JCO oncology practice最新文献

{"title":"Ambient Artificial Intelligent Scribes in Oncology: Impact on Clinician Experience and Documentation Burden.","authors":"Abigail E Baldwin-Medsker, Susan Chimonas, Suryan P Goyal, Adam J Watson, Fariha Ahsan, Gilad J Kuperman, Kenneth Seier, Cardinale Smith, Christina Ward, Gianna Zucotti, Allison Lipitz-Snyderman","doi":"10.1200/OP-26-00822","DOIUrl":"https://doi.org/10.1200/OP-26-00822","url":null,"abstract":"<p><strong>Purpose: </strong>Ambient artificial intelligence (AI) scribes, widely implemented to reduce clinician burden and dissatisfaction, are not optimized for oncology. We evaluated this technology at-scale at a high-volume cancer center.</p><p><strong>Methods: </strong>This prospective mixed-methods study used surveys, electronic health record (EHR), and utilization data to assess adoption, burden, and satisfaction with an ambient AI scribe that was implemented from June to September 2025. Descriptive statistics categorized clinicians as adopters (3+ weeks of use), attempted adopters (1-2 weeks), and never-users (0 weeks). Generalized estimating equations assessed the adoption's effect on the likelihood of closing notes on visit days and pajama time. Pre- and postimplementation surveys obtained clinicians' insights into satisfaction and documentation burden.</p><p><strong>Results: </strong>In all, 190 (19.8%) of 958 clinicians used the tool, most often with new, video, and in-person visits. Adopters (n = 124) and attempted adopters (n = 66) were more commonly physicians from medicine and surgery. Pre- to post-rollout, the likelihood of closing notes on visit days remained unchanged among never-users (70% <i>v</i> 70%) and decreased among attempted adopters (73% <i>v</i> 70%) and adopters (56% <i>v</i> 54%). Pajama time remained unchanged among attempted adopters (50.6 <i>v</i> 50.1 minutes per week) and decreased among never-users (69.5 <i>v</i> 62.2) and adopters (86.9 <i>v</i> 81.4). Clinicians completing both pre- and postrollout surveys (n = 45) showed a decrease in high/excessive note-writing time (78% <i>v</i> 60%; <i>P</i> = .043). Postrollout surveys (n = 77) showed largely positive experiences, with 73% reporting they would recommend the tool to colleagues.</p><p><strong>Conclusion: </strong>This study of an ambient AI scribe at-scale showed positive satisfaction but mixed burden outcomes among oncology clinicians. Notably, despite enterprise-wide implementation and training, adoption was low and varied by clinician and visit characteristics. Future research should explore adoption barriers and tool optimization to support oncology documentation workflows.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600822"},"PeriodicalIF":5.5,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Decade of QOPI in Spain: From Quality Measurement to Continuous Improvement in Oncology Practice.","authors":"Jesús García-Foncillas, Paula Gratal, Ana Blasco Cordellat, Carlos Burriel, Francisco Javier Jiménez, Marta Alba, Sandra Chamochin, Álvaro Rogado, Luis de la Cruz, Pilar García Alfonso, Pedro Pérez Segura, Delvys Rodríguez, Rafael López","doi":"10.1200/OP-26-01123","DOIUrl":"https://doi.org/10.1200/OP-26-01123","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated 10 years of QOPI implementation in Spain to characterize quality performance across successive stages of participation, assess sustainability over time, compare performance with contemporaneous QOPI benchmarks, identify persistent certification gaps, and examine quality performance across repeated certification and reassessment cycles.</p><p><strong>Methods and materials: </strong>We conducted a longitudinal descriptive study of QOPI implementation in Spanish oncology practices between 2015 and 2025. Analyses included within-practice changes in QOPI quality measures among certified practices, comparing the last available pre-certification assessment with the first post-certification assessment, including disease-specific measures for breast, colorectal, and lung cancer; descriptive comparisons between first participation and post-certification assessments, benchmarking against the contemporaneous QOPI Aggregate, and findings from external certification and recertification surveys.</p><p><strong>Results: </strong>Within-practice longitudinal analyses among certified practices showed higher post-certification performance in several patient-centered measures, including emotional well-being assessment (75.56% to 85.20%), infertility risk discussion (70.33% to 78.67%), appropriate pain management (83.57% to 89.15%), and pain assessment (83.56% to 89.50%). Certified practices maintained broadly high performance over time, although lower post-certification performance was observed in some chemotherapy and other documentation measures. Benchmarking showed a shift: pain assessment, emotional well-being assessment, appropriate pain management, and infertility counseling moved from below to above the contemporaneous QOPI Aggregate after certification. External surveys identified recurrent opportunities for improvement in treatment verification and patient information and education.</p><p><strong>Conclusion: </strong>A decade of QOPI implementation in Spain was associated with sustained high-quality performance, higher scores in selected patient-centered measures after certification, and the identification of persistent opportunities for improvement. Repeated measurement, benchmarking, certification, and reassessment may support organizational change and continuous quality improvement.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"101200OP2601123"},"PeriodicalIF":5.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putting the Patient at the Center of Patient-Centered Care.","authors":"Gabrielle Rocque, Ryan Nipp, Mina S Sedrak","doi":"10.1200/OP-26-00798","DOIUrl":"https://doi.org/10.1200/OP-26-00798","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600798"},"PeriodicalIF":5.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Canadian Oncology Physician Workforce: A Review of Training, Distribution, and Systemic Pressures Across Oncology-Related Physician Specialties.","authors":"Zejia F Chen, Luis L Leiva Tobelem, Samara Saory D'Agostino Dos Santos, Fabio Y Moraes","doi":"10.1200/OP-26-00777","DOIUrl":"https://doi.org/10.1200/OP-26-00777","url":null,"abstract":"<p><p>Between 1994 and 2020, new cancer cases in Canada increased by 88%, with 40% of the oncology workforce now nearing retirement age. With increasing cancer incidence and an aging workforce, organizations such as the Canadian Association of Provincial Cancer Agencies have expressed concern that Canada's cancer workforce is overstretched, with a need for workforce monitoring. This scoping review investigates the workforce trends and pressures affecting the workforce across key Canadian physician specialties involved in oncology care (surgical oncology, medical oncology, radiation oncology, hematology, pediatric hematology/oncology, and palliative care). Data were synthesized from a database search and included gray literature or national workforce sources such as the Canadian Institute for Health Information. Distinct patterns, supply-demand imbalances, and emerging solutions to growing issues in each field are reported. We also report on documented strategies already being implemented to help alleviate pressures. Data showed that despite workforce growth, burnout and regional distribution pressures threaten access to Canadian cancer care, demonstrating a need for reallocation of resources.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600777"},"PeriodicalIF":5.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Real World Data and Survival: Bias Is Not Evidence.","authors":"Karlyn A Martin, Chris E Holmes, Steven Ades","doi":"10.1200/OP-26-00935","DOIUrl":"https://doi.org/10.1200/OP-26-00935","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600935"},"PeriodicalIF":5.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility Status of Economic Evaluations of Cancer Drugs: An Assessment of 150 Cost-Effectiveness Models.","authors":"Naimi Johansson, Jonathan Siverskog, Martin Henriksson, Mikael Svensson","doi":"10.1200/OP-26-00690","DOIUrl":"https://doi.org/10.1200/OP-26-00690","url":null,"abstract":"<p><strong>Purpose: </strong>Model-based cost-effectiveness analyses (CEAs) published in scientific journals have increased in recent years. The studies involve many discretionary judgements that, if not properly reported and justified, may reduce the credibility of cost-effectiveness evidence. In this study, we aimed to evaluate the reproducibility of published model-based CEAs and to explore associations between reproducibility and study characteristics.</p><p><strong>Methods: </strong>We conducted a systematic search for model-based CEAs of cancer drugs. Data were extracted on the journal type, impact factor, study design, model structure, and model inputs. Reproducibility was assessed based on access to model code (Computational Reproducibility) and whether reporting was transparent and sufficiently detailed across four criteria (model structure, transitions, costs, and health outcomes) for an external researcher to recreate the model (Recreate Reproducibility). Logistic regression was used to investigate associations between reproducibility and study characteristics.</p><p><strong>Results: </strong>Among 266 eligible CEAs, 150 were randomly selected for full-text review, of which 2.7% (95% CI, 1.0 to 6.7) were assessed as Computationally Reproducible and 16.7% (95% CI, 11.6 to 23.4) as Recreate Reproducible. While most studies reported the overall model structure (85% [95% CI, 77 to 91]), only 39% (95% CI, 28 to 51) fully reported all cost inputs. Regression analyses showed no association between reproducibility and study characteristics such as funding source, country setting, or journal impact factor.</p><p><strong>Conclusion: </strong>Only a small fraction of oncology CEAs was assessed as reproducible, irrespective of journal or study characteristics. Critical information necessary for external review and reproducibility remains largely unavailable, even in high-impact oncology journals. Standardized reporting and open modeling practices are needed to strengthen the scientific reliability of cost-effectiveness evidence in oncology.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600690"},"PeriodicalIF":5.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting High-Quality, Accessible Cancer Care for People With Disabilities.","authors":"Sean Smith, Maggie Salinger, Rebecca A Spence, Ash B Alpert, Deborah B Doroshow, Leila Hamroun-Yazid, Yara Abdou, Samilia Obeng-Gyasi, Lori J Pierce","doi":"10.1200/OP-26-00656","DOIUrl":"https://doi.org/10.1200/OP-26-00656","url":null,"abstract":"<p><p>People with disabilities (PWD) face numerous challenges throughout the continuum of cancer care. Many of these are due to personal and structural biases that have historically made it more difficult for PWD to access oncologic care and which can be dehumanizing. We provide a narrative review of these challenges, starting with a review of disability statistics and methodologic considerations when reviewing the epidemiology of disability. We then discuss historic legal frameworks designed to support PWD, and barriers to oncology care faced by PWD, organized around the following primary topics: (1) biases faced by PWD from health care professionals, (2) screening, (3) diagnosis, (4) treatment, (5) survivorship, and (6) historical exclusion from oncology research. We conclude by identifying key areas that must be addressed to provide high-quality oncologic care for PWD. A variety of suggestions for addressing these issues are presented, including additional education of oncology providers, rethinking performance status, engaging stakeholders in the disability community, improving enrollment in clinical trials for PWD, and collecting consistent disability-related data.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600656"},"PeriodicalIF":5.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Truth Becomes Asymmetrical: Toxicity, Benefit, and Vulnerable Autonomy in Oncology.","authors":"Gianmauro Numico, Anna Merlotti, Elvio G Russi","doi":"10.1200/OP-26-00592","DOIUrl":"https://doi.org/10.1200/OP-26-00592","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600592"},"PeriodicalIF":5.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Tool to Predict Primary Tumor Location in the Setting of Metastatic Cancer With Unknown Primary.","authors":"Kerolous Eldeeb, Saad Badat, Haley K Perlow, Atallah Baydoun, Prashant Vempati, Yifan Yang, Daniel E Spratt, Ming Wang, Nicholas G Zaorsky","doi":"10.1200/OP-26-00212","DOIUrl":"https://doi.org/10.1200/OP-26-00212","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop and validate a tool to predict the primary tumor site in patients with metastatic cancer of unknown primary using demographic and clinical variables, including imaging-derived sites of metastasis, without pathology or laboratory data.</p><p><strong>Methods: </strong>In this population-based study, data were extracted from the SEER database. Patients diagnosed between 2010 and 2020 with a known primary cancer site, metastatic staging, and metastasis in the bone, liver, brain, and lungs were included. Patients were randomly split into training (70%) and/or testing (30%) sets. A total of 27 primary tumor sites were included. A gradient boosting model was trained to predict the primary tumor site, with random forest and classification tree models evaluated as comparators. Random guess and frequency-weighted guessing models were used for baseline comparison.</p><p><strong>Results: </strong>A total of 689,715 patients were included from 9,208,295 queried. The most common primary cancer sites were non-small cell lung cancer (NSCLC) (n = 211,338), intestines (n = 64,187), and pancreas (n = 60,310). The baseline models achieved Top-5 accuracies of 0.179 for a random guess and 0.476 for a frequency-weighted guess. The gradient boosting model achieved Top-1, Top-3, and Top-5 accuracies of 0.40 ± 0.001, 0.680 ± 0.001, and 0.790 ± 0.001, respectively, across 100 Monte-Carlo replicates. Top-5 accuracy was highest for primary NSCLC (0.990 ± 0.001) and intestinal cancer (0.900 ± 0.003). Our model was most influenced by sex (gain = 0.27) and metastasis to bone (gain = 0.20). A web app was constructed: primarycancerpredictor.netlify.app.</p><p><strong>Conclusion: </strong>This study developed and evaluated a gradient boosting machine learning model and a user-friendly web tool to aid in the diagnosis of cancer of unknown primary.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600212"},"PeriodicalIF":5.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting BRCA1/2 Clonal Hematopoiesis in the ASCO Circulating Tumor DNA Testing Guideline.","authors":"Alexander Gamisch","doi":"10.1200/OP-26-01043","DOIUrl":"https://doi.org/10.1200/OP-26-01043","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2601043"},"PeriodicalIF":5.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}