scholarly journals Clinical Impact of Chemotherapy-Related Adverse Events in Patients with Metastatic Breast Cancer in an Integrated Health Care System

2015 ◽  
Vol 21 (10) ◽  
pp. 863-871b ◽  
Author(s):  
Nazia Rashid ◽  
Han A. Koh ◽  
Hilda C. Baca ◽  
Zhaoliang Li ◽  
Susan Malecha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Adverse Events ◽  
Health Care System ◽  
Metastatic Breast ◽  
Integrated Health Care ◽  
Clinical Impact ◽  
Integrated Health ◽  
Integrated Health Care System

scholarly journals Implementation of Intraoperative Ultrasound Localization for Breast-Conserving Surgery in a Large, Integrated Health Care System is Feasible and Effective

2021 ◽  
Vol 28 (10) ◽  
pp. 5648-5656 ◽  
Author(s):  
Jeffery M. Chakedis ◽  
Annie Tang ◽  
Gillian E. Kuehner ◽  
Brooke Vuong ◽  
Liisa L. Lyon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Care System ◽  
Intraoperative Ultrasound ◽  
Breast Conserving Surgery ◽  
Integrated Health Care ◽  
Wire Localization ◽  
Integrated Health ◽  
Seed Localization ◽  
Integrated Health Care System

Abstract Background Intraoperative ultrasound (IUS) localization for breast cancer is a noninvasive localization technique. In 2015, an IUS program for breast-conserving surgery (BCS) was initiated in a large, integrated health care system. This study evaluated the clinical results of IUS implementation. Methods The study identified breast cancer patients with BCS from 1 January to 31 October 2015 and from 1 January to 31 October 2019. Clinicopathologic characteristics were collected, and localization types were categorized. Clinical outcomes were analyzed, including localization use, surgeon adoption of IUS, day-of-surgery intervals, and re-excision rates. Multivariate logistic regression analysis was performed to evaluate predictors of re-excision. Results The number of BCS procedures increased 23%, from 1815 procedures in 2015 to 2226 procedures in 2019. The IUS rate increased from 4% of lumpectomies (n = 79) in 2015 to 28% of lumpectomies (n = 632) in 2019 (p < 0.001). Surgeons using IUS increased from 6% (5 of 88 surgeons) in 2015 to 70% (42 of 60 surgeons) in 2019. In 2019, 76% of IUS surgeons performed at least 25% of lumpectomies with IUS. The mean time from admission to incision was shorter with IUS or seed localization than with wire localization (202 min with IUS, 201 with seed localization, 262 with wire localization in 2019; p < 0.001). The IUS re-excision rates were lower than for other localization techniques (13.6%, vs 19.6% for seed localization and 24.7% for wire localization in 2019; p = 0.006), and IUS predicted lower re-excision rates in a multivariable model (odds ratio [OR], 0.59). Conclusions In a high-volume integrated health system, IUS was adopted for BCS by a majority of surgeons. The use of IUS decreased the time from admission to incision compared with wire localization, and decreased re-excision rates compared with other localization techniques.

scholarly journals Disparities in Uptake of HIV Preexposure Prophylaxis in a Large Integrated Health Care System

2016 ◽  
Vol 106 (10) ◽  
pp. e2-e3 ◽  
Author(s):  
Julia L. Marcus ◽  
Leo B. Hurley ◽  
C. Bradley Hare ◽  
Michael J. Silverberg ◽  
Jonathan E. Volk
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Integrated Health Care ◽  
Preexposure Prophylaxis ◽  
Integrated Health ◽  
Integrated Health Care System ◽  
Care System
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