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Article ; Online: Utility of a Rule-Based Algorithm in the Assessment of Standardized Reporting in PI-RADS.

Zhang, Dylan / Neely, Ben / Lo, Joseph Y / Patel, Bhavik N / Hyslop, Terry / Gupta, Rajan T

2022 Volume 30, Issue 6, Page(s) 1141–1147

Abstract: Rationale and objectives: Adoption of the Prostate Imaging Reporting & Data System (PI-RADS) has been shown to increase detection of clinically significant prostate cancer on prostate mpMRI. We propose that a rule-based algorithm based on Regular ... ...

Abstract	Rationale and objectives: Adoption of the Prostate Imaging Reporting & Data System (PI-RADS) has been shown to increase detection of clinically significant prostate cancer on prostate mpMRI. We propose that a rule-based algorithm based on Regular Expression (RegEx) matching can be used to automatically categorize prostate mpMRI reports into categories as a means by which to assess for opportunities for quality improvement. Materials and methods: All prostate mpMRIs performed in the Duke University Health System from January 2, 2015, to January 29, 2021, were analyzed. Exclusion criteria were applied, for a total of 5343 male patients and 6264 prostate mpMRI reports. These reports were then analyzed by our RegEx algorithm to be categorized as PI-RADS 1 through PI-RADS 5, Recurrent Disease, or "No Information Available." A stratified, random sample of 502 mpMRI reports was reviewed by a blinded clinical team to assess performance of the RegEx algorithm. Results: Compared to manual review, the RegEx algorithm achieved overall accuracy of 92.6%, average precision of 88.8%, average recall of 85.6%, and F1 score of 0.871. The clinical team also reviewed 344 cases that were classified as "No Information Available," and found that in 150 instances, no numerical PI-RADS score for any lesion was included in the impression section of the mpMRI report. Conclusion: Rule-based processing is an accurate method for the large-scale, automated extraction of PI-RADS scores from the text of radiology reports. These natural language processing approaches can be used for future initiatives in quality improvement in prostate mpMRI reporting with PI-RADS.
MeSH term(s)	Humans ; Male ; Prostate/pathology ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Magnetic Resonance Imaging/methods ; Multiparametric Magnetic Resonance Imaging ; Algorithms ; Retrospective Studies ; Image-Guided Biopsy/methods
Language	English
Publishing date	2022-07-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1355509-1
ISSN	1878-4046 ; 1076-6332
ISSN (online)	1878-4046
ISSN	1076-6332
DOI	10.1016/j.acra.2022.06.024
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Zs.A 4594: Show issues

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Article ; Online: Sample size in pilot genetic studies.

Hyslop, Terry

Clinical and translational science

2010 Volume 1, Issue 2, Page(s) 162

MeSH term(s)	Genetic Association Studies ; Humans ; Pilot Projects ; Polymorphism, Single Nucleotide/genetics ; Sample Size ; Translational Medical Research
Language	English
Publishing date	2010-04-21
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2433157-0
ISSN	1752-8062 ; 1752-8054
ISSN (online)	1752-8062
ISSN	1752-8054
DOI	10.1111/j.1752-8062.2008.00042.x
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Article ; Online: Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives.

Fayanju, Oluwadamilola M / Greenup, Rachel A / Zafar, S Yousuf / Hyslop, Terry / Hwang, E Shelley / Fish, Laura J

The Journal of surgical research

2023 Volume 284, Page(s) 269–279

Abstract: Introduction: We sought to examine patient and provider perspectives regarding modifiable contributors to breast cancer treatment and to assess perceptual alignment between these two groups.: Materials: Participants were women≥18 y with stage 0-IV ... ...

Abstract	Introduction: We sought to examine patient and provider perspectives regarding modifiable contributors to breast cancer treatment and to assess perceptual alignment between these two groups. Materials: Participants were women≥18 y with stage 0-IV breast cancer who received all oncologic care in a single health system and physicians and advanced practice providers who provided medical, radiation, or surgical oncology care for breast cancer. All completed ∼45-min semistructured interviews that were recorded and transcribed verbatim. A 5-stage approach to thematic analysis was conducted, with emergent themes and exemplar quotes placed into clinical, psychological, social/logistical, financial, and lifestyle categories using a multilevel conceptual framework. Results: Eighteen patients (9 Black, 9 White, and median age 60 y) and 10 providers (6 physicians and 4 advanced practice providers) were interviewed from May to November 2018. Both patients and providers perceived suboptimal communication, parking and transportation, and competing family-caregiving responsibilities as modifiable barriers to care. Treatment costs were cited by patients as barriers that were inadequately addressed even with referrals to financial counselors, but providers did not raise the issue of cost unless prompted by patients and did not feel prepared to discuss the topic when it arose. Providers cited obesity as a barrier to treatment, a view not shared by patients. Conclusions: Several modifiable factors were recognized by both patients and providers as either promoting or detracting from treatment receipt, but there was also significant incongruence and asymmetry. Alignment of provider and patient perceptions regarding contributors to guideline-concordant care receipt could mitigate disparities in breast cancer treatment and outcomes.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Breast Neoplasms/therapy ; Breast Neoplasms/psychology ; Qualitative Research ; Communication ; Referral and Consultation
Language	English
Publishing date	2023-01-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.11.074
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Zs.A 178: Show issues

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Article ; Online: Reply to J. Heil et al.

Hwang, E Shelley / Hyslop, Terry

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

2016 Volume 34, Issue 34, Page(s) 4192

Language	English
Publishing date	2016
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	604914-x
ISSN	1527-7755 ; 0732-183X
ISSN (online)	1527-7755
ISSN	0732-183X
DOI	10.1200/JCO.2016.69.1121
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Zs.A 1847: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Understanding mechanisms of racial disparities in breast cancer: an assessment of screening and regular care in the Carolina Breast Cancer Study.

Dunn, Matthew R / Metwally, Eman M / Vohra, Sanah / Hyslop, Terry / Henderson, Louise M / Reeder-Hayes, Katherine / Thompson, Caroline A / Lafata, Jennifer Elston / Troester, Melissa A / Butler, Eboneé N

Cancer causes & control : CCC

2024 Volume 35, Issue 5, Page(s) 825–837

Abstract: Purpose: Screening history influences stage at detection, but regular preventive care may also influence breast tumor diagnostic characteristics. Few studies have evaluated healthcare utilization (both screening and primary care) in racially diverse ... ...

Abstract	Purpose: Screening history influences stage at detection, but regular preventive care may also influence breast tumor diagnostic characteristics. Few studies have evaluated healthcare utilization (both screening and primary care) in racially diverse screening-eligible populations. Methods: This analysis included 2,058 women age 45-74 (49% Black) from the Carolina Breast Cancer Study, a population-based cohort of women diagnosed with invasive breast cancer between 2008 and 2013. Screening history (threshold 0.5 mammograms per year) and pre-diagnostic healthcare utilization (i.e. regular care, based on responses to "During the past ten years, who did you usually see when you were sick or needed advice about your health?") were assessed as binary exposures. The relationship between healthcare utilization and tumor characteristics were evaluated overall and race-stratified. Results: Among those lacking screening, Black participants had larger tumors (5 + cm) (frequency 19.6% vs 11.5%, relative frequency difference (RFD) = 8.1%, 95% CI 2.8-13.5), but race differences were attenuated among screening-adherent participants (10.2% vs 7.0%, RFD = 3.2%, 0.2-6.2). Similar trends were observed for tumor stage and mode of detection (mammogram vs lump). Among all participants, those lacking both screening and regular care had larger tumors (21% vs 8%, RR = 2.51, 1.76-3.56) and advanced (3B +) stage (19% vs 6%, RR = 3.15, 2.15-4.63) compared to the referent category (screening-adherent and regular care). Under-use of regular care and screening was more prevalent in socioeconomically disadvantaged areas of North Carolina. Conclusions: Access to regular care is an important safeguard for earlier detection. Our data suggest that health equity interventions should prioritize both primary care and screening.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/diagnosis ; Breast Neoplasms/ethnology ; Middle Aged ; Aged ; Early Detection of Cancer/statistics & numerical data ; Healthcare Disparities/statistics & numerical data ; Healthcare Disparities/ethnology ; North Carolina/epidemiology ; Mammography/statistics & numerical data ; Patient Acceptance of Health Care/statistics & numerical data ; Patient Acceptance of Health Care/ethnology ; Black or African American/statistics & numerical data ; Cohort Studies ; White People/statistics & numerical data ; Mass Screening/statistics & numerical data ; Mass Screening/methods
Language	English
Publishing date	2024-01-13
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1064022-8
ISSN	1573-7225 ; 0957-5243
ISSN (online)	1573-7225
ISSN	0957-5243
DOI	10.1007/s10552-023-01833-5
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Zs.A 3375: Show issues

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Article ; Online: Tips for Analyzing Large Data Sets From the JAMA Surgery Statistical Editors.

Kaji, Amy H / Rademaker, Alfred W / Hyslop, Terry

JAMA surgery

2018 Volume 153, Issue 6, Page(s) 508–509

MeSH term(s)	Health Care Costs ; Humans ; Inpatients
Language	English
Publishing date	2018-04-03
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2018.0647
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Article ; Online: Disparities in OncotypeDx Testing and Subsequent Chemotherapy Receipt by Geography and Socioeconomic Status.

Van Alsten, Sarah C / Dunn, Matthew R / Hamilton, Alina M / Ivory, Joannie M / Gao, Xiaohua / Kirk, Erin L / Nsonwu-Farley, Joseph S / Carey, Lisa A / Abdou, Yara / Reeder-Hayes, Katherine E / Roberson, Mya L / Wheeler, Stephanie B / Emerson, Marc A / Hyslop, Terry / Troester, Melissa A

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

2024 Volume 33, Issue 5, Page(s) 654–661

Abstract: Background: OncotypeDx is a prognostic and predictive genomic assay used in early-stage hormone receptor-positive, HER2- (HR+/HER2-) breast cancer. It is used to inform adjuvant chemotherapy decisions, but not all eligible women receive testing. We ... ...

Abstract	Background: OncotypeDx is a prognostic and predictive genomic assay used in early-stage hormone receptor-positive, HER2- (HR+/HER2-) breast cancer. It is used to inform adjuvant chemotherapy decisions, but not all eligible women receive testing. We aimed to assess variation in testing by demographics and geography, and to determine whether testing was associated with chemotherapy. Methods: For 1,615 women in the Carolina Breast Cancer Study with HR+/HER2-, Stage I-II tumors, we estimated prevalence differences (PD) and 95% confidence intervals (CI) for receipt of OncotypeDx genomic testing in association with and sociodemographic characteristics. We assessed associations between testing and chemotherapy receipt overall and by race. Finally, we calculated the proportion of eligible women receiving OncotypeDx by county-level rurality, census tract-level socioeconomic status, and Area Health Education Center regions. Results: 38% (N = 609) of potentially eligible women were tested, with lower testing prevalences in Black (31%; PD, -11%; 95% CI, -16%-6%) and low-income women (24%; PD, -20%; 95% CI, -29% to -11%) relative to non-Black and higher income women. Urban participants were less likely to be tested than rural participants, though this association varied by region. Among women with low genomic risk tumors, tested participants were 29% less likely to receive chemotherapy than untested participants (95% CI, -40% to -17%). Racial differences in chemotherapy were restricted to untested women. Conclusions: Both individual and area-level socioeconomics predict likelihood of OncotypeDx testing. Impact: Variable adoption of OncotypeDx by socioeconomics and across geographic settings may contribute to excess chemotherapy among patients with HR+/HER2- cancers. See related In the Spotlight, p. 635.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/drug therapy ; Breast Neoplasms/genetics ; Middle Aged ; Adult ; Aged ; Social Class ; Healthcare Disparities/statistics & numerical data ; Genetic Testing/statistics & numerical data ; Genetic Testing/methods ; Receptor, ErbB-2/metabolism ; Receptor, ErbB-2/genetics
Chemical Substances	Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1153420-5
ISSN	1538-7755 ; 1055-9965
ISSN (online)	1538-7755
ISSN	1055-9965
DOI	10.1158/1055-9965.EPI-23-1201
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Article ; Online: Design and Evaluation of a Computational Phenotype to Identify Patients With Metastatic Breast Cancer Within the Electronic Health Record.

Neely, Benjamin / Shahsahebi, Mohammad / Marks, Caitlin E / Power, Steve / Kanter, Andrew / Howell, Claire / Hyslop, Terry / Plichta, Jennifer K

JCO clinical cancer informatics

2022 Volume 6, Page(s) e2200056

Abstract: Purpose: Outcomes for patients with metastatic breast cancer (MBC) are continually improving as more effective treatments become available. Granular data sets of this unique population are lacking, and the standard method for data collection relies ... ...

Abstract	Purpose: Outcomes for patients with metastatic breast cancer (MBC) are continually improving as more effective treatments become available. Granular data sets of this unique population are lacking, and the standard method for data collection relies largely on chart review. Therefore, using electronic health records (EHR) collected at a tertiary hospital system, we developed and evaluated a computational phenotype designed to identify all patients with MBC, and we compared the effectiveness of this algorithm against the gold standard, clinical chart review. Methods: A cohort of patients with breast cancer were identified according to International Classification of Diseases codes, the institutional tumor registry, and SNOMED codes. Chart review was performed to determine whether distant metastases had occurred. We developed a computational phenotype, on the basis of SNOMED concept IDs, which was applied to the EHR to identify patients with MBC. Contingency tables were used to aggregate and compare results. Results: A total of 1,741 patients with breast cancer were identified using data from International Classification of Diseases codes, the tumor registry, and/or SNOMED concept identifiers. Chart review of all patients classified each patient as having MBC (n = 416; 23.9%) versus not (n = 1,325; 75.9%). The final computational phenotype successfully classified 1,646 patients (95% accuracy; 82% sensitivity; 99% specificity). Conclusion: Hospital systems with robust EHRs and reliable mapping to SNOMED have the ability to use standard codes to derive computational phenotypes. These algorithms perform reasonably well and have the added ability to be run at disparate health care facilities. Better tooling to navigate the polyhierarchical structure of SNOMED ontology could yield better-performing computational phenotypes.
MeSH term(s)	Electronic Health Records ; Humans ; International Classification of Diseases ; Neoplasms ; Phenotype ; Systematized Nomenclature of Medicine
Language	English
Publishing date	2022-09-30
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2473-4276
ISSN (online)	2473-4276
DOI	10.1200/CCI.22.00056
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Article ; Online: Going beyond the means: Exploring the role of bias from digital determinants of health in technologies.

Charpignon, Marie-Laure / Carrel, Adrien / Jiang, Yihang / Kwaga, Teddy / Cantada, Beatriz / Hyslop, Terry / Cox, Christopher E / Haines, Krista / Koomson, Valencia / Dumas, Guillaume / Morley, Michael / Dunn, Jessilyn / Ian Wong, An-Kwok

PLOS digital health

2023 Volume 2, Issue 10, Page(s) e0000244

Abstract: Background: In light of recent retrospective studies revealing evidence of disparities in access to medical technology and of bias in measurements, this narrative review assesses digital determinants of health (DDoH) in both technologies and medical ... ...

Abstract	Background: In light of recent retrospective studies revealing evidence of disparities in access to medical technology and of bias in measurements, this narrative review assesses digital determinants of health (DDoH) in both technologies and medical formulae that demonstrate either evidence of bias or suboptimal performance, identifies potential mechanisms behind such bias, and proposes potential methods or avenues that can guide future efforts to address these disparities. Approach: Mechanisms are broadly grouped into physical and biological biases (e.g., pulse oximetry, non-contact infrared thermometry [NCIT]), interaction of human factors and cultural practices (e.g., electroencephalography [EEG]), and interpretation bias (e.g, pulmonary function tests [PFT], optical coherence tomography [OCT], and Humphrey visual field [HVF] testing). This review scope specifically excludes technologies incorporating artificial intelligence and machine learning. For each technology, we identify both clinical and research recommendations. Conclusions: Many of the DDoH mechanisms encountered in medical technologies and formulae result in lower accuracy or lower validity when applied to patients outside the initial scope of development or validation. Our clinical recommendations caution clinical users in completely trusting result validity and suggest correlating with other measurement modalities robust to the DDoH mechanism (e.g., arterial blood gas for pulse oximetry, core temperatures for NCIT). Our research recommendations suggest not only increasing diversity in development and validation, but also awareness in the modalities of diversity required (e.g., skin pigmentation for pulse oximetry but skin pigmentation and sex/hormonal variation for NCIT). By increasing diversity that better reflects patients in all scenarios of use, we can mitigate DDoH mechanisms and increase trust and validity in clinical practice and research.
Language	English
Publishing date	2023-10-12
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2767-3170
ISSN (online)	2767-3170
DOI	10.1371/journal.pdig.0000244
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Article ; Online: Helicobacter pylori testing prior to or at gastric cancer diagnosis and survival in a diverse US patient population.

Garman, Katherine S / Brown, HannahSofia / Alagesan, Priya / McCall, Shannon J / Patierno, Steven / Wang, Qichen / Wang, Frances / Hyslop, Terry / Epplein, Meira

Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association

2023 Volume 27, Issue 1, Page(s) 28–35

Abstract: Background: Gastric cancer (GC) accounts for the greatest disparity in cancer mortality between Black and White Americans. Although clinical trials have shown that Helicobacter pylori (Hp) treatment reduces risk of GC, Hp testing and treatment is not ... ...

Abstract	Background: Gastric cancer (GC) accounts for the greatest disparity in cancer mortality between Black and White Americans. Although clinical trials have shown that Helicobacter pylori (Hp) treatment reduces risk of GC, Hp testing and treatment is not consistently performed in the US, and may offer an opportunity to improve survival. Methods: In a diverse retrospective cohort of 99 GC cases diagnosed at Duke University from 2002-2020 (57% Black; 43% white), we examined the association of Hp testing and treatment prior to or at cancer diagnosis with overall survival using Cox regression analyses to calculate adjusted hazards ratios (HRs) and 95% confidence intervals (CIs). Results: Overall, 62% of patients were tested for Hp prior to or at GC diagnosis. Of those, 25% tested positive and were treated < 1 year prior to or at diagnosis, 15% tested positive and were treated ≥ 1 year prior to diagnosis, 6% tested positive without evidence of treatment, and 54% tested negative. Compared to never tested, Hp testing and treatment < 1 year prior to or at diagnosis was associated with a significantly reduced likelihood of death (HR 0.21, 95% CI 0.08-0.58). The benefit of any Hp test and treat prior to or at GC diagnosis was significant even among stage IV patients only (HR, 0.22; 95% CI 0.05-0.96). Conclusions: These findings support Hp testing and treatment for patients at risk of or diagnosed with GC, and suggest Hp treatment may provide an opportunity to reduce GC mortality disparities in the US.
MeSH term(s)	Humans ; Stomach Neoplasms/epidemiology ; Helicobacter pylori ; Retrospective Studies ; Helicobacter Infections/diagnosis ; Helicobacter Infections/drug therapy ; Helicobacter Infections/complications ; Proportional Hazards Models
Language	English
Publishing date	2023-11-20
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1463526-4
ISSN	1436-3305 ; 1436-3291
ISSN (online)	1436-3305
ISSN	1436-3291
DOI	10.1007/s10120-023-01448-4
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