Luca Di Benedetto, Mario Pinto, Valentina Ieritano, Francesco Maria Lisci, Laura Monti, Elisa Marconi, Daniela Pia Rosaria Chieffo, Silvia Montanari, Georgios D Kotzalidis, Gabriele Sani, Delfina Janiri
{"title":"Gender Differences in Alexithymia, Emotion Regulation, and Impulsivity in Young Individuals with Mood Disorders.","authors":"Luca Di Benedetto, Mario Pinto, Valentina Ieritano, Francesco Maria Lisci, Laura Monti, Elisa Marconi, Daniela Pia Rosaria Chieffo, Silvia Montanari, Georgios D Kotzalidis, Gabriele Sani, Delfina Janiri","doi":"10.3390/jcm14062030","DOIUrl":"10.3390/jcm14062030","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Alexithymia, emotion regulation, and impulsivity are key factors in youths with mood disorders. However, gender differences within these dimensions remain insufficiently studied in this population. This study seeks to explore these dimensions in a sample of adolescents and young adults with mood disorders, aiming to identify gender-specific characteristics with important clinical implications. <b>Methods:</b> We assessed 115 outpatients aged 13 to 25 years with a DSM-5 diagnosis of mood disorder. The evaluation included the Toronto Alexithymia Scale (TAS-20), the Difficulties in Emotion Regulation Scale (DERS), and the UPPS-P Impulsive Behavior Scale. The associations with suicidal ideation were tested using two different multivariate models. Results were controlled for age and intelligence measures. <b>Results:</b> The first model (Wilks' Lambda = 0.720, <i>p</i> < 0.001) revealed significantly higher scores in women than men for TAS-20 (<i>p</i> < 0.001), DERS (<i>p</i> < 0.001), and the UPPS-P subscales \"Lack of Premeditation\" (<i>p</i> = 0.004) and \"Lack of Perseverance\" (<i>p</i> = 0.001). Regression analyses confirmed gender as a significant predictor of these variables, also controlling for age and intelligence. Furthermore, intelligence measure influenced Lack of Premeditation and age influenced Lack of Perseverance. <b>Conclusions:</b> Women with mood disorders exhibit greater alexithymia, emotional dysregulation, and impulsivity, particularly in difficulties with planning and task persistence. These findings highlight the need for gender-sensitive interventions that address emotional awareness and impulse control to improve clinical outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad El Masri, Diala El Masri, Maya Ghazi, Ahmad Afyouni, Hani Finge, Jad El Ahdab, Maryam Tlayss, Soltan Al Chaar, Wassim Abou-Kheir, Pascale Salameh, Hassan Hosseini
{"title":"Description of the Risk Factors for Ischemic Stroke in the Lebanese Population: Their Association with Age at First Stroke Incidence and the Predictors of Recurrence.","authors":"Jad El Masri, Diala El Masri, Maya Ghazi, Ahmad Afyouni, Hani Finge, Jad El Ahdab, Maryam Tlayss, Soltan Al Chaar, Wassim Abou-Kheir, Pascale Salameh, Hassan Hosseini","doi":"10.3390/jcm14062034","DOIUrl":"10.3390/jcm14062034","url":null,"abstract":"<p><p><b>Background</b>: Stroke is the third most common cause of death in Lebanon. With many preventive strategies identified, stroke remains a national burden, especially in developing countries, where risk factors and epidemiological states are understudied. This study aims to investigate the association of sociodemographic factors and health-related risk factors with age at first ischemic stroke and its recurrence in the Lebanese population. <b>Methods</b>: A retrospective study including 214 ischemic stroke cases was carried out. Sociodemographic characteristics and health-related risk factors were assessed, in addition to disability levels (modified Rankin score (mRS)), age at first ischemic stroke incidence, and number of ischemic strokes. Data were analyzed using SPSS software version 25, including descriptive, bivariate, and multivariate analyses. <b>Results</b>: This study showed that stressful factors were significantly associated with a younger age at first ischemic stroke, such as having no partner (<i>p</i> < 0.001), having employment (<i>p</i> < 0.001), and having migraines (<i>p</i> < 0.001). However, metabolic risk factors were associated with an older age of ischemic stroke, such as hypertension (<i>p</i> < 0.001) and hyperlipidemia (<i>p</i> < 0.001). Moreover, having a partner (OR: 2.136), having a family history of stroke (OR: 2.873), having hyperlipidemia (OR: 3.71), and having atrial fibrillation (OR: 2.521) were associated with ischemic stroke recurrence. <b>Conclusions</b>: Many modifiable factors are associated with age at first ischemic stroke and its recurrence. This study sheds light on the necessity of increasing knowledge and awareness of well-known risk factors in the Lebanese population. These results suggest implementing targeted preventive strategies and highlight the importance of complying with early detection and follow-up measures.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zein Kattih, Ho Cheol Kim, Shambhu Aryal, Steven D Nathan
{"title":"Review of the Diagnosis and Management of Pulmonary Hypertension Associated with Interstitial Lung Disease (ILD-PH).","authors":"Zein Kattih, Ho Cheol Kim, Shambhu Aryal, Steven D Nathan","doi":"10.3390/jcm14062029","DOIUrl":"10.3390/jcm14062029","url":null,"abstract":"<p><p>Pulmonary hypertension associated with interstitial lung disease (ILD-PH) frequently complicates the course of patients with fibrotic ILD. In this narrative review, the authors assess current diagnostic tools and management considerations in ILD-PH patients. ILD-PH is associated with increased morbidity and mortality and may be suggested by the presence of symptoms out of proportion to the extent of the ILD. There are other clues to the presence of PH in the context of ILD including the need for supplemental oxygen, a reduced DLCO especially if accompanied by a disproportionately higher forced vital capacity, imaging demonstrating an enlarged pulmonary artery or a dilated right ventricle, or objective evidence of a reduced exercise capacity. While echocardiography is one screening tool, right heart catheterization remains the gold standard for the diagnosis of PH. When appropriate, treatment with inhaled treprostinil, or possibly other pulmonary vasodilators, may be indicated.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jelena Havrljenko, Vesna Kopitovic, Aleksandra Trninic Pjevic, Stevan Milatovic, Sandro Kalember, Filip Katanic, Tatjana Pavlica, Nebojsa Andric, Kristina Pogrmic-Majkic
{"title":"The Effectiveness of the GnRH Agonist/Antagonist Protocols for Different Poseidon Subgroups of Poor Ovarian Responders.","authors":"Jelena Havrljenko, Vesna Kopitovic, Aleksandra Trninic Pjevic, Stevan Milatovic, Sandro Kalember, Filip Katanic, Tatjana Pavlica, Nebojsa Andric, Kristina Pogrmic-Majkic","doi":"10.3390/jcm14062026","DOIUrl":"10.3390/jcm14062026","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Poor responder patients represent the greatest challenge in ART. An inadequate response to COS strongly correlates with a reduced chance of conception. A novel classification of poor responders overcame a deficiency in the Bologna criteria and distinguished an expected and unexpected low ovarian response, allowing for an individual treatment approach to be created. In this study, we compared the clinical outcomes in poor responders, according to two different ovarian stimulation protocols, GnRH agonists and antagonists, classified according to the Poseidon criteria, to determine the most effective protocol for each group. <b>Methods:</b> This retrospective study involved 1323 low-prognosis women ranked according to the Poseidon classification and a control group of normal responders. <b>Results:</b> The GnRH-antagonist protocol showed some advantage in the Poseidon 1b group whereas the GnRH-agonist protocol was more effective in the Poseidon 4 group. There were no differences in live births or miscarriage rates in poor responders among these two protocols. <b>Conclusions:</b> Using both the agonist/antagonist approaches, live birth rates are two or even three times less in Poseidon patients in comparison to normal responders. The number of obtained oocytes, their maturity and quality, and women's ages were found to be the most influential determinants for a successful outcome. Further investigations into ovarian stimulation strategies are required to enhance oocyte number and live birth occurrence.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute Liver Failure During Early Pregnancy-Case Report and Review of Literature.","authors":"Banach Paulina, Justyna Kuczkowska, Yulia Areshchanka, Weronika Banach, Jakub Rzepka, Bartosz Kudliński, Rafał Rzepka","doi":"10.3390/jcm14062028","DOIUrl":"10.3390/jcm14062028","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This article presents the case of a 31-year-old primigravida who experienced acute liver failure in the 23rd week of pregnancy, along with a review of the literature on this rare condition during pregnancy. The purpose of this publication is to highlight the diagnostic and therapeutic challenges associated with acute liver failure in pregnant women. <b>Methods:</b> The patient presented with jaundice, pruritus, and dark-colored urine. Laboratory tests revealed a significant increase in aminotransferase, bilirubin, and bile acid levels, suggesting liver problems; however, due to the patient's rapidly deteriorating condition and test results, autoimmune hepatitis was considered. Viral infections and other causes of liver damage were excluded. No clear diagnosis was established. The patient was administered ursodeoxycholic acid and due to her worsening condition, a cesarean section was performed at 23 weeks of gestation. After delivery, the patient's condition improved, although she did experience cardiac arrest during hospitalization. The patient was discharged with a diagnosis of acute liver failure in the course of an overlap syndrome of autoimmune hepatitis and primary cholangitis or intrahepatic cholestasis of pregnancy. No abnormalities were noted during a follow-up visit 6 weeks after delivery. Despite a detailed case analysis, a final diagnosis was not established, which complicates planning for future pregnancies. <b>Discussion:</b> Several liver conditions can occur during pregnancy, including intrahepatic cholestasis of pregnancy, primary biliary cholangitis, and autoimmune hepatitis. Diagnosing these conditions can be challenging due to overlapping symptoms and metabolic and immunological adaptations during pregnancy that can affect the course of liver diseases. Rapid intervention is crucial to protect the health of both the mother and the fetus. <b>Conclusions:</b> In summary, this article aims to increase awareness of the complexities surrounding acute liver failure during pregnancy, highlighting the diagnostic challenges and importance of prompt medical intervention for the well-being of both the mother and the child. This paper aims to provide a comprehensive overview of the complexities surrounding acute liver failure during pregnancy, aiming to improve the understanding, diagnosis, and management of this condition.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janan Abbas, Malik Yousef, Kamal Hamoud, Katherin Joubran
{"title":"Low Back Pain Among Health Sciences Undergraduates: Results Obtained from a Machine-Learning Analysis.","authors":"Janan Abbas, Malik Yousef, Kamal Hamoud, Katherin Joubran","doi":"10.3390/jcm14062046","DOIUrl":"10.3390/jcm14062046","url":null,"abstract":"<p><p><b>Background and objective.</b> Low back pain (LBP) is considered the most common and challenging disorder in health care. Although its incidence increases with age, a student's sedentary behavior could contribute to this risk. Through machine learning (ML), advanced algorithms can analyze complex patterns in health data, enabling accurate prediction and targeted prevention of medical conditions such as LBP. This study aims to detect the factors associated with LBP among health sciences students. <b>Methods.</b> A self-administered modified version of the Standardized Nordic Questionnaire was completed by 222 freshman health sciences students from May to June 2022. A supervised random forest algorithm was utilized to analyze data and prioritize the importance of variables related to LBP. The model's predictive capability was further visualized using a decision tree to identify high-risk patterns and associations. <b>Results.</b> A total of 197/222 (88.7%) students participated in this study, most of whom (75%) were female. Their mean age and body mass index were 23 ± 3.8 and 23 ± 3.5, respectively. In this group, 46% (n = 90) of the students reported having experienced LBP in the last month, 15% (n = 30) were smokers, and 60% (n = 119) were involved in prolonged sitting (more than 3 h per day). The decision tree of ML revealed that a history of pain (score = 1), as well as disability (score= 0.34) and physical activity (score = 0.21), were significantly associated with LBP. <b>Conclusions.</b> Approximately 46% of the health science students reported LBP in the last month, and a machine-learning approach highlighted a history of pain as the most significant factor related to LBP.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reoperation Strategy for Failure of Cervical Disc Arthroplasty at Index and Adjacent Levels.","authors":"Chae-Gwan Kong, Jong-Beom Park","doi":"10.3390/jcm14062038","DOIUrl":"10.3390/jcm14062038","url":null,"abstract":"<p><p>Cervical disc arthroplasty (CDA) is a motion-preserving alternative to anterior cervical discectomy and fusion (ACDF) for cervical degenerative disease, reducing adjacent segment degenerative disease (ASD). Despite its benefits, some patients experience CDA failure due to prosthesis-related complications, heterotopic ossification, segmental kyphosis, ASD, or facet joint degeneration, necessitating revision surgery. Reoperation strategies depend on the failure mechanism, instability, sagittal malalignment, and neural compression. Anterior revision is suited for prosthesis failure, recurrent disc herniation, or ASD, enabling prosthesis removal, decompression, and fusion. In select cases, reimplantation may restore motion. Posterior approaches are preferred for facet degeneration, multilevel stenosis, or posterior hypertrophy, with options including foraminotomy, laminoplasty, or laminectomy and fusion. Complex cases may require combined anterior and posterior surgery for optimal decompression and stability. This narrative review outlines revision strategies, emphasizing biomechanical assessment, radiographic evaluation, and patient-specific considerations. Despite surgical challenges, meticulous planning and execution can optimize outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of Traditional and AI-Based Methods: Barrett Universal II vs. Ladas Super Formula in IOL Power Calculation.","authors":"Ionela-Iasmina Yasar, Servet Yasar, Leila Al Barri, Nadina Mercea, Mihnea Munteanu, Horia Tudor Stanca","doi":"10.3390/jcm14062023","DOIUrl":"10.3390/jcm14062023","url":null,"abstract":"<p><p><b>Background:</b> Pursuing optimal visual outcomes following cataract surgery remains a cornerstone of modern ophthalmology. Central to this objective is the precise calculation of intraocular lens power. However, despite significant advancements in biometric measurements and computational algorithms, variability in refractive outcomes continues to pose a challenge. This study aims to analyze the outcomes comprehensively by reviewing established and newer techniques. <b>Methods:</b> The eyes included in this study were evaluated based on various criteria, and a total of 210 eyes which met these criteria were included in the research. Our study is a retrospectively designed observational research study. The study included individuals who had experienced successful IOL implantation to correct refractive errors or cataracts. The ARGOS SS-OCT device, a spectral-domain optical coherence tomography system, was used in this study. In measuring the lens power, values were obtained using the Barrett Universal II and Ladas Super Formulas. These values were compared. Postoperative assessments were conducted at 1-3 months and 3-12 months, including spherical equivalents. <b>Results:</b> The mean age of the participants was 63.44 ± 11.62 years. The study's two most frequently used lens brands were ALCON and ZEISS. The lens powers calculated using the Barrett Universal II and Ladas Super Formulas were compared. The mean values calculated using both formulas were highly similar, with no statistically significant differences observed. We compared the spherical equivalent values calculated during the participants' first and second postoperative follow-ups. The spherical equivalent values were similar, with no statistically significant differences. <b>Conclusions:</b> Formulas represent significant advances in ophthalmology and significantly improve visual outcomes; however, differences in their methodology and predictive accuracy warrant further analysis.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ettore Lupi, Alessandra Ciccozzi, Roberto Becelli, Mario Mannino, Sara Bernardi, Filippo Giovannetti
{"title":"Surgical Management of Oro-Nasal Communication in Cocaine-Induced Lesions: Temporalis Muscle Flap with Le Fort I Osteotomy.","authors":"Ettore Lupi, Alessandra Ciccozzi, Roberto Becelli, Mario Mannino, Sara Bernardi, Filippo Giovannetti","doi":"10.3390/jcm14062033","DOIUrl":"10.3390/jcm14062033","url":null,"abstract":"<p><p><b>Background:</b> Cocaine is a recreational drug known for its negative impact on health and social and economic life. One of the complications for cocaine abusers is cocaine-induced midline destructive lesion (CIMDL) syndrome, which includes the extensive destruction of the osteocartilaginous structures of the nose, the sinus, and the palate. <b>Methods:</b> Here, we describe three cases of the surgical management of CIMDL using a temporalis muscle flap combined with a Le Fort I osteotomy, which allows sufficient space for the muscle to settle. <b>Results:</b> The addition of the osteotomy allowed better handling of the pedicled flap, with no signs of relapse in the reported cases and high patient satisfaction. <b>Conclusions:</b> CIMDL syndrome is an impairing disease that negatively affects the functionality of the nasal and oral cavities, as well as the aesthetic. Surgical repair using a pedicled flap is a valid option in rehabilitated and sober patients with endothelial damage.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linda D Bosserman, YiHsuan Lin, Sepideh Shayani, Brian Moore, Denise Morse, Emmanuel Enwere, Vijay Trisal, Wafa Samara
{"title":"Teams, Tools, Processes and Resources to Manage Oncologic Clinical Decision Support: Lessons Learned from City of Hope's Multistate, Academic, and Community Oncology Enterprise.","authors":"Linda D Bosserman, YiHsuan Lin, Sepideh Shayani, Brian Moore, Denise Morse, Emmanuel Enwere, Vijay Trisal, Wafa Samara","doi":"10.3390/jcm14062048","DOIUrl":"10.3390/jcm14062048","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Clinical decision support systems (CDSSs) consisting of Computerized Physician Order Entry (CPOE) and oncology pathways serve as the foundation of high-quality cancer care. However, the resources needed to develop and maintain these systems have not been characterized for oncology enterprises. <b>Methods:</b> Executive leadership appointed a medical director and clinical pharmacist to develop and lead a Pathways and Protocols Program for the City of Hope (COH) enterprise. This involved developing a program charter and governance committee and a business case for resources to support CPOE in our Epic Beacon treatment orders. Missing CPOEs for oncology treatments were identified for treatments in COH's Elsevier ClinicalPath treatment pathways and for those few diseases not in the pathways for medical oncology and hematology. New FDA oncology drug approvals were used to estimate ongoing CPOE build needs. Time estimates for Beacon analysts to build Beacon protocols were developed from a prior CPOE catch-up project, from informal surveys of our clinical pharmacists and Beacon leads, and surveys of staff leads at two other large, multisite cancer programs using Epic. Informal surveys of oncology clinicians and pharmacists were carried out to understand the time they were using to build Beacon orders that were not in the COH system. This information was used to build a business case for additional project management and staffing to catch up on building 400 missing Beacon orders, to maintain Beacon orders as new therapies and regimens are needed, and to provide required regulatory oversight of Beacon orders. Given these standards had not been shared by others, this work was gathered into a manuscript to help others evaluate and support needed resources to manage oncology pathway programs and CPOE to improve efficiencies, safety, and quality of care for medical oncology and hematology programs. <b>Results:</b> A Pathways and Protocols program was developed with a governance committee, a program charter, and a charge for disease committees to prioritize, approve, and oversee the regulation of COH's Beacon treatment orders. CPOE resources to catch up and maintain COH's Beacon treatment orders were developed and shared with COH's executive leadership. Informal surveys were completed to benchmark Beacon resources with COH and two other Beacon enterprises as well as to estimate the time used by COH clinicians to build Beacon orders for orders not in the system. <b>Conclusions:</b> The resources for managing clinical oncology pathways and CPOE for an enterprise have not previously been published. Work components identified from our work at COH are shared so that other oncology leaders might have a starting framework to evaluate their own CDSS needs for oncology pathways and CPOE.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}