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Article ; Online: Gastroblastoma with a novel ACTB::GLI1 gene fusion in a 19-year-old male.

Shabbir, Junaid / Earle, Jonathan / Glomski, Krzysztof / Mnayer, Laila / Schipper, Bret / Ligato, Saverio

Virchows Archiv : an international journal of pathology

2024

Abstract: Gastroblastoma is a rare gastric biphasic tumor composed of mesenchymal and epithelial elements in variable proportions. These tumors usually arise in the gastric antrum of children and young adults and are reported to harbor a recurrent MALAT1::GLI1 ... ...

Abstract	Gastroblastoma is a rare gastric biphasic tumor composed of mesenchymal and epithelial elements in variable proportions. These tumors usually arise in the gastric antrum of children and young adults and are reported to harbor a recurrent MALAT1::GLI1 fusion. Herein we report a case of gastroblastoma in a 19-year-old male who presented with intermittent epigastric abdominal discomfort. Antrectomy revealed a 5.6-cm multi-lobulated, tan-pink mass with solid and focally cystic areas involving the submucosa, muscularis propria, and subserosa. All tumor cells demonstrated immunoreactivity for GLI-1, CD56, and vimentin; epithelial elements expressed pancytokeratins (AE1/AE3 and Oscar), and mesenchymal cells demonstrated focal positivity for CD10. Next generation sequencing revealed a novel ACTB::GLI1 fusion without evidence of the recurrent MALAT1::GLI1 fusion. Nine months after surgery, the patient is well without evidence of recurrence or metastases. To our knowledge, this is the first case of gastroblastoma harboring this novel ACTB::GLI1 fusion.
Language	English
Publishing date	2024-01-23
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1184867-4
ISSN	1432-2307 ; 0945-6317
ISSN (online)	1432-2307
ISSN	0945-6317
DOI	10.1007/s00428-024-03742-7
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Article ; Online: Recommendations for Cell-Free DNA Assay Validations: A Joint Consensus Recommendation of the Association for Molecular Pathology and College of American Pathologists.

Lockwood, Christina M / Borsu, Laetitia / Cankovic, Milena / Earle, Jonathan S L / Gocke, Christopher D / Hameed, Meera / Jordan, Danielle / Lopategui, Jean R / Pullambhatla, Mrudula / Reuther, Jacquelyn / Rumilla, Kandelaria M / Tafe, Laura J / Temple-Smolkin, Robyn L / Terraf, Panieh / Tsimberidou, Apostolia M

The Journal of molecular diagnostics : JMD

2023 Volume 25, Issue 12, Page(s) 876–897

Abstract: Diagnosing, selecting therapy for, and monitoring cancer in patients using a minimally invasive blood test represents a significant advance in precision medicine. Wide variability exists in how circulating tumor DNA (ctDNA) assays are developed, ... ...

Abstract	Diagnosing, selecting therapy for, and monitoring cancer in patients using a minimally invasive blood test represents a significant advance in precision medicine. Wide variability exists in how circulating tumor DNA (ctDNA) assays are developed, validated, and reported in the literature, which hinders clinical adoption and may negatively impact patient care. Standardization is needed for factors affecting ctDNA assay performance and reporting, including pre-analytical variables, analytical considerations, and elements of laboratory assay reporting. The Association for Molecular Pathology Clinical Practice Committee's Liquid Biopsy Working Group (LBxWG), including organizational representation from the American Society of Clinical Oncology and the College of American Pathologists, has undertaken a full-text data extraction of 1228 ctDNA publications that describe assays performed in patients with lymphoma and solid tumor malignancies. With an emphasis on clinical assay validation, the LBxWG has developed a set of 13 best practice consensus recommendations for validating, reporting, and publishing clinical ctDNA assays. Recommendations include reporting key pre-analytical considerations and assay performance metrics; this analysis demonstrates these elements are inconsistently included in publications. The LBxWG recommendations are intended to assist clinical laboratories with validating and reporting ctDNA assays and to ensure high-quality data are included in publications. It is expected that these recommendations will need to be updated as the body of literature continues to mature.
MeSH term(s)	Humans ; United States ; Cell-Free Nucleic Acids/genetics ; Pathology, Molecular ; Consensus ; Pathologists ; Neoplasms/diagnosis ; Neoplasms/genetics
Chemical Substances	Cell-Free Nucleic Acids
Language	English
Publishing date	2023-10-06
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2000060-1
ISSN	1943-7811 ; 1525-1578
ISSN (online)	1943-7811
ISSN	1525-1578
DOI	10.1016/j.jmoldx.2023.09.004
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Article: Plaque-Like Dermatofibroma: Case Report of a Rare Entity.

Moradi, Sara / Mnayer, Laila / Earle, Jonathan / Cech, Alex C / Ehrig, Torsten

Dermatopathology (Basel, Switzerland)

2021 Volume 8, Issue 3, Page(s) 337–341

Abstract: A case of a well-demarcated plaque measuring 11 cm without satellites of several years' duration is presented. It showed typical histologic findings of dermatofibroma, prompting a diagnosis of plaque-like dermatofibroma. The relationship to multiple ... ...

Abstract	A case of a well-demarcated plaque measuring 11 cm without satellites of several years' duration is presented. It showed typical histologic findings of dermatofibroma, prompting a diagnosis of plaque-like dermatofibroma. The relationship to multiple clustered dermatofibromas and plaque-like myofibroblastic tumor is discussed.
Language	English
Publishing date	2021-08-01
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2777118-0
ISSN	2296-3529
ISSN	2296-3529
DOI	10.3390/dermatopathology8030038
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Article: AI Conversational Agent to Improve Varenicline Adherence: Protocol for a Mixed Methods Feasibility Study.

Minian, Nadia / Mehra, Kamna / Earle, Mackenzie / Hafuth, Sowsan / Ting-A-Kee, Ryan / Rose, Jonathan / Veldhuizen, Scott / Zawertailo, Laurie / Ratto, Matt / Melamed, Osnat C / Selby, Peter

JMIR research protocols

2023 Volume 12, Page(s) e53556

Abstract: Background: Varenicline is a pharmacological intervention for tobacco dependence that is safe and effective in facilitating smoking cessation. Enhanced adherence to varenicline augments the probability of prolonged smoking abstinence. However, research ... ...

Abstract	Background: Varenicline is a pharmacological intervention for tobacco dependence that is safe and effective in facilitating smoking cessation. Enhanced adherence to varenicline augments the probability of prolonged smoking abstinence. However, research has shown that one-third of people who use varenicline are nonadherent by the second week. There is evidence showing that behavioral support helps with medication adherence. We have designed an artificial intelligence (AI) conversational agent or health bot, called "ChatV," based on evidence of what works as well as what varenicline is, that can provide these supports. ChatV is an evidence-based, patient- and health care provider-informed health bot to improve adherence to varenicline. ChatV has been programmed to provide medication reminders, answer questions about varenicline and smoking cessation, and track medication intake and the number of cigarettes. Objective: This study aims to explore the feasibility of the ChatV health bot, to examine if it is used as intended, and to determine the appropriateness of proceeding with a randomized controlled trial. Methods: We will conduct a mixed methods feasibility study where we will pilot-test ChatV with 40 participants. Participants will be provided with a standard 12-week varenicline regimen and access to ChatV. Passive data collection will include adoption measures (how often participants use the chatbot, what features they used, when did they use it, etc). In addition, participants will complete questionnaires (at 1, 4, 8, and 12 weeks) assessing self-reported smoking status and varenicline adherence, as well as questions regarding the acceptability, appropriateness, and usability of the chatbot, and participate in an interview assessing acceptability, appropriateness, fidelity, and adoption. We will use "stop, amend, and go" progression criteria for pilot studies to decide if a randomized controlled trial is a reasonable next step and what modifications are required. A health equity lens will be adopted during participant recruitment and data analysis to understand and address the differences in uptake and use of this digital health solution among diverse sociodemographic groups. The taxonomy of implementation outcomes will be used to assess feasibility, that is, acceptability, appropriateness, fidelity, adoption, and usability. In addition, medication adherence and smoking cessation will be measured to assess the preliminary treatment effect. Interview data will be analyzed using the framework analysis method. Results: Participant enrollment for the study will begin in January 2024. Conclusions: By using predetermined progression criteria, the results of this preliminary study will inform the determination of whether to advance toward a larger randomized controlled trial to test the effectiveness of the health bot. Additionally, this study will explore the acceptability, appropriateness, fidelity, adoption, and usability of the health bot. These insights will be instrumental in refining the intervention and the health bot. Trial registration: ClinicalTrials.gov NCT05997901; https://classic.clinicaltrials.gov/ct2/show/NCT05997901. International registered report identifier (irrid): PRR1-10.2196/53556.
Language	English
Publishing date	2023-12-11
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2719222-2
ISSN	1929-0748
ISSN	1929-0748
DOI	10.2196/53556
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Article ; Online: Concurrent Eosinophilic Solid and Cystic Renal Cell Carcinoma and Angiomyolipoma With Epithelial Cysts in the Setting of Tuberous Sclerosis Complex: A Rare Synchronous Occurrence of 2 Distinct Entities.

Cho, Woo Cheal / Collins, Katrina / Mnayer, Laila / Cartun, Richard W / Earle, Jonathan S

International journal of surgical pathology

2019 Volume 27, Issue 7, Page(s) 804–811

Abstract: Eosinophilic solid and cystic renal cell carcinoma (ESCRCC) is a recently described distinct renal neoplasm known to occur almost exclusively in female patients with or without tuberous sclerosis complex (TSC). We report a case of ESCRCC with 2 ... ...

Abstract	Eosinophilic solid and cystic renal cell carcinoma (ESCRCC) is a recently described distinct renal neoplasm known to occur almost exclusively in female patients with or without tuberous sclerosis complex (TSC). We report a case of ESCRCC with 2 synchronous angiomyolipomas, including 1 angiomyolipoma with epithelial cysts (AMLEC), a rare cystic variant of AML that typically arises sporadically in the absence of TSC, in a 46-year-old woman with TSC. Besides additional copy number alterations identified in ESCRCC via molecular karyotyping, we also report a unique histologic feature of TSC-associated ESCRCC previously not described in detail, with formation of semicircular multinucleated neoplastic giant cells engulfing an additional intact neoplastic cell, simulating emperipolesis. To the best of our knowledge, this is the first reported case of ESCRCC with concurrent AMLEC in a patient with TSC, confirmed through additional genetic testing showing a germline heterozygous mutation in
MeSH term(s)	Angiomyolipoma/diagnosis ; Angiomyolipoma/genetics ; Angiomyolipoma/surgery ; Carcinoma, Renal Cell/diagnosis ; Carcinoma, Renal Cell/genetics ; Carcinoma, Renal Cell/surgery ; DNA Copy Number Variations ; Diagnosis, Differential ; Female ; Genetic Testing ; Germ-Line Mutation ; Giant Cells/pathology ; Heterozygote ; Humans ; Karyotyping ; Kidney/cytology ; Kidney/pathology ; Kidney/surgery ; Kidney Neoplasms/diagnosis ; Kidney Neoplasms/genetics ; Kidney Neoplasms/surgery ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis ; Neoplasms, Multiple Primary/genetics ; Neoplasms, Multiple Primary/surgery ; Nephrectomy ; Treatment Outcome ; Tuberous Sclerosis/complications ; Tuberous Sclerosis/diagnosis ; Tuberous Sclerosis/genetics ; Tuberous Sclerosis Complex 1 Protein/genetics
Chemical Substances	TSC1 protein, human ; Tuberous Sclerosis Complex 1 Protein
Language	English
Publishing date	2019-05-29
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1336393-1
ISSN	1940-2465 ; 1066-8969
ISSN (online)	1940-2465
ISSN	1066-8969
DOI	10.1177/1066896919849679
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Article ; Online: Timeliness and Modality of Treatment for New Cancer Diagnoses During the COVID-19 Pandemic in Canada.

Fu, Rui / Sutradhar, Rinku / Li, Qing / Hanna, Timothy P / Chan, Kelvin K W / Irish, Jonathan C / Coburn, Natalie / Hallet, Julie / Dare, Anna / Singh, Simron / Parmar, Ambica / Earle, Craig C / Lapointe-Shaw, Lauren / Krzyzanowska, Monika K / Finelli, Antonio / Louie, Alexander V / Hong, Nicole J Look / Witterick, Ian J / Mahar, Alyson /

Urbach, David R / McIsaac, Daniel I / Enepekides, Danny / Tinmouth, Jill / Eskander, Antoine

JAMA network open

2023 Volume 6, Issue 1, Page(s) e2250394

Abstract: Importance: The impact of COVID-19 on the modality and timeliness of first-line cancer treatment is unclear yet critical to the planning of subsequent care.: Objective: To explore the association of the COVID-19 pandemic with modalities of and wait ... ...

Abstract	Importance: The impact of COVID-19 on the modality and timeliness of first-line cancer treatment is unclear yet critical to the planning of subsequent care. Objective: To explore the association of the COVID-19 pandemic with modalities of and wait times for first cancer treatment. Design, setting, and participants: This retrospective population-based cohort study using administrative data was conducted in Ontario, Canada, among adults newly diagnosed with cancer between January 3, 2016, and November 7, 2020. Participants were followed up from date of diagnosis for 1 year, until death, or until June 26, 2021, whichever occurred first, to ensure a minimum of 6-month follow-up time. Exposures: Receiving a cancer diagnosis in the pandemic vs prepandemic period, using March 15, 2020, the date when elective hospital procedures were halted. Main outcomes and measures: The main outcome was a time-to-event variable describing number of days from date of diagnosis to date of receiving first cancer treatment (surgery, chemotherapy, or radiation) or to being censored. For each treatment modality, a multivariable competing-risk regression model was used to assess the association between time to treatment and COVID-19 period. A secondary continuous outcome was defined for patients who were treated 6 months after diagnosis as the waiting time from date of diagnosis to date of treatment. Results: Among 313 499 patients, the mean (SD) age was 66.4 (14.1) years and 153 679 (49.0%) were male patients. Those who were diagnosed during the pandemic were less likely to receive surgery first (subdistribution hazard ratio [sHR], 0.97; 95% CI, 0.95-0.99) but were more likely to receive chemotherapy (sHR, 1.26; 95% CI, 1.23-1.30) or radiotherapy (sHR, 1.16; 95% CI, 1.13-1.20) first. Among patients who received treatment within 6 months from diagnosis (228 755 [73.0%]), their mean (SD) waiting time decreased from 35.1 (37.2) days to 29.5 (33.6) days for surgery, from 43.7 (34.1) days to 38.4 (30.6) days for chemotherapy, and from 55.8 (41.8) days to 49.0 (40.1) days for radiotherapy. Conclusions and relevance: In this cohort study, the pandemic was significantly associated with greater use of nonsurgical therapy as initial cancer treatment. Wait times were shorter in the pandemic period for those treated within 6 months of diagnosis. Future work needs to examine how these changes may have affected patient outcomes to inform future pandemic guideline development.
MeSH term(s)	Adult ; Humans ; Male ; Aged ; Female ; COVID-19/epidemiology ; Retrospective Studies ; Cohort Studies ; Pandemics ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Neoplasms/therapy ; Ontario/epidemiology
Language	English
Publishing date	2023-01-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.50394
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Article ; Online: Association between the COVID-19 pandemic and first cancer treatment modality: a population-based cohort study.

CMAJ open

2023 Volume 11, Issue 3, Page(s) E426–E433

Abstract: Background: Physicians were directed to prioritize using nonsurgical cancer treatment at the beginning of the COVID-19 pandemic. We sought to quantify the impact of this policy on the modality of first cancer treatment (surgery, chemotherapy, ... ...

Abstract	Background: Physicians were directed to prioritize using nonsurgical cancer treatment at the beginning of the COVID-19 pandemic. We sought to quantify the impact of this policy on the modality of first cancer treatment (surgery, chemotherapy, radiotherapy or no treatment). Methods: In this population-based study using Ontario data from linked administrative databases, we identified adults diagnosed with cancer from January 2016 to November 2020 and their first cancer treatment received within 1 year postdiagnosis. Segmented Poisson regressions were applied to each modality to estimate the change in mean 1-year recipient volume per thousand patients (rate) at the start of the pandemic (the week of Mar. 15, 2020) and change in the weekly trend in rate during the pandemic (Mar. 15, 2020, to Nov. 7, 2020) relative to before the pandemic (Jan. 3, 2016, to Mar. 14, 2020). Results: We included 321 535 people diagnosed with cancer. During the first week of the COVID-19 pandemic, the mean rate of receiving upfront surgery over the next year declined by 9% (rate ratio 0.91, 95% confidence interval [CI] 0.88-0.95), and chemotherapy and radiotherapy rates rose by 30% (rate ratio 1.30, 95% CI 1.23-1.36) and 13% (rate ratio 1.13, 95% CI 1.07-1.19), respectively. Subsequently, the 1-year rate of upfront surgery increased at 0.4% for each week (rate ratio 1.004, 95% CI 1.002-1.006), and chemotherapy and radiotherapy rates decreased by 0.9% (rate ratio 0.991, 95% CI 0.989-0.994) and 0.4% (rate ratio 0.996, 95% CI 0.994-0.998), respectively, per week. Rates of each modality resumed to prepandemic levels at 24-31 weeks into the pandemic. Interpretation: An immediate and sustained increase in use of nonsurgical therapy as the first cancer treatment occurred during the first 8 months of the COVID-19 pandemic in Ontario. Further research is needed to understand the consequences.
MeSH term(s)	Adult ; Humans ; Pandemics ; Cohort Studies ; COVID-19/epidemiology ; COVID-19/therapy ; Databases, Factual ; Ontario/epidemiology ; Neoplasms/epidemiology ; Neoplasms/therapy
Language	English
Publishing date	2023-05-09
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2701622-5
ISSN	2291-0026 ; 2291-0026
ISSN (online)	2291-0026
ISSN	2291-0026
DOI	10.9778/cmajo.20220102
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Article ; Online: Early survival for patients newly diagnosed with cancer during COVID-19 in Ontario, Canada: A population-based cohort study.

Fu, Rui / Sutradhar, Rinku / Li, Qing / Kamalraj, Pabiththa / Dare, Anna / Hanna, Timothy P / Chan, Kelvin K W / Irish, Jonathan C / Coburn, Natalie / Hallet, Julie / Singh, Simron / Parmar, Ambica / Earle, Craig C / Lapointe-Shaw, Lauren / Krzyzanowska, Monika K / Louie, Alexander V / Mahar, Alyson / Urbach, David R / McIsaac, Daniel I /

Enepekides, Danny / Gomez, David / Look Hong, Nicole J / Tinmouth, Jill / Eskander, Antoine

Cancer medicine

2023 Volume 12, Issue 10, Page(s) 11849–11859

Abstract: Background: Little is known about the association between the COVID-19 pandemic and early survival among newly diagnosed cancer patients.: Methods: This retrospective population-based cohort study used linked administrative datasets from Ontario, ... ...

Abstract	Background: Little is known about the association between the COVID-19 pandemic and early survival among newly diagnosed cancer patients. Methods: This retrospective population-based cohort study used linked administrative datasets from Ontario, Canada. Adults (≥18 years) who received a cancer diagnosis between March 15 and December 31, 2020, were included in a pandemic cohort, while those diagnosed during the same dates in 2018/2019 were included in a pre-pandemic cohort. All patients were followed for one full year after the date of diagnosis. Cox proportional hazards regression models were used to assess survival in relation to the pandemic, patient characteristics at diagnosis, and the modality of first cancer treatment as a time-varying covariate. Interaction terms were explored to measure the pandemic association with survival for each cancer type. Results: Among 179,746 patients, 53,387 (29.7%) were in the pandemic cohort and 37,741 (21.0%) died over the first post-diagnosis year. No association between the pandemic and survival was found when adjusting for patient characteristics at diagnosis (HR 0.99 [95% CI 0.96-1.01]), while marginally better survival was found for the pandemic cohort when the modality of treatment was additionally considered (HR 0.97 [95% CI 0.95-0.99]). When examining each cancer type, only a new melanoma diagnosis was associated with a worse survival in the pandemic cohort (HR 1.25 [95% CI 1.05-1.49]). Conclusions: Among patients able to receive a cancer diagnosis during the pandemic, one-year overall survival was not different than those diagnosed in the previous 2 years. This study highlights the complex nature of the COVID-19 pandemic impact on cancer care.
MeSH term(s)	Adult ; Humans ; Ontario/epidemiology ; Retrospective Studies ; Cohort Studies ; Pandemics ; COVID-19/epidemiology ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Neoplasms/therapy
Language	English
Publishing date	2023-03-31
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.5861
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Article ; Online: Influenza Vaccine Effectiveness Among Patients With Cancer: A Population-Based Study Using Health Administrative and Laboratory Testing Data From Ontario, Canada.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

2019 Volume 37, Issue 30, Page(s) 2795–2804

Abstract: Purpose: Seasonal influenza vaccination is recommended for patients with cancer despite concerns of disease or treatment-associated immunosuppression. The objective of this study was to evaluate vaccine effectiveness (VE) against laboratory-confirmed ... ...

Abstract	Purpose: Seasonal influenza vaccination is recommended for patients with cancer despite concerns of disease or treatment-associated immunosuppression. The objective of this study was to evaluate vaccine effectiveness (VE) against laboratory-confirmed influenza for patients with cancer. Patients and methods: We conducted an observational test-negative design study of previously diagnosed patients with cancer 18 years of age and older who underwent influenza testing during the 2010-2011 to 2015-2016 influenza seasons in Ontario, Canada. We linked individual-level cancer registry, respiratory virus testing, and health administrative data to identify the study population and outcomes. Vaccination status was determined from physician and pharmacist billing claims. We used multivariable logistic regression to estimate VE, adjusting for age, sex, rurality, income quintile, cancer characteristics, chemotherapy exposure, comorbidities, previous health care use, influenza season, and calendar time. Results: We identified 26,463 patients with cancer who underwent influenza testing, with 4,320 test-positive cases (16%) and 11,783 (45%) vaccinated. Mean age was 70 years, 52% were male, mean time since diagnosis was 6 years, 69% had solid tumor malignancies, and 23% received active chemotherapy. VE against laboratory-confirmed influenza was 21% (95% CI, 15% to 26%), and VE against laboratory-confirmed influenza hospitalization was 20% (95% CI, 13% to 26%). For patients with solid tumor malignancies, VE was 25% (95% CI, 18% to 31%), compared with 8% (95% CI, -5% to 19%) for patients with hematologic malignancies ( Conclusion: Our results support recommendations for influenza vaccination for patients with cancer. VE was decreased for patients with hematologic malignancies, and there was no significant difference in VE among patients with solid tumor cancer receiving active chemotherapy. Strategies to optimize influenza prevention among patients with cancer are warranted.
MeSH term(s)	Aged ; Canada ; Clinical Laboratory Techniques ; Female ; Humans ; Influenza Vaccines/pharmacology ; Influenza Vaccines/therapeutic use ; Male ; Neoplasms/complications ; Neoplasms/drug therapy ; Ontario ; Retrospective Studies
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2019-08-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604914-x
ISSN	1527-7755 ; 0732-183X
ISSN (online)	1527-7755
ISSN	0732-183X
DOI	10.1200/JCO.19.00354
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Article ; Online: Integration of patient-reported outcomes (PROs) for personalized symptom management in "real-world" oncology practices: a population-based cohort comparison study of impact on healthcare utilization.

Howell, Doris / Li, Madeline / Sutradhar, Rinku / Gu, Sumei / Iqbal, Javaid / O'Brien, Mary Ann / Seow, Hsien / Dudgeon, Deborah / Atzema, Clare / Earle, Craig C / DeAngelis, Carlo / Sussman, Jonathan / Barbera, Lisa

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2020 Volume 28, Issue 10, Page(s) 4933–4942

Abstract: Background: The use of patient-reported outcomes (PROs) for routine cancer distress screening is endorsed globally as a quality-care standard. However, there is little research on the integration of PROs in "real-world" oncology practices using ... ...

Abstract	Background: The use of patient-reported outcomes (PROs) for routine cancer distress screening is endorsed globally as a quality-care standard. However, there is little research on the integration of PROs in "real-world" oncology practices using implementation science methods. The Improving Patient Experience and Health Outcome Collaborative (iPEHOC) intervention was established at multisite disease clinics to facilitate the use of PRO data by clinicians for precision symptom care. The aim of this study was to examine if patients exposed to the intervention differed in their healthcare utilization compared with contemporaneous controls in the same time frame. Methods: We used a PRE- and DURING-intervention population cohort comparison study design to estimate the effects of the iPEHOC intervention on the difference in difference (DID) for relative rates (RR) for emergency department (ED) visits, hospitalizations, psychosocial oncology (PSO), palliative care visits, and prescription rates for opioids and antidepressants compared with controls. Results: A small significantly lower Difference in Difference (DID) (- 0.223) in the RR for ED visits was noted for the intervention compared with controls over time (0.947, CI 0.900-0.996); and a DID (- 0.0329) for patients meeting ESAS symptom thresholds (0.927, CI 0.869-0.990). A lower DID in palliative care visits (- 0.0097), psychosocial oncology visits (- 0.0248), antidepressant prescriptions (- 0.0260) and an increase in opioid prescriptions (0.0456) in the exposed population compared with controls was also noted. A similar pattern was shown for ESAS as a secondary exposure variable. Conclusion: Facilitating uptake of PROs data may impact healthcare utilization but requires examination in larger scale "real-world" trials.
MeSH term(s)	Aged ; Cohort Studies ; Early Detection of Cancer ; Emergency Service, Hospital/statistics & numerical data ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Medical Oncology/methods ; Middle Aged ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Neoplasms/therapy ; Ontario/epidemiology ; Palliative Care/methods ; Patient Acceptance of Health Care/statistics & numerical data ; Patient Reported Outcome Measures ; Precision Medicine/methods ; Quality of Health Care
Language	English
Publishing date	2020-02-04
Publishing country	Germany
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-020-05313-3
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