Science and Health Policy最新文献

{"title":"Abstract 2635: Contemporary clinical practice guidelines for the management of glioblastoma: an international survey","authors":"A. L. McLean, J. Walter","doi":"10.1158/1538-7445.AM2021-2635","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2021-2635","url":null,"abstract":"Introduction: Clinical practice guidelines are systematically developed statements to assist clinician and patient decisions about appropriate healthcare for specific clinical circumstances. In some cases, guidelines are utilized by health policymakers and insurers in determining coverage and reimbursement policies. Little is known about the global status of guideline development and implementation for the management of glioblastoma multiforme (GBM) or about the incorporation of novel therapies such as tumor treating fields (TTFields) into these guidelines. Methods: A comprehensive systematic review of published guidelines and consensus statements from national and international bodies such as health ministries and specialty societies, covering North, Central and South America, Europe, the Middle East, Africa and the Asia-Pacific region was performed. In addition, key stakeholders were surveyed to identify country-specific guidance and practice patterns, with a specific focus on guideline contemporariness and reference to TTFields. Results: The vast majority of countries worldwide do not have national guidelines for GBM management. Three multinational guidelines were identified, from SNO/EANO, ESMO and Germany-Austria-Switzerland. In addition, 18 national guidelines from 16 countries were identified, with some countries having multiple national guidelines in place (USA, Germany, Brazil). In over half of cases, the national guidelines had not been updated within the past three years. 10/18 national guidelines and 2/3 multinational guidelines mentioned TTFields. A minority of guidelines had an explicit expiry or revision date. Conclusions: An array of consensus guidelines and recommendations have been published to facilitate clinical decision-making in GBM. However, substantive differences exist between these guidelines regarding their contemporariness and revision process. Three years after the publication of a seminal randomized controlled trial (Stupp et al., 2017) attesting to the efficacy of TTFields in newly diagnosed GBM, little over half of published national guidelines mention the therapy, let alone recommend it. While guidelines naturally reflect local clinical, administrative and health-economic concerns, unwarranted variation in the production, quality, content and implementation of guidelines has potential implications for the quality of care. Ideally, guidelines should be updated dynamically when new evidence indicates a need for a substantive change in the guideline based on a priori criteria. An ongoing revision process for guidelines, perhaps with shorter validity periods or a more flexible approach, may facilitate more expedient adoption of novel therapies in clinical practice guidelines and in practice. Citation Format: Aaron Lawson McLean, Jan Walter. Contemporary clinical practice guidelines for the management of glioblastoma: an international survey [abstract]. In: Proceedings of the American Association for Cancer Research An","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76410967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 2624: Clinical trial participation in real-world patients with metastatic breast cancer: disparities and barriers","authors":"Ruoding Tan, Rongrong Wang, I. Abbass, L. Cassoli, E. Mitchell","doi":"10.1158/1538-7445.AM2021-2624","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2021-2624","url":null,"abstract":"Background: Reducing barriers to patient participation in clinical trials is vitally important to the cancer care community. Using data from a real-world cohort of metastatic breast cancer (mBC) patients (pts), we evaluated how race/ethnicity and other socioeconomic, institutional, and clinical barriers play a role in trial participation. Methods: Adult females with mBC were selected from Flatiron Health EHR-derived de-identified database (2011- 2020). Clinical trial participation was determined by having “clinical study drug” in any line of therapy. Multivariate logistic regressions were used to assess how various barriers impact trial participation. Results: In this cohort of 22,220 mBC pts, 1,131 (5.1%) were enrolled in clinical trials and participation rates vary by line of therapy, race/ethnicity, age, insurance, location, and care setting (Table 1). Comparing pts characteristics between enrolled vs. not enrolled, pts ever enrolled were significantly younger (mean age: 59 vs 63), had better performance status (ECOG PS ≥ 2: 3% vs 8%), and less Brain/CNS metastasis (3% vs 6%), more likely to be white (75% vs 61%), lived in the south (55% vs 38%), and had commercial insurance (34% vs 29%), with all p Conclusions: Preliminary results of this study reveal significant demographic and socioeconomic disparities in trial participation among mBC patients. In particular, AA and Hispanic patients were less likely to participate in clinical trials after controlling for other individual- or system-level factors that may impact enrollment. Future efforts to understand the relationship between racial disparity and other well-known barriers are needed. Citation Format: Ruoding Tan, Rongrong Wang, Ibrahim Abbass, Lourenia Cassoli, Edith P. Mitchell. Clinical trial participation in real-world patients with metastatic breast cancer: disparities and barriers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2624.","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88906495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3335: Innovative mathematical model links TRPV6 genotype to high triple negative breast cancer mortality rate in African-American females","authors":"Constance Hilliard","doi":"10.1158/1538-7445.SABCS18-3335","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3335","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73190127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract LB-158: Tribal sovereignty and approval for research in Native American communities","authors":"Carol Goldtooth, N. Teufel-Shone, F. Gachupin","doi":"10.1158/1538-7445.SABCS18-LB-158","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-LB-158","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76877767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3344: Effect of anticoagulation on the cancer stage at time of diagnosis of endometroid adenocarcinoma in a cohort of postmenopausal patients","authors":"G. Shukr, T. Pham, T. Buekers","doi":"10.1158/1538-7445.SABCS18-3344","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3344","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87718242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3346: The role of insurance on mammogram adherence among Latina ethnicity and citizenship status","authors":"Roman B Johnson, S. Bae","doi":"10.1158/1538-7445.SABCS18-3346","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3346","url":null,"abstract":"Introduction: Cancer screening researchers have long observed that Latinas are less likely to be mammogram adherent, but little is understood how this varies by citizenship status. Methods: Logistic regression analysis. The sample size was weighed according to CDC specifications. There were 1002 latina women in the sample. The 2016 National Health Interview Survey was utilized. Results: Compared to naturalized Latina women, both U.S. citizen and non-citizen Latina women are less likely to be mammogram adherent (p Findings: Cancer screening researchers benefit from disaggregating Latina ethnicity by citizenship status to develop more tailored interventions regarding mammogram adherence in this population. This study points to the need for policy makers to advocate for Latina populations impacted by insurance coverage disparities. Citation Format: Roman B. Johnson, Sejong Bae. The role of insurance on mammogram adherence among Latina ethnicity and citizenship status [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3346.","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80618937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3354: Patterns of care for patients with non-operable T1-4 N+ M0 non-small cell lung cancer in the US and outcomes with radiation or chemotherapy monotherapies","authors":"Ellen Kim, M. Daly, K. Westover, James D. Murphy, T. Mitin","doi":"10.1158/1538-7445.SABCS18-3354","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3354","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89678419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3342: A novel indigenous knowledge system based approach to study cancer health disparities in rural population of North East India","authors":"Lekhika Pathak, Bidisha Pal, Tutumoni Baishya, A. Sarma, Bikul Das","doi":"10.1158/1538-7445.SABCS18-3342","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3342","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75009049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3338: Understanding the effect of racial disparities on patients response to dietary intervention during cancer therapy","authors":"Sylvester Jusu, K. Dykes, K. Ko, T. Deangelis, E. Mitchell, N. Simone","doi":"10.1158/1538-7445.SABCS18-3338","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3338","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80503073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3339: Ethnic disparity in ovarian malignancy tumor markers: MIA and ROMA","authors":"C. Dunton, H. Fritsche, Rowan G. Bullock","doi":"10.1158/1538-7445.SABCS18-3339","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3339","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84131967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}