clinics, and the medical nutrition therapy they provide is often not reimbursed. Thus, adequate nutrition care in US oncology clinics remains a gap area. Some oncology clinics are addressing this gap through implementation of nutrition-focused quality improvement programs (QIPs) but many are not. What is needed is a change of perspective. This paper outlines how and why quality nutrition care is integral to the OCM and can benefit patient health and provider outcomes.


2012 ◽  
Vol 31 (6) ◽  
pp. 648-650 ◽  
Author(s):  
Henriette Schneider ◽  
Gernot Geginat ◽  
Michael Hogardt ◽  
Alexandra Kramer ◽  
Matthias Dürken ◽  
...  

Cancer ◽  
2019 ◽  
Vol 126 (1) ◽  
pp. 140-147 ◽  
Author(s):  
Molly McFatrich ◽  
Jennifer Brondon ◽  
Nicole R. Lucas ◽  
Pamela S. Hinds ◽  
Scott H. Maurer ◽  
...  

2019 ◽  
Vol 102 (4) ◽  
pp. 656-662 ◽  
Author(s):  
Johanna Granhagen Jungner ◽  
Elisabet Tiselius ◽  
Klas Blomgren ◽  
Kim Lützén ◽  
Pernilla Pergert

2015 ◽  
Vol 20 (3) ◽  
pp. 340-348 ◽  
Author(s):  
Felipe Otondo

The role of spatial design in music has become more prominent in recent years, mostly because of the affordability of powerful software and hardware tools. Although spatial audio tools are widely used nowadays in studios and concert halls, there are only few examples of robust and comfortable wearable sound systems with a suitable acoustic response. A wireless body-worn loudspeaker prototype featuring original costume elements, a hybrid full-range loudspeaker array and an improved acoustic response was designed and implemented. The size, shape and acoustic performance of the prototype was optimised using data gathered from anechoic measurements and interviews with performers and audiences. Future developments of this project will consider the implementation of an extended multi-channel performance platform to explore sonic and spatial relationships created by several wearable devices on stage synchronised with a multi-loudspeaker diffusion system.


Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1305-1305
Author(s):  
Jennifer R Teichman ◽  
Sumit Gupta ◽  
Angela Punnett

Abstract Introduction: Systems to quantify and incentivize quality of care (QoC) have been developed in multiple healthcare settings. In pediatric oncology, lists of QoC metrics or recommendations have been procured through consensus methodologies such as the Delphi process. To date, no QoC metrics have been developed for outpatient pediatric oncology. Objectives: The aim of this study was to develop a list of QoC metrics for the leukeumia-lymphoma (LL) clinic at the Hospital for Sick Children in Toronto, using a consensus process that could be adapted to other clinic settings. Methods: A modified Delphi process following the American Society of Clinical Oncology (ASCO) guidelines was used to generate consensus on a list of QoC metrics (Loblaw et al., 2012). A Medline-Ovid search was conducted for quality indicators, metrics and recommendations relevant to pediatric oncology. Results were screened for (a) system-level metrics that could be translated to a clinic level and (b) clinic-level recommendations that could be converted to measurable quantities. Additional metrics outside the literature search were considered. A provisional list was compiled and circulated electronically to local stakeholders, including medical and nursing staff (n=10). Stakeholders ranked each metric on a 5-point Likert scale based on importance and feasibility of measurement (round 1). Stakeholders provided feedback on the metrics and suggested additional metrics. Median, interquartile range and full ranges were calculated for each metric. A metric was considered to reach consensus if the percent of respondents ranking within two consecutive scores was ≥70%. Results and comments from round 1 were re-circulated to stakeholders in personalized reports. This allowed each stakeholder to compare his or her previous scores with overall scores for each metric. Stakeholders were asked to re-rank each metric (round 2). Results: The literature search yielded 2 relevant publications from which a provisional list of 27 metrics was generated. Metrics were grouped into 7 categories (Table 1). In round 1, 19/27 (70%) metrics reached consensus. Stakeholders’ comments resulted in 4 new metrics and edits to 8 original metrics. All metrics were included in round 2 for a total of 31. Twenty-four of 31 (77%) metrics reached consensus after round 2 (Table 1). Thirteen were chosen for the final list based on highest consensus scores, highest interquartile and full ranges, and minimizing redundancy. Conclusion: This study demonstrates the feasibility of using a modified Delphi process to generate QoC metrics for a pediatric hematology oncology clinic, and provides a model other clinics may employ for local use. The final metrics will be used to evaluate the quality of care in the LL clinic, and to identify areas for improvement in clinic function. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


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