Expectations in the Care of Lung Cancer

2015 ◽  
pp. e420-e424
Author(s):  
Rogerio Lilenbaum ◽  
Natasha B. Leighl ◽  
Marcus Neubauer
Keyword(s):  
Lung Cancer ◽  
Clinical Trial ◽  
Decision Making ◽  
Clinical Practice ◽  
Statistical Significance ◽  
Real Life ◽  
Clinical Trial Data ◽  
Routine Clinical Practice ◽  
Trial Data ◽  
Decision Making Process

One of the main challenges oncologists face in the care of patients with lung cancer is the decision to incorporate new clinical trial data into routine clinical practice. Beyond the question of statistical significance, which is a more objective metric, are the results meaningful and applicable to a broader population? Furthermore, in an era of value care, do the results justify a potential increase in costs? This article discusses the main points that clinicians consider in their decision-making process and illustrates the arguments with real-life examples.

Translation of clinical trial data to changes in clinical practice: rapid transition from tenofovir disoproxil fumarate to tenofovir alafenamide-based therapies in a Sydney HIV clinic

2018 ◽  
Vol 29 (10) ◽  
pp. 1011-1013
Author(s):  
Don E Smith ◽  
Merrion Tom ◽  
Bruce H Bowden
Keyword(s):  
Clinical Trial ◽  
Clinical Practice ◽  
Antiviral Therapy ◽  
Tenofovir Disoproxil Fumarate ◽  
Clinical Trial Data ◽  
Routine Clinical Practice ◽  
Trial Data ◽  
Slow Process ◽  
Rapid Transition ◽  
Tenofovir Alafenamide

The transition of clinical trial data to changes in routine clinical practice is often a slow process. We describe a rapid transition of patients from one form of antiviral therapy to a modified and potentially safer version that can occur quickly when there are no financial or organisational restrictions on the prescribers.

The impact of immunotherapy education on GI cancers.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 479-479
Author(s):  
Kinjal Parikh ◽  
Katie Lucero ◽  
Charlotte Warren ◽  
Emily Sherene Van Laar ◽  
Patrick Kugel ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Checkpoint Inhibitors ◽  
Statistical Significance ◽  
Clinical Trial Data ◽  
Trial Data ◽  
Educational Activities ◽  
Cancer Subtypes ◽  
Gi Cancers ◽  
The Impact

479 Background: Gastrointestinal (GI) cancers are a heterogeneous group of cancers with varying underlying pathophysiology and distinct treatment paradigms. Immunotherapy (IO) is unique in each of the subtypes and biomarkers utility varies. With the expansion of IO in each cancer subtypes, education remains essential to optimize patient outcomes through integration of the latest evidence-based data at point of care. Through the partnership between Medscape Oncology and the Society for Immunotherapy of Cancer, 2 educational activities were designed to increase the knowledge and competence of oncologists surrounding the role of IO in patients with advanced GI cancers. Methods: The 2 educational activities included a text based online activity with 3 chapters focused on gastroesophageal cancers, colorectal cancers, and hepatocellular carcinoma (HCC) and a 30-minute online, video discussion with 3 faculty and synchronized slides on HCC. Educational effectiveness was assessed with repeated paired pre/post assessment where learners served as their own controls. A chi-square test was used to identify statistical significance in proportion of correct responses. The first activity launched 11/27/2019 and the second activity launched on 5/8/20. Data were collected and reported through 8/25/2020. Results: A total of 8433 learners, including 1543 oncologists, participated from 11/2019 through 8/2020. Participation in education resulted in significant relative improvements among oncologist learners on IO in GI cancers in (n = 641): 110%: role or eligibility of immune checkpoint inhibitors (ICIs) (p < .001) 38%: clinical trial data of ICIs (p < .001) Subsequent education on unresectable HCC demonstrated a significant relative improvement in both knowledge and competence for oncologist learners (n = 902): 19%: regarding clinical trial data in unresectable HCC (p = .073) 19%; competence identifying role of ICIs in unresectable HCC (p < .05) 59%: competence managing irAEs in unresectable HCC (p < .001). Conclusions: These 2 online CME-certified educational activities resulted in statistically significant gains in oncologist knowledge surrounding the use of IO in advanced GI cancers Follow-up education on HCC demonstrated the value and benefit of multi-modal and sequential activities on improving competence among oncologists caring for patients with unresectable HCC There remains a need for continuous education as more oncologists utilize IO in their practice while the understanding and availability of clinical data continues to expand and evolve in the varying GI cancer subtypes. More than 50% of learners continued to demonstrate a need in understanding the clinical trial data or role of IO in metastatic GI cancers with more than 40% of the learners demonstrating continued need on clinical trial data or role of IO in HCC specifically.

scholarly journals Treatment effectiveness in interstitial cystitis/bladder pain syndrome: Do patient perceptions align with efficacy-based guidelines?

2017 ◽  
Vol 12 (1) ◽  
pp. E1-5 ◽  
Author(s):  
Avril Lusty ◽  
Elizabeth Kavaler ◽  
Kay Zakariasen ◽  
Victoria Tolls ◽  
J. Curtis Nickel
Keyword(s):  
Clinical Trial ◽  
Interstitial Cystitis ◽  
Botulinum Toxin A ◽  
Real Life ◽  
Clinical Trial Data ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Trial Data ◽  
Bladder Pain ◽  
Perceived Outcomes

Introduction: We sought to determine if patients’ perceptions of success or failure of interstitial cystitis/bladder pain syndrome (IC/ BPS) therapies proposed in treatment guidelines align with the evidence from available clinical trial treatment data.Methods: A total of 1628 adult females with a self-reported diagnosis of IC completed a web-based survey in which patients described their perceived outcomes with the therapies they were exposed to. Previously published literature, used in part to develop IC/ BPS guidelines, provided the clinical trial data outcomes. Patientreported outcomes were compared to available clinical trial outcomes and published treatment guidelines.Results: Based on patient perceived outcomes (benefit:risk ratio), the most effective treatments were opioids, phenazopyridine, and alkalizing agents, with amitriptyline and antihistamines reported as moderately effective. The only surgical procedure with any effectiveness was electrocautery of Hunner’s lesions. In order of efficacy reported in the literature, the therapies for IC/BPS with predicted superior outcomes should be: cyclosporine A, amitriptyline, hyperbaric oxygen, pentosan polysulfate plus subcutaneous heparin, botulinum toxin A plus hydrodistension, and L-arginine. While some of the guideline recommendations aligned with patientreported effectiveness data, there was a general disconnect between guidelines and effectiveness reported in clinical practice.Conclusions: There is a disconnect between real-world patient perceived effectiveness of IC/BPS treatments compared to the efficacy reported from clinical trial data and subsequent guidelines developed from this efficacy data. Optimal therapy must include the best evidence from clinical research, but should also include real-life clinical practice implementation and effectiveness.

Challenges in Using Real-World Clinical Practice Records for Retrospective Validation of Clinical Trial Data: Lessons Learned

2016 ◽  
Vol 111 ◽  
pp. S324-S325
Author(s):  
Sunanda V. Kane ◽  
Anita Afzali ◽  
Doug Wolf ◽  
Ira Shafran ◽  
Matthew A. Ciorba ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Practice ◽  
Real World ◽  
Clinical Trial Data ◽  
Trial Data ◽  
Lessons Learned

Integrating clinical trial data into clinical practice

Neurology ◽  
2002 ◽  
Vol 58 (Issue 12, Supplement 7) ◽  
pp. S6-S12 ◽  
Author(s):  
T. A. Glauser
Keyword(s):  
Clinical Trial ◽  
Clinical Practice ◽  
Clinical Trial Data ◽  
Trial Data

scholarly journals Person-Centred Care Including Deprescribing for Older People

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 101 ◽  
Author(s):  
Heather Smith ◽  
Karen Miller ◽  
Nina Barnett ◽  
Lelly Oboh ◽  
Emyr Jones ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Older People ◽  
Shared Decision Making ◽  
Real Life ◽  
Decision Making Process ◽  
Shared Decision ◽  
Good Communication ◽  
Values And Beliefs

There is concern internationally that many older people are using an inappropriate number of medicines, and that complex combinations of medicines may cause more harm than good. This article discusses how person-centred medicines optimisation for older people can be conducted in clinical practice, including the process of deprescribing. The evidence supports that if clinicians actively include people in decision making, it leads to better outcomes. We share techniques, frameworks, and tools that can be used to deprescribe safely whilst placing the person’s views, values, and beliefs about their medicines at the heart of any deprescribing discussions. This includes the person-centred approach to deprescribing (seven steps), which incorporates the identification of the person’s priorities and the clinician’s priorities in relation to treatment with medication and promotes shared decision making, agreed goals, good communication, and follow up. The authors believe that delivering deprescribing consultations in this manner is effective, as the person is integral to the deprescribing decision-making process, and we illustrate how this approach can be applied in real-life case studies.

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