Science and Health Policy最新文献

{"title":"Abstract LB-157: Impact of hurricane-related stressors and responses on oncology care and outcomes of women with gynecologic cancer in Puerto Rico","authors":"A. P. Ortiz, M. Rivera, S. García-Camacho, W. Calo, G. Tortolero-Luna, S. Umpierre, I. Daluz-Santana, Pablo Mendez","doi":"10.1158/1538-7445.AM2019-LB-157","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2019-LB-157","url":null,"abstract":"Objective: Cancer patients have increased risk of poor outcomes after disasters. On September 2017 Hurricanes Irma and Maria affected Puerto Rico (PR) and US Virgin Islands, causing the population to experience major disruptions in essential services and environmental health issues. Using qualitative methods, this ongoing study documents the stressors, responses, and experiences of patients, and providers/organizations involved in the receipt and delivery of gynecologic oncology care in PR, respectively. Methods: We conducted two focus groups (November-December 2018) among women ≥21 years with gynecologic cancer (n=12) and eight key-informant interviews among providers/stakeholders who offer services to these population in PR. Patients’ interviews addressed psychosocial and environmental stressors and multi-level responses experienced by the women in the aftermath of the hurricanes, and concerns regarding their condition. Key-informants’ interviews addressed problems encountered in their clinics/organizations in the aftermath of the hurricanes, perceived stressors and risks of patients, and recommendations for future preparedness efforts. Sessions were audio-recorded and transcribed to identify emergent themes. Results: The focus groups evidence that all patients faced lasting difficulties having a healthy diet and with communication, electricity and water services. Women under the Government Health Plan (GHP) faced longer time without essential services and were less prepared for the hurricanes than those with private health insurance. None received disaster preparedness information from their clinics/physicians and all expressed feeling environmental stressors such as heat, mosquitoes, humidity, noise and air pollution produced by household electric generators. All patients experienced delay in cancer treatment, but women in the GHP had longer delays, as most public hospitals were saturated or inoperable. Key-informants expressed that clinics/organizations did not have an emergency plan in place, services were saturated because the collapse of many facilities, and that some patients decided to interrupt their treatments, and others experienced recurrence. The biggest obstacle was lack of effective communication between the government and the health services, calling for interdependence of systems, but with better communication. Conclusion: Study results are guiding the topics that will be assessed in the subsequent quantitative phase of this NCI sponsored project, and the development of a disaster management plan for cancer patients in PR. Results show that all components of disaster management (planning, preparedness, response and recovery) failed. Disparities in preparedness and healthcare interruption in patients in the GHP could affect patient outcomes. NCI Grant #R21CA239457. Citation Format: Ana P. Ortiz, Mirza Rivera, Sandra I. Garcia-Camacho, William Calo, Guillermo Tortolero-Luna, Sharee Umpierre, Istoni Daluz-Santana, Pablo Mendez. Im","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85040211","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-161: Application of the ASCO and ESMO frameworks to TTFields treatment of mesothelioma","authors":"J. Kelly, U. Weinberg, C. Proescholdt","doi":"10.1158/1538-7445.AM2019-LB-161","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2019-LB-161","url":null,"abstract":"Objective: To assess the clinical value of tumor treating fields (TTFields) in malignant pleural mesothelioma (MPM) by means of the ASCO and ESMO frameworks. Background: The potential effectiveness and safety of TTFields in addition to pemetrexed and cisplatin or carboplatin in MPM was recently shown by the analysis of the Phase II single arm EF-23 STELLAR trial. To account for the need of physicians and policymakers to objectively and comparably capture the clinical value of new cancer treatments the American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) have both developed assessment frameworks. We quantified the clinical value of the TTFields treatment in MPM by applying ASCO and ESMO frameworks to the comparison of the STELLAR data to historical controls. Materials/Methods: The EF-23 STELLAR Trial (n=80) demonstrated that adding TTFields to pemetrexed and cisplatin or carboplatin for malignant pleural mesothelioma patients resulted in overall survival of 18.2 months (95% CI 12.1-25.8) and progression free survival of 7.6 months (95% CI 6.7-8.6). The ESMO Magnitude of Clinical Benefit Scale (MCBS) and the ASCO Net Health Benefit (NHB) frameworks were applied to the EF-23 trial data using a historical control as comparator. Results: The application of the ASCO framework to the EF-23 data resulted in a NHB score of 52. This result was at the higher end of the score range of novel cancer treatments and compares well to the results for nivolumab in advanced non-squamous NSCLC and advanced squamous NSCLC as reference points. Applying the ESMO framework resulted in MCBS scores of A/5 (adjuvant/advanced) which would be the first score reported for MPM. The MCBS scores of A/5 are the highest scores achievable in the ESMO framework, and higher then the ESMO MCBS scores reported in the literature for NSCLC treatments. Conclusions: Despite differences in their respective concepts, both the ASCO and ESMO frameworks suggest that adding TTFields to Pemetrexed and Cisplatin or Carboplatin in malignant pleural mesothelioma patients may provide a significant clinical benefit. The high scores underline the fact that treatment with TTFields may extended progression free and overall survival without additional systemic toxicities. Citation Format: Justin Kelly, Uri Weinberg, Christina Proescholdt. Application of the ASCO and ESMO frameworks to TTFields treatment of mesothelioma [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 LB-161.","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75109124","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 3347: Young onset colorectal cancer patients are diagnosed with advanced disease after multiple misdiagnoses","authors":"R. Yarden, K. L. Newcomer, Colorectal CancerAlliance","doi":"10.1158/1538-7445.SABCS18-3347","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3347","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79588756","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 3343: The Florida women’s cancer study: Breast cancer presentation among African American and Afro Caribbean women in south Florida, a 10-year cohort","authors":"P. B. Coelho, M. Schlumbrecht, D. Cerbon, Carlos Parra, J. Hurley, S. George","doi":"10.1158/1538-7445.AM2019-3343","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2019-3343","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78259702","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-159: The bench with bedside initiative: A “trans-relational” approach to translational research","authors":"B. Salhia","doi":"10.1158/1538-7445.SABCS18-LB-159","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-LB-159","url":null,"abstract":"Translational research necessitates the use of human specimens. As per the regulations for the protection of human subjects, study participants (SP) are not required to be informed of the outcomes of research. While individual results should mostly not be reported back to patients to avoid anxiety and misinterpretation of yet to be proven data, general research results should be delivered back to the study participants. It can be argued that SP/researcher relationships are inadequately developed in most cases and that research lacks in transparency. As such, The Bench with Bedside Initiative™ (TBBI) was launched to serve as a trans-relational approach to conducting translational research, where scientists at the bench collaborate and engage with SP at the bedside. As an initial effort of TBBI™ social media and grass roots efforts were used to identify breast cancer survivors to donate blood for a blood-based biomarker study. A web-based survey (https://thebenchwithbedsideinitiative.usc.edu/) was used to determine eligibility and perceptions for enhanced involvement. The study was described to the future SP as a long-term collaboration with the lead researcher where data transparency would be integral to the study design. A total of 316 women completed the survey in a three-month period. When asked, 85% of survey takers said they would be very interested in getting updates on the use of their samples and 100% said they want to know the outcomes of the research. Furthermore, 76% said they had a moral and ethical right to learn the fate of their sample. A total of 86% of survey takers said they would be interested in building a relationship with the research scientist. Among the most widely used words in the comment box were empowering, involvement, hope, future, important, progress, and information. Of 316 women, 132 were deemed eligible to donate blood. As part of TBBI™ 59 eligible SP travelled to meet the PI and under informed consent donated blood in the PI’s lab. SP represented every major racial and ethnic group and socioeconomic background. SP came from 30 cities and traveled an average of 50 miles and as far as 675 miles. The use of biospecimens and associated data for research entails significant ethical obligations to the individuals from whom those specimens were obtained. Researchers owe it to themselves and to their SP to provide information as soon as it becomes available. While the long-term outcomes are yet to be determined, the perceived benefits to a trans-relational approach to conducting human research include diversification of study participants, ease of long-term follow-up, improved clinical trial enrollment, better accountability of resources, and not least of all is providing a lot of hope to those we are trying the hardest to help. Citation Format: Bodour Salhia. The bench with bedside initiative: A “trans-relational” approach to translational research [abstract]. In: Proceedings of the American Association for Cancer Resea","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82611197","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 3356: Working together to put kids first: Outreach strategies driving collaborative research, data sharing and cross-disease analysis to accelerate discoveries in pediatric cancer and structural birth defects","authors":"Tatiana S. Patton, R. Moulder, E. Alexander, D. Vito, J. Waller, Colleen Gaynor, Sarah Thomas, Bailey K. Farrow, J. T. Yamada, Kim Cullion, Danyelle A. Winchester, A. Waanders, Allison P. Heath, P. Raman, A. Resnick, Jena V. Lilly","doi":"10.1158/1538-7445.SABCS18-3356","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3356","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"28 12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83505694","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}