Advances in cancer education and quality improvement最新文献

{"title":"The Impact of Fellowship Training on Peer-Reviewed Publication Productivity in Academic Anesthesiologists as Evaluated by the h-Index.","authors":"Acsa M Zavala, Jagtar Singh Heir, Juan P Cata, Lei Feng, Jose M Soliz","doi":"10.52519/aceqi.25.1.1.a8","DOIUrl":"10.52519/aceqi.25.1.1.a8","url":null,"abstract":"<p><strong>Background: </strong>The effect of anesthesiology fellowships on scholarly contributions has been minimally studied. In this study we analyzed differences in h-index between fellowship-trained and non-fellowship-trained anesthesiologists, as well as by type of fellowship, academic rank, and years in practice.</p><p><strong>Methods: </strong>All anesthesiologists on staff between September 1, 2021, and August 31, 2022, were included in this study. The variables collected were fellowship training status, h-index, total number of publications, years in practice, academic rank, and years at the institution. For analysis, the anesthesiologists were divided into 2 groups: those with fellowship training and those without.</p><p><strong>Results: </strong>Among 78 anesthesiologists, 40 were not fellowship-trained and 38 were, with 10 types of anesthesiology fellowships identified. The h-index and number of publications did not differ between fellowship-trained and non-fellowship-trained anesthesiologists, and the number of publications per years in practice did not differ by fellowship type. The number of publications per years in practice was higher in the fellowship-trained group than in the non-fellowship-trained group (1.2 ± 1.1 vs. 0.71 ± 0.6; P = .04), as was the number of publications per years in practice at our institution (1.5 ± 1.1 compared with 0.9 ± 0.9; P = .0093).</p><p><strong>Conclusion: </strong>Fellowship training among academic anesthesiologists was not associated with a difference in h-index. However, fellowship training was associated with a higher number of publications per years in practice. Further research could elucidate the usefulness of h-index to support career development and contributions of anesthesiologists in academia.</p>","PeriodicalId":520864,"journal":{"name":"Advances in cancer education and quality improvement","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent Improvement in Opioid Perceptions and Prescribing for Cancer Surgery: 5-Year Follow-Up.","authors":"Brittany C Fields, Timothy E Newhook, Heather A Lillemoe, Jessica E Maxwell, Jose M Soliz, Keyuri U Popat, Christina L Roland, Jean-Nicolas Vauthey, Matthew H G Katz, Ching-Wei D Tzeng","doi":"10.52519/aceqi.25.1.1.a15","DOIUrl":"10.52519/aceqi.25.1.1.a15","url":null,"abstract":"<p><strong>Background and objectives: </strong>We previously reported that implementation of a department-wide opioid education program led to post-education improvements in opioid perceptions and prescription recommendations, with one-month and one-year retention. With ongoing programmatic and quality improvement efforts, we sought to re-evaluate the retention of these improvements five years after initial efforts.</p><p><strong>Methods: </strong>Attending surgeons, clinical fellows, and advanced practice providers were surveyed five years after implementation of a comprehensive, departmental opioid reduction framework in August 2018. This framework initially consisted of dedicated opioid education sessions and retrospective assessment of prescribing practices, and subsequently expanded over time to include prospective quality improvement and implementation studies, as well as integration of opioid stewardship measures into usual clinical care. Providers' perceptions of expected pain scores, opioid requirements, and ideal prescribing habits were assessed with the same survey administered at 1-month (2018) and 1-year post-initial education (2019).</p><p><strong>Results: </strong>Eighty-seven of 162 (53.7%) providers responded to the follow-up survey. More providers expressed strong agreement with the statement, \"After an inpatient procedure, a patient who has not required opioids for 24 hours before discharge should not receive a discharge opioid prescription.\" Significant decreases in the number of opioid pills providers would prescribe at discharge for five sample operations were also observed between 2018-2023. Stepwise decreases in opioid volume prescribed in both inpatient and outpatient settings were reported since the initial 2018 education sessions.</p><p><strong>Conclusions: </strong>Dedicated department-wide opioid education, ongoing quality improvement and prospective evaluation, and integration of opioid stewardship into clinical practice were associated with sustained improvement over five years in perceptions of postoperative pain management and decreased discharge opioid prescription recommendations.</p>","PeriodicalId":520864,"journal":{"name":"Advances in cancer education and quality improvement","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5x-Multiplier vs 3-Tier Model for Discharge Opioid Prescriptions After Intra-Abdominal Cancer Surgery: Randomized Clinical Trial Protocol.","authors":"Brittany C Fields, Timothy E Newhook, Heather A Lillemoe, Wei Qiao, Jose A Karam, Surena F Matin, Larissa A Meyer, Ching-Wei D Tzeng","doi":"10.52519/aceqi.25.1.1.a19","DOIUrl":"10.52519/aceqi.25.1.1.a19","url":null,"abstract":"<p><strong>Background: </strong>Surgeons provide up to 10% of total opioid prescriptions across all specialties, and more than one-third of surgeon-prescribed medications are opioids. Patient-reported opioid consumption and risk of persistent opioid use beyond the postoperative recovery period correlate with the initial opioid quantity prescribed at discharge. Interventions to reduce postoperative opioid prescribing have demonstrated no adverse effects on pain control or increased need for prescription refill; however, in the absence of standardized prescription protocols, opioid prescribing practices vary widely.</p><p><strong>Objective: </strong>The study objective is to identify the opioid prescribing model that provides the lowest oral morphine equivalents (OME) volume prescribed at discharge and OME consumed in the 14 days after discharge, with no adverse effect on refills and patient quality of life or satisfaction.</p><p><strong>Methods and analysis: </strong>This is a pragmatic single-center, multispecialty, double-arm phase II randomized clinical trial of two discharge opioid prescribing models. All adult (≥18 years) patients who undergo any one of five open abdominal oncologic operations (pancreatectomy, hepatectomy, retroperitoneal sarcoma resection, nephrectomy, or cytoreductive surgery for ovarian cancer) with curative intent and have a planned postoperative inpatient stay of at least 48 hours will be eligible. Patients will be stratified by their managing clinical service and randomized to receive a discharge opioid prescription based on either the 5x-multiplier algorithm or the 3-tier model. The co-primary outcomes are initial discharge OME volume and OME consumption in the 14 days after hospital discharge. Secondary outcomes include rates of patients with zero OME at discharge; rates of refill requests and completions, number of unused or leftover pills, persistent opioid use, and patient-reported quality-of-life metrics at various follow-up times; patient, prescriber, and oncologic factors predictive of persistent opioid use; and patient satisfaction. Each co-primary endpoint will be analyzed using two-sample t-test to compare means and linear regression models to assess differences between the two arms.</p><p><strong>Ethics and dissemination: </strong>This study was approved by the Institutional Review Board of The University of Texas MD Anderson Cancer Center (2023-0818). The study will evaluate the difference in initial discharge OME volume and in 14-day post-discharge OME consumption between two discharge opioid prescribing models. Upon completion of the data collection and analyses, a manuscript describing the study results will be submitted to a peer-reviewed journal for publication and dissemination. Trial Registration Number: NCT06232577.</p>","PeriodicalId":520864,"journal":{"name":"Advances in cancer education and quality improvement","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}