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Edwards, G. S., and N. H. Tolk. "Vanderbilt University FEL center for biomedical and materials research." Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment 272, no. 1-2 (October 1988): 37–39. http://dx.doi.org/10.1016/0168-9002(88)90191-x.
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Ekstrom, Leeland, Michael K. Gibson, Jordan Berlin, Judsen Schneider, and James Stover. "Oncology volume assessment program: Novel approach to determine patient volumes at Vanderbilt-Ingram Cancer Center (VICC) and Vanderbilt University Medical Center (VUMC)." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e14047-e14047. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e14047.
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e14047 Background: There is currently a lack of easily-accessible data regarding the volume and type of cancer patients seen at VUMC, despite extensive use of an electronic medical record (EMR) with a dedicated tumor registry. This leads to errors in estimating metrics that depend on subject accrual to clinical trials. We aimed to develop a tool to determine the number of head and neck squamous cell carcinoma (HNSCC) patients, stratified by desired subsets, seen yearly at the VUMC in order to achieve a more accurate and efficacious approach to estimating future patient accrual to clinical trials. Methods: Working with Nashville Biosciences, we identified patients with HNSCC using ICD codes in combination with VUMC’s Tumor Registry data (collected for patients diagnosed and treated at VUMC). We estimated the rate of accrual of HNSCC patient blood samples (a proxy for ICD code) based on the number of specimens acquired over the past 3 years. Each patient was counted only once based on their first blood sample acquired during this period, based on a comprehensive list of laboratories and clinical procedures that require a specimen to be drawn. We then evaluated the distribution of patients by primary site, standardized to SEER registry terminology. We also investigated what fraction of patients received treatment with surgery, radiation, and/or chemotherapy (we expect that this includes treatment with biologics) using a combination of ICD9/10 and CPT coding. Results: We identified a total of 1,131 HNSCC patients. SEER summary staging information was available for 603 patients - 432 (72%) had Stage 1-3 disease and 171 (28%) had Stage 4 disease. Primary site data was available for 717 patients - 648 (90%) HNSCC of the oral cavity, 20 (3%) had HNSCC of the oropharynx, 29 (4%) HNSCC of the larynx, 20 (3%) HNSCC of the hypopharynx. Of all patients, we found that 598 had at least 1 code for chemotherapy, 540 for radiotherapy, and 825 for surgery such that the majority (96%) received cancer treatment. We have not evaluated the timing of the treatment relative to diagnosis. Conclusions: By using ICD codes and tumor registry data extracted from VUMC’s EMR, we determined the site distribution and type of treatment for HNSCC over a 3-year period. The disease site distribution did not match prior experience Refinements are ongoing. However, once improved, these methods may be used to estimate future clinical trial accrual, thus reducing start-up time, cost and poor trial site performance, while increasing accrual.
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Brau, C. A., and M. H. Mendenhall. "Medical and materials research at the Vanderbilt University Free-Electron Laser Center." Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment 341, no. 1-3 (March 1994): ABS21—ABS22. http://dx.doi.org/10.1016/0168-9002(94)90422-7.
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McGoon, Michael, Victor F. Tapson, Richard N. Channick, Valerie V. McLaughlin, Ronald J. Oudiz, and Ivan M. Robbins. "Recapping Highlights from Pulmonary Hypertension Association Scientific Sessions and Identifying Key Issues Driving Translational Research." Advances in Pulmonary Hypertension 3, no. 3 (August 1, 2004): 23–27. http://dx.doi.org/10.21693/1933-088x-3.3.23.
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This discussion was moderated by Michael McGoon, MD, Professor of Medicine and Consultant in the Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. Participants included members of the Editorial Advisory Board of Advances in Pulmonary Hypertension: Victor F. Tapson, MD, Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, and Editor-in-Chief of the journal; Richard N. Channick, MD, Associate Professor of Medicine, Pulmonary and Critical Care Division, University of California, San Diego Medical Center, San Diego, California; Vallerie V. McLaughlin, MD, Associate Professor of Medicine, Director, Pulmonary Hypertension Program, University of Michigan Health System, Ann Arbor, Michigan; Ronald J. Oudiz, MD, Associate Professor of Medicine, UCLA School of Medicine, and Director, Liu Center for Pulmonary Hypertension, Division of Cardiology, Harbor-UCLA Medical Center, Torrance, California; and Ivan M. Robbins, MD, Director, Pulmonary Hypertension Center, Vanderbilt University, Nashville, Tennessee.
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Wang, Sophia. "Reviewer Acknowledgements for Journal of Mathematics Research, Vol. 9, No. 6." Journal of Mathematics Research 9, no. 6 (November 28, 2017): 156. http://dx.doi.org/10.5539/jmr.v9n6p156.
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Journal of Mathematics Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated.Many authors, regardless of whether Journal of Mathematics Research publishes their work, appreciate the helpful feedback provided by the reviewers.Reviewers for Volume 9, Number 6 Cinzia Bisi, Ferrara University, ItalyGuy Biyogmam, Georgia College & State University, USAJalal Hatem, Baghdad University, IraqKong Liang, University of Illinois at Springfield, USAKuldeep Narain Mathur, University Utara Malaysia, MalaysiaMaria Alessandra Ragusa, University of Catania, ItalyMaria Cecília Santos Rosa, Instituto Politecnico da Guarda, PortugalMohammad A. AlQudah, German Jordanian University, JordanN. V. Ramana Murty, Andhra Loyola College, IndiaRami Ahmad El-Nabulsi, Athens Institute for Education and Research, GreeceSanjib Kumar Datta, University of Kalyani, IndiaShenghua Ni, Vanderbilt University Medical Center, USAXinyun Zhu, University of Texas of the Permian Basin, USAYaqin Feng, Ohio University, USAYifan Wang, University of Houston, USAYoussef El-Khatib, United Arab Emirates University, United Arab Emirates Sophia WangOn behalf of,The Editorial Board of Journal of Mathematics ResearchCanadian Center of Science and Education
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Wang, Sophia. "Reviewer Acknowledgements for Journal of Mathematics Research, Vol. 9, No. 5." Journal of Mathematics Research 9, no. 5 (September 26, 2017): 142. http://dx.doi.org/10.5539/jmr.v9n5p142.
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Journal of Mathematics Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated.Many authors, regardless of whether Journal of Mathematics Research publishes their work, appreciate the helpful feedback provided by the reviewers.Reviewers for Volume 9, Number 5 Arman Aghili, University of Guilan, IranEnrico Jabara, Universita di Ca Foscari, ItalyJingbo Xia, Huazhong agricultural Univ, ChinaKhalil Ezzinbi, Cadi Ayyad University, MoroccoKuldeep Narain Mathur, University Utara Malaysia, MalaysiaLuca Di Persio, University of Verona, ItalyMaria Alessandra Ragusa, University of Catania, ItalyOmur Deveci, Kafkas University, TurkeyÖzgür Ege, Celal Bayar University, TurkeyRami Ahmad El-Nabulsi, Athens Institute for Education and Research, GreeceRovshan Bandaliyev, National Academy of Sciences of Azerbaijan, AzerbaijanSaima Anis, Comsats Institute of Information Technology, PakistanSanjib Kumar Datta, University of Kalyani, IndiaSelcuk Koyuncu, University of North Georgia, USASergiy Koshkin, University of Houston Downtown, USAShenghua Ni, Vanderbilt University Medical Center, USAVishnu Narayan Mishra, Sardar Vallabhbhai National Institute of Technology, IndiaZhongming Wang, Florida International University, USAZoubir Dahmani, University of Mostaganem, Algeria Sophia WangOn behalf of,The Editorial Board of Journal of Mathematics ResearchCanadian Center of Science and Education
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Park, Myung H., Rene Alvarez, Teresa De Marco, Ivan Robbins, and Marc Semigran. "PH and Left Heart Disease: Defining the Clinical Dilemma." Advances in Pulmonary Hypertension 10, no. 1 (January 1, 2011): 49–56. http://dx.doi.org/10.21693/1933-088x-10.1.49.
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A panel of experts convened by telephone on April 20, 2011 to discuss their experiences and recommendations regarding diagnosis and management of patients with Group 2 PH. The conversation was facilitated by Myung Park, MD, Associate Professor of Medicine and Director, Pulmonary Vascular Disease Program, Division of Cardiology at University of Maryland School of Medicine and guest editor of this issue. The participants were Rene Alvarez, MD, Associate Professor of Medicine and Director, Advanced Heart Failure/Pulmonary Hypertension Outreach Program, University of Pittsburgh School of Medicine; Teresa De Marco, MD, Professor of Medicine, Director, Heart Failure and Pulmonary Hypertension Program and Director, Heart Transplantation, University of California San Francisco Medical Center; Marc Semigran, MD, Medical Director of the Heart Failure and Cardiac Transplant Program at the Massachusetts General Hospital Center and Associate Professor of Medicine at Harvard Medical School; and Ivan Robbins, MD, Assistant Professor of Medicine and Director, Lung Transplant Program, Vanderbilt University Medical Center.
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Asare, Eugenia Vicky Naa Kwarley, Yvonne Adomakoh, Edeghonghon Olayemi, Enoch Mensah, Harriet Ghansah, Yvonnne Osei- Bonsu, Selina Crabbe, et al. "Prospective Implementation of Multi-Disciplinary Obstetric Team Decreases the Mortality Rate of Pregnant Women with Sickle Cell Disease in Ghana." Blood 128, no. 22 (December 2, 2016): 1017. http://dx.doi.org/10.1182/blood.v128.22.1017.1017.
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Abstract Introduction: Pregnant women with sickle cell disease (SCD) are at increased risk for both pregnancy and SCD related morbidity and mortality. At the Korle-Bu Teaching Hospital (KBTH), a national referral center in Accra, Ghana, the estimated maternal mortality ratio of women with and without SCD is 8,300 and 690 per 100,000 live births respectively (US, general population, maternal mortality ratio 14 per 100, 000 live births). In 2015, a multi-disciplinary obstetric SCD team was formed comprising obstetricians, hematologists, pulmonologists and nurses. In a before and after study design, we tested the hypothesis that implementing a multi-disciplinary team for care of pregnant women with SCD would significantly decrease maternal mortality. Methodology: The study received ethical approval from the Ethical and Protocol Review Committee, College of Health Sciences, University of Ghana Institutional Review Board and Vanderbilt University Medical Center (Data Coordinating Center (DCC). The pre-intervention period was from January 2014 to April 2015, and the post intervention period was May 2015 to May 2016. During the intervention period, members of the multi-disciplinary team evaluated participants at enrollment, during outpatient visits and during acute illnesses (inpatient and outpatient). Simple protocols were implemented for preventing and treating Acute Chest Syndrome (ACS). Balloons were purchased (substituted for incentive spirometry devices) and used routinely during management of acute pain episodes and after surgery. Multiple pulse oximetry machines were integrated into routine clinical practice for monitoring of oxygen desaturation. Close maternal and fetal monitoring were implemented. During the pre-intervention period, pregnant women were admitted to multiple wards throughout the hospital. Post-intervention, pregnant women were primarily admitted to two designated wards at the Obstetrics Department, for better coordinated care. All participants in the post-intervention period were followed from enrollment until six weeks postpartum. Members of the clinical research team and DCC adjudicated every vaso-occlusive pain episode, ACS episode, and acute event requiring hospitalization. Pain was defined as an acute episode, unrelated to labor and requiring hospitalization. ACS was defined based on the presence of at least 2 of the following criteria: fever, increased respiratory rate, chest pain, pulmonary auscultatory findings, increased O2 requirement or new radiodensity on chest roentgenogram. Results: A total of 154 and 91 deliveries by women with SCD were evaluated in the pre- and post-intervention period, respectively. The median age for cases in the pre-intervention period was 29 (range 18- 43) years. The median age for cases in post-intervention period was 29 (range 18-41) years and 35 participants had hemoglobin SSand 56had HbSC. Among the 91 participants, rates of pain and ACS were 194.6 (64/32.89) and 42.6 (14/32.89) events per 100 patient-years, respectively. Median gestational age at enrollment was 24 (range 7 - 40) weeks. Median gestational age at delivery was 38 (range 26 - 41) weeks. Perinatal mortality rates pre- and post-intervention were 74.3 per 1000 total births (11/ 148 X 1000) and 54.9 per 1000 total births (5/91 X 1000) respectively. Maternal mortality pre- and post-intervention were 9.7% (15 of 154) and 1.1% (1 of 91) of total deliveries respectively. The maternal mortality ratio pre- and post-intervention were 10,949 (15/137) and 1,163 (1/86) per 100,000 live births respectively. Cause of death pre-intervention period included: cardiopulmonary disease-60.0%, preeclampsia-6.67%, acute kidney injury-6.67%, severe anemia-20.0%, hypovolemic shock-6.67%. During the post-intervention period, the only death was an autopsy confirmed massive pulmonary embolism four days postpartum. Conclusion: In a low and middle income setting, a multidisciplinary team approach to care of pregnant women with SCD can dramatically decrease maternal mortality, as well as perinatal mortality. Further strategies must be employed to decrease the SCD related maternal mortality and perinatal mortality rates to levels expected in the non-SCD population and to implement multi-disciplinary SCD obstetric teams in other regions. Disclosures Asare: Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Adomakoh:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Olayemi:Intramural University of Ghana Research fund: Research Funding; Vanderbilt University Medical Center Gift Funds: Research Funding. Mensah:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Ghansah:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Osei- Bonsu:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Crabbe:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Musah:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Hayfron- Benjamin:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Boafor:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Kassim:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. James:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research Fund: Research Funding. Oppong:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding.
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Wang, Sophia. "Reviewer Acknowledgements for Journal of Mathematics Research, Vol. 9, No. 2." Journal of Mathematics Research 9, no. 2 (March 26, 2017): 155. http://dx.doi.org/10.5539/jmr.v9n2p155.
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Journal of Mathematics Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated.Many authors, regardless of whether Journal of Mathematics Research publishes their work, appreciate the helpful feedback provided by the reviewers.Reviewers for Volume 9, Number 2 Alberto Simoes, University of Beira Interior, PortugalAli Berkol, Space and Defense Technologies & Baskent University, TurkeyArman Aghili, University of Guilan, IranCecilia Maria Fernandes Fonseca, Polytechnic of Guarda, PortugalGane Sam Lo, Universite Gaston Berger de Saint-Louis, SenegalMarek Brabec, Academy of Sciences of the Czech Republic, Czech RepublicMaria Alessandra Ragusa, University of Catania, ItalyMohammad Sajid, Qassim University, Saudi ArabiaMohd Hafiz, Universiti Sains Malaysia, , MalaysiaN. V. Ramana Murty, Andhra Loyola College, IndiaOlivier Heubo-Kwegna, Saginaw Valley State University, USAOmur Deveci, Kafkas University, TurkeyÖzgür Ege, Celal Bayar University, TurkeyPeng Zhang, State University of New York at Stony Brook, USAPhilip Philipoff, Bulgarian Academy of Sciences, BulgariaRovshan Bandaliyev, National Academy of Sciences of Azerbaijan, AzerbaijanSanjib Kumar Datta, University of Kalyani, IndiaSelcuk Koyuncu, University of North Georgia, USASergiy Koshkin, University of Houston Downtown, USAShenghua Ni, Vanderbilt University Medical Center, USAVishnu Narayan Mishra, Sardar Vallabhbhai National Institute of Technology, IndiaWaleed Al-Rawashdeh, Montana Tech, USAYifan Wang, University of Houston, USAYoussef Ei Foutayeni, Modeling and Simulation Laboratory Lams Hassan II University, MoroccoYoussef El-Khatib, United Arab Emirates University, United Arab EmiratesZoubir Dahmani, University of Mostaganem, Algeria Sophia WangOn behalf of,The Editorial Board of Journal of Mathematics ResearchCanadian Center of Science and Education
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Wang, Sophia. "Reviewer Acknowledgements for Journal of Mathematics Research, Vol. 11, No. 3." Journal of Mathematics Research 11, no. 3 (June 3, 2019): 103. http://dx.doi.org/10.5539/jmr.v11n3p103.
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Journal of Mathematics Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated.
Many authors, regardless of whether Journal of Mathematics Research publishes their work, appreciate the helpful feedback provided by the reviewers.
Reviewers for Volume 11, Number 3
Abdessadek Saib, University of Tebessa, Algeria
Arman Aghili, University of Guilan, Iran
Cinzia Bisi, Ferrara University, Italy
Gabriela Ciuperca, University Lyon 1, France
Gener Santiago Subia, NUeva Ecija University of Science and Technology, Philippines
Kong Liang, University of Illinois at Springfield, USA
Kuldeep Narain Mathur, University Utara Malaysia, Malaysia
Maria Alessandra Ragusa, University of Catania, Italy
Rami Ahmad El, Athens Institute for Education and Research, Greece
Rovshan Bandaliyev, National Academy of Sciences of Azerbaijan, Azerbaijan
Sanjib Kumar Datta, University of Kalyani, India
Shenghua Ni, Vanderbilt University Medical Center, USA
Sreedhara Rao Gunakala, The University of The West Indies, Trinidad and Tobago
Xiaofei Zhao, Texas A&M University, United States
Yaqin Feng, Ohio University, USA
Yifan Wang, University of Houston, USA
Sophia Wang
On behalf of,
The Editorial Board of Journal of Mathematics Research
Canadian Center of Science and Education
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Keedy, V. L., L. Horn, A. Hayes, B. Spencer, G. Garcia, N. Campbell, A. Sandler, D. Carbone, and D. H. Johnson. "Enrollment of lung cancer patients on clinical trials at an NCI comprehensive cancer center." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 6633. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.6633.
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6633 Background: Enrollment of cancer patients (pt) in clinical trials is considered essential in order to improve cancer care. However, cancer clinical trials participation remains low. Understanding barriers to pt enrollment is necessary to overcome this problem. Previous reports have identified pt age, race, and ethnicity, disease stage, performance status (PS) and relationship with their health care provider as factors that can influence the enrollment of pts in clinical trials. Methods: We conducted a retrospective review of the charts of all lung cancer pts seen in the Thoracic Oncology Clinic at Vanderbilt Ingram Cancer Center between November 2005 and November 2008. A total of 1075 lung cancer pts were seen. Results: 577 charts (of a planned 1075) have been audited to date. Pt demographics: median age = 64 yrs; male = 54%; Caucasian = 92%, African American = 4%, and Asian = 1%; NSCLC = 80%, SCLC = 17%. Male pts were more likely than females to be eligible for a clinical trial (p = 0.056). A study protocol was available for 57% of pts; 52% of pts proved eligible; 36% were entered into a study (11% total population). Significantly more protocols were available for NSCLC pts compared to pts with SCLC (p ≤ 0.001); there was also a non-significant trend towards higher enrollment of eligible NSCLC pts. There was no difference in eligibility between ethnicity; the percentage of eligible pts enrolling on trials was similar between Caucasian & African American pts (46% and 43%); no Asian pts were enrolled. The most common reasons for not enrolling included a preference for treatment closer to home (29%), patient refusal (19%), PS (19%), and co-morbidities (17%). The distance pts traveled was inversely correlated with likelihood of study participation. Conclusions: A total of 11% of lung cancer pt evaluated in our Thoracic Oncology Clinic were enrolled in clinical trials. Our data suggest additional strategies are needed to attract minority groups, increase enrollment of women and pts with comorbidities and poor PS. Travel distances influence pt willingness to participate in clinical trials. Strategies are needed to overcome this factor. No significant financial relationships to disclose.
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Wilson, Jo Ellen, Kristina Stepanovic, Baxter Rogers, Amy Kiehl, E. “Wes” Ely, and James Jackson. "4417 Association between Brain Volumes and Posttraumatic Stress Disorder in Intensive Care Unit Survivors." Journal of Clinical and Translational Science 4, s1 (June 2020): 22. http://dx.doi.org/10.1017/cts.2020.106.
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OBJECTIVES/GOALS: To explore the severity of posttraumatic stress disorder (PTSD) symptoms in association with hippocampal and amygdala volumes in ICU survivors. We hypothesize that the severity of posttraumatic stress symptoms in ICU survivors is associated with lower volumes of both the hippocampus and amygdala. METHODS/STUDY POPULATION: Secondary analysis of the VISIONS study, a prospective sub-study of the BRAIN-ICU cohort, which included survivors of critical illness. Patients were screened for preexisting PTSD before discharge. The PTSD Checklist Specific (PCL-S) was used at 3 and 12 months to evaluate the ICU as a traumatic experience. A score of >30, indicated significant symptoms of PTSD. A Philips Achieva 3T MRI scanner was used to scan patients at both discharge and 3-month follow-up. To compare median brain volumes at discharge and 3 months for those with and without significant PTSD symptomatology (PCL-S ≥30) at 3 and 12 months, we used a Kruskal-Wallis (KW) equality-of-populations rank test. RESULTS/ANTICIPATED RESULTS: The median age for our sample was 58.5 (52.6, 63.7). One-third of the sample was female, and 90% were Caucasian. Fifty-seven percent of individuals (N = 12) had at least one prior mental health diagnosis, with two having a prior history of PTSD. One third of individuals experienced delirium during their critical illness. At 3-month follow up, there were three patients with PTSD symptomatology and one at 12-month follow up. Median brain volumes (hippocampus or amygdala) did not differ between individuals with or without PTSD symptomatology at either 3 or 12 months (p-values for all tests >0.05). DISCUSSION/SIGNIFICANCE OF IMPACT: Although our study did not reveal significant differences in brain volumes between PTSD patients and non-PTSD patients, sample size is a major limitation and larger scale studies should be undertaken to elucidate possible neurobiological markers of PTSD in ICU survivors. CONFLICT OF INTEREST DESCRIPTION: Dr. Wilson would like to acknowledge salary support from the Vanderbilt Faculty Research Scholars Program (1KL2TR002245), HL111111 and GM120484. Drs. Ely and Jackson as well as Mrs. Kiehl all receive funding for their time working on this investigation from AG035117 and HL111111. Dr. Ely would additionally like to acknowledge salary support from the Tennessee Valley Healthcare System Geriatric Research Education and Clinical Center (GRECC). Dr. Ely will also disclose additional funding for his time from AG027472 and having received honoraria from Orion and Hospira for CME activity; he does not hold stock or consultant relationships with those companies. The authors would like to acknowledge the following: this work was conducted in part using the resources of the Center for Computational Imaging at Vanderbilt University Institute of Imaging Science and the Advanced Computing Center for Research and Education at Vanderbilt University, Nashville, TN, and study data were collected and managed using REDCap electronic data capture tools hosted at Vanderbilt University.
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Barst, Robyn J., Marc Humbert, Ivan M. Robbins, Lewis J. Rubin, and Robyn J. Park. "Roundtable Discussion of the Impact of the 4th World Symposium on Pulmonary Hypertension." Advances in Pulmonary Hypertension 8, no. 2 (April 1, 2009): 89–94. http://dx.doi.org/10.21693/1933-088x-8.2.89.
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A discussion among attendees of the 4th World Symposium on Pulmonary Hypertension took place to share “an insider's look” into the current and future research and treatment implications in pulmonary hypertension. Myung H. Park, MD, guest editor of this issue of Advances in Pulmonary Hypertension, Assistant Professor of Medicine and Director, Pulmonary Vascular Diseases Program, Division of Cardiology, University of Maryland School of Medicine, Baltimore, moderated the discussion. Participants included Robyn Barst, MD, Professor Emerita, Columbia University, New York; Marc Humbert, MD, PhD, Universite Paris-Sud, French Referal Center for Pulmonary Hypertension, Hopital Antoine-Beclere, Assistance Publique Hopitaux de Paris, Clamart, France; Ivan Robbins, MD, Associate Professor of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; and Lewis J. Rubin, MD, Clinical Professor, Department of Medicine, University of California, San Diego.
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John, Albert. "Reviewer Acknowledgements." International Journal of Chemistry 9, no. 3 (July 31, 2017): 94. http://dx.doi.org/10.5539/ijc.v9n3p94.
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International Journal of Chemistry wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated. Many authors, regardless of whether International Journal of Chemistry publishes their work, appreciate the helpful feedback provided by the reviewers.Reviewers for Volume 9, Number 3 Ahmad Galadima, Usmanu Danfodiyo University, NigeriaAhmet Ozan Gezerman, Yildiz Technical University, TurkeyAmer A. Taqa, Mosul University, IraqAsghari Gul, Comsats IIT, PakistanAyodele Temidayo Odularu, University of Fort Hare, South AfricaChanchal Kumar Malik, Vanderbilt University, USADiego Antonio Alonso, Alicante University, SpainFarkhondeh Fathi, University of Toronto, CanadaGreg Peters, University of Findlay, USAJiajue Chai, Brown University, USAJignasu P. Mehta, Bhavnagar University, IndiaJuan Rafael Garcia, Research Institute on Catalysis and Pertrochemistry (INCAPE), ArgentinaK. Ishara Silva, Rensselaer Polytechnic Institute, USAKallen Mulilo Nalyanya, Egerton University, KenyaLeiming Wang, Konica Minolta Laboratory, USAMeriem Belhachemi, University of Bechar, AlgeriaMonira Nessem Michael, National institute of standards (NIS), EgyptMustafa Oguzhan Kaya, Siirt University, TurkeyPriyanka Singh, University of Iowa, USAR. K. Dey, Birla Institute of Technology (BIT), IndiaRabia Rehman, University of the Punjab, PakistanSaroj Kumar Panda, Research & Development Center, Saudi ArabiaSujan Kumar Sarkar, Ruhr University Bochum, GermanyThirupathi Barla, Harvard University, USAVijay Ramalingam, Columbia University, USAWaseem Hassan, Universidade Federal de Santa Maria, Brazil Albert JohnOn behalf of,The Editorial Board of International Journal of ChemistryCanadian Center of Science and Education
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Slone, Jeremy, Catherine Chunda-Liyoka, Marta Perez, Nora Mutalima, Robert Newton, Chifumbe Chintu, Chipepo Kankasa, et al. "Treatment outcomes of pediatric oncology patients in Zambia." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 9558. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.9558.
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9558 Background: Due to challenges in the delivery of pediatric oncology care in low-middle income countries (LMIC), diagnosis and treatment remains inadequate for the majority of patients. The University of Zambia School of Medicine/University Teaching Hospital (UTH) and Vanderbilt University School of Medicine/Vanderbilt Institute for Global Health established a partnership to investigate treatment outcomes at UTH, the only institution providing pediatric oncology care in Zambia, and assess risk factors associated with treatment abandonment. Methods: A retrospective study was conducted in a cohort of patients, presenting from July 2008 – June 2010, using an established database and medical record review. Results: Of the 230 children enrolled in the database, 162 met the inclusion criteria. The average age at diagnosis was 6.0 years; males comprised 55.6% of the cohort; 51.6% had a histopathological diagnosis and 10.5% of the cohort was HIV positive. The most common diagnoses were lymphoma (25.9%), Wilms tumor (22.8%), and retinoblastoma (17.9%). Leukemia and Kaposi sarcoma accounted for 7.4% each. Death (46.3%) and abandonment of treatment (45.7%) were the most common outcomes with only 8.0% having completed treatment or currently undergoing treatment, including palliative regimens, at the time of data acquisition. Residence in Lusaka or Central provinces, closest in proximity to UTH, was associated with a decreased risk for abandonment of treatment (Odds Ratio (OR) 0.41 (95% CI 0.21-0.81, p = 0.009) while maternal education less than secondary school (OR 2.73 95% CI 1.2-6.6, p = 0.03) was associated with an increased risk for abandonment of treatment. Conclusions: At the only pediatric cancer center in Zambia, treatment outcomes are dire with the majority of the cohort abandoning treatment or dying during therapy. Challenges include access to cancer chemotherapy, logistical facilitation, fiscal support of radiotherapy, and community engagement. Further investigation is required to inform effective intervention strategies to improve outcomes.
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Wang, Sophia. "Reviewer Acknowledgements for Journal of Mathematics Research, Vol. 11, No. 4." Journal of Mathematics Research 11, no. 4 (July 31, 2019): 86. http://dx.doi.org/10.5539/jmr.v11n4p86.
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Journal of Mathematics Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated.
Many authors, regardless of whether Journal of Mathematics Research publishes their work, appreciate the helpful feedback provided by the reviewers.
Reviewers for Volume 11, Number 4
Abimbola Abolarinwa, Landmark University, Nigeria
Ahmed Saad Rashed, Zagazig University, Egypt
Cibele Cristina Trinca Watanabe, Federal University of Tocantins (UFT), Brazil
Cinzia Bisi, Ferrara University, Italy
Denis Khleborodov, Lomonosov Moscow State University, Russia
Gener Santiago Subia, NUeva Ecija University of Science and Technology, Philippines
Hayat REZGUI, Ecole normale Supérieure de Kouba, Algeria
Jalal Hatem, Baghdad University, Iraq
Liwei Shi, China University of Political Science and Law, China
Maria Alessandra Ragusa, University of Catania, Italy
Martin Anokye, University of Cape Coast, Ghana
Mashadi Ali, Riau University, Indonesia
Mohammad A. AlQudah, German Jordanian University, Jordan
N. V. Ramana Murty, Andhra Loyola College, India
Özgür Ege, Ege University, Turkey
Philip Yordanoff Philipoff, Bulgarian Academy of Sciences, Bulgaria
Rami Ahmad El-Nabulsi, Athens Institute for Education and Research, Greece
Rovshan Bandaliyev, National Academy of Sciences of Azerbaijan, Azerbaijan
Sanjib Kumar Datta, University of Kalyani, India
Sergiy Koshkin, University of Houston Downtown, USA
Shenghua Ni, Vanderbilt University Medical Center, USA
Vishnu Narayan Mishra, Indira Gandhi National Tribal University, India
Xingbo WANG, Foshan University, China
Xinyun Zhu, University of Texas of the Permian Basin, USA
Zoubir Dahmani, University of Mostaganem, Algeria
Sophia Wang
On behalf of,
The Editorial Board of Journal of Mathematics Research
Canadian Center of Science and Education
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Tran, Thuan V., Huong T. T. Tran, Minh V. Hoang, Oanh T. Bui, Sang M. Nguyen, Pingping Bao, Qiuyin Cai, et al. "Establishing the Vietnam Center of Research Excellence on Cancer and Other Noncommunicable Diseases (V-CORE): Challenges and Opportunities." JCO Global Oncology 6, Supplement_1 (July 2020): 19. http://dx.doi.org/10.1200/go.20.14000.
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PURPOSE Noncommunicable diseases (NCDs), including cancer, have emerged as a major public health problem in Vietnam; however, NCD research in Vietnam is limited, primarily because of inadequate research infrastructures, funding, and well-trained investigators. To address these challenges, we established a US-Vietnam-China partnership to plan for building the V-CORE (Vietnam Center of Research Excellence on Cancer and Other Noncommunicable Diseases) with the support of a grant from the US National Cancer Institute. The objectives of this program are to assess the need and current NCD research capabilities and infrastructure in Vietnam and to develop and pilot test research capacity building/enrichment programs, including conducting two research projects for demonstration. METHODS AND RESULTS Through a need- and capacity-assessment workshop, with participation of stakeholders in NCD research and prevention in Vietnam, we identified top priorities and gaps and needs in cancer and other NCD research in Vietnam. We organized two site visits for Vietnam National Cancer Institute delegates to observe epidemiologic research field operations, core laboratories, and biorepositories at Vanderbilt University Medical Center and Vanderbilt Epidemiology Center, as well as at several partner institutes in Shanghai, People’s Republic of China. We organized an in-country workshop on the principles and methodology of epidemiology and biostatistics. We sponsored overseas training for 4 Vietnamese scholars. We conducted two demonstration projects: a case-control study involving 501 patients with breast cancer and 468 controls, and a community survey for diabetes and other metabolic conditions involving 1,035 urban and rural residents of Vietnam. We also jointly sponsored with Vietnam National Cancer Institute an international conference on cancer research and prevention in 2017, and jointly published 11 papers. CONCLUSION Within a 3-year period, we have built a productive collaborative network and laid a solid foundation for building the V-CORE in Vietnam. We strive to maintain and expand the collaboration and bring the success of the National Cancer Institute grant work to full fruition.
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McCombs, Glenn B., Jennifer A. Ufnar, and Virginia L. Shepherd. "The Virtual Scientist: connecting university scientists to the K–12 classroom through videoconferencing." Advances in Physiology Education 31, no. 1 (January 2007): 62–66. http://dx.doi.org/10.1152/advan.00006.2006.
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The Vanderbilt University Center for Science Outreach (CSO) connects university scientists to the K–12 community to enhance and improve science education. The Virtual Scientist program utilizes interactive videoconference (IVC) to facilitate this connection, providing 40–50 sessions per academic year to a national audience. Scientists, defined as research faculty members, clinicians, postdoctoral fellows, graduate and medical students, and professional staff, participate through conventional volunteer recruitment and program announcements as well as outreach partnership efforts with other Vanderbilt centers. These experts present 30- to 45-min long, grade-appropriate content sessions from the CSO IVC studio or their own laboratory. Teachers register for sessions via an on-line application process. After the session, teachers, students, and experts are requested to complete an anonymous on-line evaluation that addresses both technical- and content-associated issues. Results from 2003 to the present indicated a favorable assessment for a promising program. Results showed that 69% of students ( n = 335) and 88% of teachers ( n = 111) felt that IVC improved access to scientists, whereas 97% of students ( n = 382) and teachers ( n = 126) and 100% of scientists ( n = 23) indicated that they would participate in future videoconferences. Students and teachers considered that the Virtual Scientist program was effective [76% ( n = 381) and 89% ( n = 127), respectively]. In addition, experts supported IVC as effective in teaching [87% ( n = 23)]. Because of the favorable responses from experts, teachers, and students, the CSO will continue to implement IVC as a tool to foster interactions of scientists with K–12 classrooms.
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Lee, Joan. "Reviewer Acknowledgements for Sustainable Agriculture Research, Vol. 6, No. 1." Sustainable Agriculture Research 6, no. 1 (January 24, 2017): 120. http://dx.doi.org/10.5539/sar.v6n1p120.
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Sustainable Agriculture Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal are greatly appreciated.Sustainable Agriculture Research is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://www.ccsenet.org/reviewer and e-mail the completed application form to sar@ccsenet.org. Reviewers for Volume 6, Number 1Abha Mishra, Asian Institute of Technology, ThailandAftab Alam, Vice President Agriculture (R&D), Edenworks Inc. New York, United StatesAmor Slama, Science Faculty of Bizerte, TunisiaAndre Lindner, Dresden University of Technology, Tropical Forestry, GermanyBernard Palmer Kfuban Yerima, University of Dschang, CameroonBeye Amadou Amadou Moustapha, Rice Research Center, Côte d'IvoireDario Stefanelli, Department of Primary Industries, AustraliaDietrich Darr, Hochschule Rhein-Waal, GermanyInder Pal Singh, Guru Angad Dev Veterinary and Animal Science University (GADVASU), IndiaIvo Grgic, University of Zagreb, CroatiaJose Antonio Alburquerque, Spanish National Research Council (CEBAS-CSIC), SpainKhaled Sassi, National Agronomic Institute of Tunisia, TunisiaMahmoud Shehata Mahmoud, Alexandria University, EgyptManuel Teles Oliveira, University Tras os Montes Alto Douro (UTAD), PortugalMirela Kopjar, University of Osijek, CroatiaMohammad Valipour, Payame Noor University, IranMurtazain Raza, Subsidiary of Habib Bank AG Zurich, PakistanNehemie Tchinda Donfagsiteli, Institute of Medical Research and Medicinal Plants Studies, CameroonRabia Rehman, University of the Punjab, PakistanRoberto José Zoppolo, Instituto Nacional de Investigación Agropecuaria (Uruguay), UruguaySilviu Beciu, University of Agronomic Sciences and Veterinary Medicine Bucharest, RomaniaStefano Marino, University of Molise, ItalySubbu Kumarappan, Ohio State ATI, United StatesSuheb Mohammed, University of Virginia, United StatesTunde Akim Omokanye, Agricultural Research and Extension Council of Alberta (ARECA), CanadaWei Wang, Vanderbilt University, United States
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Benneh, Amma A., Eugenia Vicky Naa Kwarley Asare, and Edeghonghon Olayemi. "Managing BCR-ABL 1 Negative Myeloproliferative Neoplasms in an Emerging Economic Environment." Blood 128, no. 22 (December 2, 2016): 5489. http://dx.doi.org/10.1182/blood.v128.22.5489.5489.
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Abstract Background: Myeloproliferative neoplasms (MPN) are a group of diseases characterized by clonal disorders of the pluripotent stem cell. The annual incidence of all subtypes of MPN is 6-10/100,000 population. MPN without Philadelphia chromosome or BCR-ABL1 fusion gene such as Polycythaemia Vera(PV), Essential Thrombocythaemia (ET) and Myelofibrosis (MF) are known as BCR-ABL1 negative MPN. Diagnosis and management of these conditions in a limited resource environment can be challenging. Some successes have however been chalked when diagnostic and therapeutic difficulties have been overcome. Methodology: A retrospective patient chart review of patients who attended Hematology clinic at the Department of Hematology, Korle-Bu Teaching Hospital was conducted between January 2005 and December 2015.This review included all adult patients diagnosed with PV, ET and MF over the period. Diagnosis of MPN was made mainly by film comment, bone marrow aspirate, trephine biopsy and JAK 2 mutation analysis if patient could afford. Patients records were analyzed for demographic characteristics, clinical signs, hematological parameters, treatment options and outcomes. Results: The annual incidence of MPN over the period under study was 2.4 per year. The median age was 46 (range 24 - 75) years. There was male predominance of 1.9: 1. Splenomegaly was the commonest organomegaly seen. Polycythaemia Vera was the commonest (10; 38.5%) BCR-ABL1 negative MPN to be diagnosed at the hospital within the period. Treatment options available for patients with PV was venesection and hydroxycarbamide. For ET and MF it was hydroxycarbamide and supportive treatment. The longest survivor within the period of study has lived with Polycythaemia Vera for the past 10 years. Conclusion: The diagnosis and management of BCR-ABL1 negative MPN in emerging economic environments can be challenging as resources are limited. Certain conditions such as Hyperreactive malarial splenomegaly (HMS) can also mimic MPN and as such a high index of suspicion coupled with appropriate diagnostic facilities are required for early diagnosis and prompt management. Despite these odds, the disease is controlled reasonably well in our environment giving the patients more years of quality life than they would have had without any intervention. Disclosures Asare: Intramural University of Ghana Research fund: Research Funding; Vanderbilt University Medical Center Gift Funds: Research Funding. Olayemi:Intramural University of Ghana Research fund: Research Funding; Vanderbilt University Medical Center Gift Funds: Research Funding.
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Mangum, M. D., F. A. Greco, J. D. Hainsworth, K. R. Hande, and D. H. Johnson. "Combined small-cell and non-small-cell lung cancer." Journal of Clinical Oncology 7, no. 5 (May 1989): 607–12. http://dx.doi.org/10.1200/jco.1989.7.5.607.
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Nine (2%) of 429 small-cell lung cancer (SCLC) patients seen at Vanderbilt University between 1977 and 1983 had a combined subtype SCLC at diagnosis (ie, small-cell carcinoma plus squamous cell or adenocarcinoma). Staging procedures and chemotherapy treatment were uniform for all 429 patients. The diagnosis of combined histology was established via bronchoscopy (six patients), needle aspiration biopsy (one), lymph node biopsy (one), and thoracotomy (one). The clinical characteristics of the combined subtype patients were similar to patients with other subtypes of SCLC (ie, there were no differences in median age, sex, performance status, and stage of disease). However, patients with a combined subtype histology had a higher incidence of peripheral lesions on chest x-ray (56% v 14%, P less than .001) and a lower median lactate dehydrogenase (LDH) (301 IU/L v 341 IU/L, P = .0002) at diagnosis. The overall response to chemotherapy (57% v 78; P = .5) and the median survival (8 months v 10 months; P = .4) of the combined subtype patients were similar to patients with other subtypes of SCLC. Two (22%) combined histology patients survived greater than or equal to 5 years. Both had had surgical resection in addition to chemotherapy. These data suggest that the combined subtype of SCLC is clinically similar to pure SCLCs and that surgery may play a prominent role in the management of these tumors. The possibility of a combined histology tumor should be considered in patients thought to have SCLC on the basis of limited biopsy material, such as a needle aspiration or bronchial biopsy, and when the primary lesion is peripherally located on chest x-ray.
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Pai, Sara, Douglas Adkins, Lori Wirth, Christine Chung, Michael Gibson, Ammar Sukari, Francis Worden, et al. "354 A phase 1 trial of CUE-101 a novel HPV16 E7-pHLA-IL2-Fc fusion protein in patients with recurrent/metastatic HPV16+ head and neck cancer." Journal for ImmunoTherapy of Cancer 8, Suppl 3 (November 2020): A379. http://dx.doi.org/10.1136/jitc-2020-sitc2020.0354.
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BackgroundImmuno-STATsTM are novel, modular fusion proteins designed to selectively activate tumor-antigen-specific CD8+ T cells. Human papillomavirus (HPV) associated cancers serve as a model system to assess the safety and efficacy of the Immuno-STAT platform. CUE-101 is comprised of human leukocyte antigen (HLA) complex, HLA A*0201, a peptide epitope derived from the HPV type 16 E7 protein, and 4 molecules of a reduced affinity human interleukin-2 (IL2) designed to bind and activate HPV-specific T cells for eradication of HPV16-driven cancers. In preclinical studies CUE-101 demonstrated selective binding, activation, and expansion of HPV16 E7-specific CD8+ T cells, which translated into anti-tumor activity.1MethodsCUE-101-01 is a first-in-human (FIH) phase 1 study in patients diagnosed with HPV16+ recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) refractory to one or more lines of therapy. Trial eligibility includes MHC class I type HLA-A*0201 and a diagnosis of an HPV16+ HNSCC, as assessed by p16 IHC and confirmed by HPV16 mRNA ISH. CUE-101 is administered intravenously over 60 minutes every 21 days. Objectives include determination of safety, pharmacodynamics (PD), pharmacokinetics (PK), recommended phase 2 dose (RP2D), and preliminary anti-tumor activity. The safety results from treated participants will be presented.Results19 participants have received CUE-101 monotherapy as of August 7, 2020. Doses ranging from 0.06 to 1 mg/kg were determined to be safe and well-tolerated, enabling dose escalation to 2 mg/kg. Preliminary PK data demonstrate dose-dependent increases in drug exposure which are sustained upon repeat dosing, and low inter-subject variability. Preliminary data from systemic blood analyses show early signals of expansion of HPV-16 E711-20-specific CD8+ T cells. Stable disease (SD), as determined by RECIST 1.1, was observed in several participants in these early dose cohorts, with one subject maintaining SD up to 19 weeks. The maximum tolerated dose (MTD) has not yet been reached. As of May 14, 2020 (the development safety update report (DSUR) data-lock date), no dose limiting toxicities and the following adverse events were observed in the first 12 patients treated with CUE-101: fatigue (n=3), decreased appetite (n=1), arthralgia (n=1), muscular weakness (n=1), parasthesia (n=1), bullous pemphigoid (n=1), and infusion-related reactions (n=1).ConclusionsCUE-101 is a novel agent that is demonstrating acceptable tolerability, favorable PK, and preliminary PD signals that support selective activation of tumor-specific T cells. Neither the MTD nor the monotherapy RP2D have been established. PD and PK analyses are ongoing as dose escalation continues.AcknowledgementsThe authors would like to thank all the patients who are participating in this study. The study is sponsored by Cue Biopharma.Trial RegistrationClinicalTrials. gov NCT03978689Ethics ApprovalThis study was approved by Ethics and Institutional Review Boards (IRBs) at all study sites; IRB reference numbers: DF/HCC IRB# 19-374 (Massachusetts General Hospital), HRPO# 201905108 (Washington University School of Medicine), IRB 191714 (Vanderbilt University Medical Center Vanderbilt-Ingram Cancer Center), Advarra Pro00037736 (Moffitt Cancer Center), IRB(IRBMED) HUM00165746 (University of Michigan Comprehensive Cancer Center), 2019-087 (Karmanos Cancer Institute), WIRB IRB00112341(Winship Cancer Institute/Emory University), WIRB 2000026098 (Yale Cancer Center), WIRB STUDY00008948 (University of Washington, Seattle ), WIRB 1908869642 (University of Arizona Cancer Center, IRB 20-073 (Memorial Sloan Kettering Cancer Center), 2019-0578 (The University of Texas MD Anderson Cancer Center), IRB 52744 (Stanford University School of Medicine).ReferenceQuayle SN, Girgis N, Thapa DR, et al. CUE-101, a Novel HPV16 E7-pHLA-IL-2-Fc Fusion Protein, Enhances Tumor Antigen Specific T Cell Activation for the Treatment of HPV16-Driven Malignancies. Clin Cancer Res 2020;26:1953–64.
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Friedman, Debra L., Maureen Sanderson, Pamela Hull, Debra Wujcik, Dira R. Ashworth, Amaka Okafor, Jane Kennedy, et al. "Psychosocial outcomes in cancer survivors treated at a comprehensive cancer center or a minority-serving institution." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e20523-e20523. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20523.
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e20523 Background: Cancer health disparities are well described for incidence, diagnosis and treatment. Little is known about disparities among long-term survivors. Methods: At Vanderbilt-Ingram Cancer Center (VICC), an NCI-designated comprehensive cancer center and Meharry Medical College (MMC), minority serving institutional partner, we evaluated quality of life (QOL) using the FACT-G, FACT-B, FACT-L, and FACT-P; posttraumatic stress disorder (PTSD) using the PTSD Checklist (PCL); and posttraumatic growth (PTG) using the PTG Inventory (PTGI) among breast, lung or prostate cancer survivors. We used linear regression to compare the scale mean values by institution while adjusting for confounding variables. Results: Among 111 breast, 53 lung and 68 prostate cancer survivors, mean age was 62 years, 61% were female, 33% were black, 65% were married, 22% and 67% respectively had a high school degree or some college/higher education, 36% were employed and 94% were insured. MMC survivors were younger (p = 0.0005), more likely to be black (p <0.0001), less likely to be married (p < 0.0001), less educated (p<0.0001) and more likely to be uninsured (p < 0.0001). After adjusting for race, insurance status and educational level, there were no significant differences in cancer-related QOL between VICC and MMC survivors. MMC survivors did score significantly higher than VICC survivors on the PCL (33.9 vs. 28.3; p = 0.01) and the PTGI (75.9 vs. 62.5; p = 0.002). A total of 19 (8.3%) survivors met criteria for PTSD with a score of 50 or more (18.1% MMC, 3.8% VICC, p =0.003). Scores were significantly increased for MMC survivors relative to VICC survivors on all PTG subscales, especially the appreciation for life subscale (p = 0.0005). Conclusions: Cancer health disparities extend into the survivorship period. Although overall QOL did not differ, survivors treated at an underserved institution had significantly higher PTSD than those treated at a comprehensive cancer center. Underserved survivors also exhibited higher degrees of PTG. Further evaluation will identify the most significant sources of stress and resilience in order to design interventions to improve psychosocial wellbeing and decrease disparities.
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Xu, Hua, Melinda C. Aldrich, Qingxia Chen, Hongfang Liu, Neeraja B. Peterson, Qi Dai, Mia Levy, et al. "Validating drug repurposing signals using electronic health records: a case study of metformin associated with reduced cancer mortality." Journal of the American Medical Informatics Association 22, no. 1 (July 22, 2014): 179–91. http://dx.doi.org/10.1136/amiajnl-2014-002649.
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Abstract Objectives Drug repurposing, which finds new indications for existing drugs, has received great attention recently. The goal of our work is to assess the feasibility of using electronic health records (EHRs) and automated informatics methods to efficiently validate a recent drug repurposing association of metformin with reduced cancer mortality. Methods By linking two large EHRs from Vanderbilt University Medical Center and Mayo Clinic to their tumor registries, we constructed a cohort including 32 415 adults with a cancer diagnosis at Vanderbilt and 79 258 cancer patients at Mayo from 1995 to 2010. Using automated informatics methods, we further identified type 2 diabetes patients within the cancer cohort and determined their drug exposure information, as well as other covariates such as smoking status. We then estimated HRs for all-cause mortality and their associated 95% CIs using stratified Cox proportional hazard models. HRs were estimated according to metformin exposure, adjusted for age at diagnosis, sex, race, body mass index, tobacco use, insulin use, cancer type, and non-cancer Charlson comorbidity index. Results Among all Vanderbilt cancer patients, metformin was associated with a 22% decrease in overall mortality compared to other oral hypoglycemic medications (HR 0.78; 95% CI 0.69 to 0.88) and with a 39% decrease compared to type 2 diabetes patients on insulin only (HR 0.61; 95% CI 0.50 to 0.73). Diabetic patients on metformin also had a 23% improved survival compared with non-diabetic patients (HR 0.77; 95% CI 0.71 to 0.85). These associations were replicated using the Mayo Clinic EHR data. Many site-specific cancers including breast, colorectal, lung, and prostate demonstrated reduced mortality with metformin use in at least one EHR. Conclusions EHR data suggested that the use of metformin was associated with decreased mortality after a cancer diagnosis compared with diabetic and non-diabetic cancer patients not on metformin, indicating its potential as a chemotherapeutic regimen. This study serves as a model for robust and inexpensive validation studies for drug repurposing signals using EHR data.
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Khan, Mahir, Ryan Huu-Tuan Nguyen, Mary Pasquinelli, and Lawrence Eric Feldman. "Molecular testing in advanced lung adenocarcinoma: A single-center experience." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e21157-e21157. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e21157.
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e21157 Background: Standard of care testing prior to first-line therapy for advanced lung non-small cell lung cancer (NSCLC) includes EGFR mutations, ALK rearrangements, and PD-L1 expression. There is limited real-world evidence on NSCLC molecular testing patterns in underrepresented racial and ethnic populations. Methods: We identified adult patients newly diagnosed with stage IV lung adenocarcinoma at the University of Illinois Hospital & Health Sciences System between January 1, 2015 and October 1, 2019. Rates of biomarker testing for EGFR, ALK, and PD-L1 were determined, as well as the median time from tissue biopsy to each result. Data were stratified by race and ethnicity. Timelines of molecular testing were studied in relation to cancer therapy initiation. Results: Among 80 patients diagnosed with advanced NSCLC, 70 (87.5%) received EGFR testing, 69 (86.3%) received ALK testing, and 40 (50%) received PD-L1 testing from 2015-2019. Thirty-one (81.6%) patients diagnosed from 2017-2019 had PD-L1 testing. Median time from biopsy to molecular test result in the overall population was 3.0 weeks for EGFR, 3.0 weeks for ALK, and 2.0 weeks for PD-L1. There was no significant difference in EGFR and ALK testing rates between Black and non-Black patients. PD-L1 testing was decreased in Black patients compared to non-Black patients ( p = 0.02) from 2015-2019, but there was no significant difference from 2017-2019. All three biomarkers had similar testing rates between White and non-White patients and between Hispanic and non-Hispanic patients. Median time from biopsy to PD-L1 result decreased from over 12 weeks in 2015 and 2016 to 2 weeks in 2018 and 2019. Six (7.5%) patients received first-line treatment before results were available. Two (2.5%) required treatment changes based on results. Conclusions: In an urban, academic center we found similar EGFR and ALK testing rates among race and ethnicity subgroups. PD-L1 testing was lower in Black patients from 2015-2019 but not after national guidelines recommended PD-L1 testing in 2017. Treatment was initiated without full biomarker data in multiple cases, sometimes leading to changes in therapy after results were obtained. Further studies are indicated to determine strategies for comprehensive, timely, and equitable biomarker testing in advanced NSCLC.[Table: see text]
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Chan, Emily, Laura Williams Goff, Dana Backlund Cardin, Jordan Berlin, Mia Alyce Levy, Cindy L. Vnencak-Jones, and William Pao. "Routine multiplexed mutational analysis of colorectal cancers (CRCs): A single-institution experience." Journal of Clinical Oncology 33, no. 3_suppl (January 20, 2015): 599. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.599.
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599 Background: Colorectal tumors harbor mutations in genes that play key roles in CRC carcinogenesis and that may enable prioritization of appropriate anti-cancer therapy. KRAS testing is part of standard of care testing prior to initiation of anti-epidermal growth factor receptor antibodies. Other mutations are emerging as significant drivers, but they are not yet part of routine screening. Methods: As part of Vanderbilt-Ingram Cancer Center’s Personalized Cancer Medicine Initiative, we developed a clinical algorithm to genotype patient’s colorectal tumors using a SNaPshot-based assay (multiplexed PCR, primer extension, and capillary electrophoresis) designed to detect 65 somatic mutations in 7 genes (KRAS, BRAF, AKT1, PIK3CA, SMAD4, PTEN, and NRAS) important in CRC carcinogenesis. Adult patients with metastatic CRC were consented for genotyping of tumor tissue. Mutational profiling was performed in Vanderbilt’s CLIA-certified Molecular Diagnostics Laboratory. Results were reported in the electronic medical record for clinical use. Results: Study enrolled from May 2012 to February 2014. SNaPshot results were available from 126 patients. 49 tumors (38.9%) were wildtype for all mutations tested. 58 (46.0%) tumors had a KRAS mutation, including one with two KRAS mutations; the most common was G12D (n=23), but two had a Q61H mutation and two had a K117N mutation, which are not included in some commercial KRAS tests. Ten (8.9%) tumors carried the V600E BRAF mutation. Nine (7.1%) tumors harbored a PIK3CA mutation. Three (2.4%) tumors had mutations in SMAD4. Four (3.2%) tumors had a NRAS mutation. One (0.8%) tumor had a PTEN mutation. Nine (7.1%) tumors harbored double mutations, the most common being KRAS and PIK3CA double mutations (N=6). 24 (19%) subjects subsequently were treated on clinical trial therapy, including 6 subjects on therapy based on the SNaPshot results. Not surprisingly, RAS results impacted use of anti-EGFR therapy. Conclusions: 61% of the tumors carried at least one mutation in the seven genes tested, suggesting that trials of tumor genotyping-based treatment assignment are feasible. Study was supported by Vanderbilt University Medical Center.
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Washetine, Kevin, Simon Heeke, Christelle Bonnetaud, Mehdi Kara-Borni, Marius Ilié, Sandra Lassalle, Catherine Butori, et al. "Establishing a Dedicated Lung Cancer Biobank at the University Center Hospital of Nice (France). Why and How?" Cancers 10, no. 7 (June 29, 2018): 220. http://dx.doi.org/10.3390/cancers10070220.
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Delasos, Lukas, Anna Kookoolis, Meghana Singh, Alla Turshudzhyan, Nerea Lopetegui-Lia, and Radhika Kulkarni. "Differences in rates of low-dose computed tomography screening for lung cancer amongst various outpatient care centers." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 245. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.245.
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245 Background: Despite low-dose computed tomography (LDCT) screening for lung cancer recommended by the United States Preventive Services Task Force (USPSTF) demonstrating a relative reduction in mortality, there remains low rates of testing nationwide. Yet studies are limited regarding specific differences in screening rates amongst various outpatient care settings. Methods: We performed retrospective chart reviews of patients followed by resident providers within an academic internal medicine residency program who met USPSTF guidelines for lung cancer screening between 2015-2020. This was conducted at three separate outpatient clinic sites including a state-funded academic institution, inner city community health center, and veteran affairs medical center. Data collection included patient demographic and smoking histories as well as rates of ordered and completed LDCT screening. Results: A total of 832 patients were identified as current or former smokers between the ages of 55 and 80 years: 320 from Hartford Hospital Community Health Center (HHCHC), 262 from University of Connecticut Health Center (UCHC), and 250 from the Veteran Affairs (VA) Medical Center. 85 (27%) of these patients from HHCHC, 84 (32%) from UCHC, and 56 (22%) from the VA met USPSTF eligibility criteria for LDCT screening. Overall compliance rates of screening were found to be 44% at HHCHC, 59.5% at UCHC, and 51.8% at the VA. Results are outlined in Table. Conclusions: Screening rates for lung cancer with LDCT remain low but have been steadily improving throughout the United States following new recommendations and increased awareness provided by multiple medical organizations. We sought to compare differences in compliance rates amongst various outpatient clinics within the same internal medicine residency program at University of Connecticut. Our findings demonstrate significant differences in LDCT screening for lung cancer between the program’s community health center versus its state and federally funded outpatient clinics. Automatic reminders to providers can potentially improve rates of lung cancer screening. Patients should also be educated about the importance of screening to improve adherence with imaging. [Table: see text]
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Lloyd, M. Cooper, Melinda Sanders, Maria Gabriela Kuba, Jaime Farley, Darson Lai, Zengliu Su, Ingrid A. Mayer, et al. "Clinical and pathologic characteristics of patients with PI3K-mutant breast cancers." Journal of Clinical Oncology 31, no. 26_suppl (September 10, 2013): 8. http://dx.doi.org/10.1200/jco.2013.31.26_suppl.8.
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8 Background: Mutations in PIK3CA are the most common somatic alterations in breast cancer and represent a potentially useful therapeutic target. As more PI3K pathway inhibitors enter the clinical arena, it is important to understand the characteristics of patients harboring mutations. This study seeks to identify the clinico/pathological characteristics of PI3K mutant breast cancers in patients evaluated at Vanderbilt University Medical Center. Methods: Molecular profiling (SNaPShot) was used to detect mutations in three genes in the PI3K pathway (PIK3CA, PTEN, AKT1). Electronic medical records of breast cancer patients whose tumors underwent testing from June 2010 to January 2013 were reviewed. PI3K mutation rates, histological tumor grade, receptor status (ER/PR/HER2), and recurrence-free survival were tabulated. Results: Three hundred evaluable tests were identified, with PI3K mutations detected in 83/300 (28%). Patients with PI3K mutations were more likely to be ER/PR positive (73% vs. 48%; p<0.001) and less likely to be HER2 positive (6.0% vs. 20.7%, p=0.0022). Only 6/83 patients (7.2%) with triple negative cancers harbored PI3K mutations. 32% of patients with PI3K mutations participated in clinical trials, versus 25% without. Conclusions: Tumors with PI3K mutations were more likely to be ER/PR positive, of intermediate grade, and associated with longer recurrence-free survival. Patients with PI3K mutations were more likely to participate in clinical trials. These data and the potential eligibility of patients harboring mutations for clinical trials support the prognostic and clinical utility of SNaPShot testing for all breast cancer patients at a tertiary care center. [Table: see text]
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Al-Hader, Ahmad Abdelfattah, Weili Wang, Olumide B. Gbolahan, and Feng-Ming Spring Kong. "Racial disparities in non-small cell lung cancer, analysis of the Indiana University Cancer Center registry database 2000-2015." Journal of Clinical Oncology 36, no. 15_suppl (May 20, 2018): e18622-e18622. http://dx.doi.org/10.1200/jco.2018.36.15_suppl.e18622.
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Chakravarthy, A., and Hak Choy. "A Phase I Trial of Outpatient Weekly Irinotecan/Carboplatin and Concurrent Radiation for Stage III Unresectable Non–Small-Cell Lung Cancer: A Vanderbilt-Ingram Cancer Center Affiliate Network Trial." Clinical Lung Cancer 1, no. 4 (May 2000): 310–11. http://dx.doi.org/10.3816/clc.2000.n.014.
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Choy, H., R. F. DeVore, K. R. Hande, L. L. Porter, P. A. Rosenblatt, B. Slovis, K. Laporte, Y. Shyr, and D. H. Johnson. "Phase I trial of outpatient weekly docetaxel, carboplatin and concurrent thoracic radiation therapy for stage III unresectable non-small-cell lung cancer: a Vanderbilt cancer center affiliate network (VCCAN) trial." Lung Cancer 34, no. 3 (December 2001): 441–49. http://dx.doi.org/10.1016/s0169-5002(01)00279-3.
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Florescu, Marie, Normand Blais, Mustapha Ali Tehfe, and Mathieu Gravel. "Adjuvant chemotherapy outcome in unselected single-center non-small cell lung cancer (NSCLC) population." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e20089-e20089. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e20089.
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e20089 Background: Adjuvant chemotherapy with Cisplatinum/Vinorelbine is an established regimen since a decade in selected resected NSCLC population in order to improve DFS and overall survival. However, the outcome of patients treated outside the research protocols is not as good as in clinical trials. Methods: We retrospectively reviewed 209pts resected stage I to III NSCLC patients using our SARDO database, treated in our University hospital between 2006 and 2015 with a median follow-up of 13mos. Any adjuvant chemotherapy was recorded. Results: Amongst 209 resected NSCLC patients, 185pts (89%) had negative margins and 24pts (11%) have positive margins resection. The observation group and the chemotherapy group in both settings were well-balanced in terms of demographic, co-morbidities and tumor characteristics. As expected, the median overall survival (mOS) in negative margins was significantly better than in positive margins patients (43mos vs 24mos p = 0.029). In negative margins patients, no survival benefit was seen in stage I (A and B) (57 mos for chemo group vs 77 mos for observation group p = 0,217) and stage III (A and B) (39mos mOS for chemo group vs 40mos for observation group, p = 0.37), but a trend for improved mOS was seen in stage II (52 mos for chemo group vs 38 mos for observation group, p = 0.114), also consistent with mPFS results for each group. However, for the small number of patients with positive margins, a significant improvement in survival was seen in chemotherapy arm (mOS 37mos) compared to observational arm (mOS 11mos p = 0,039). No significant difference in survival was seen between Carbo/Taxol regimen and Cisplatinum/Vinorelbine regimen (43 mos vs 38 mos p = 0,658). Conclusions: In our unselected population, adjuvant chemotherapy did not show the improvement in survival expected with margin negative resected NSCLC. In positive resected NSCLC, adjuvant chemotherapy benefit was statistically significant, emphasizing need to treatment to these patients.
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Sahin, Ibrahim Halil, Wanqi Chen, Mohamad Bassam Sonbol, Satya Das, Zhengjia Chen, Mehmet Akce, Olatunji B. Alese, et al. "Analysis of age, tumor-sidedness, and mismatch repair (MMR) genes with response to immune checkpoint inhibitors (ICIs) in MMR-deficient (dMMR) colorectal cancer (CRC) patients (pts): A multi-institutional study." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e15029-e15029. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e15029.
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e15029 Background: ICIs induce durable responses in dMMR CRC pts with overall response rates (ORR) of 30-50%. Even though the loss of expression of any MMR gene predicts ICIs response, it is unknown if ORRs are similar across all MMR genes (MLH1, PMS2, MSH2, and MSH6). In this study, we analyzed the impact of each specific MMR gene loss and clinical characteristics of pts with best response to ICIs. Methods: Pts were eligible if they had confirmed dMMR CRC by IHC or microsatellite instability-high (MSI-H) by PCR, and received ICIs between 01/01/2012 and 10/01/2018 at Winship Cancer Institute of Emory University, Mayo Clinic or Vanderbilt University Medical Center. Due to the pattern of frequent concurrent loss and functional dependency, the groups were categorized as MLH1 ±PMS2 vs. MSH2 ±MSH6. Cox proportional hazard model and Fisher’s exact test were used for the best response and the distribution of variable among the subgroups. Results: A total of 45 pts with dMMR CRC were identified. ORRs in MLH1 ±PMS2 and MSH2 ±MSH6 groups were 68% and 57.1% respectively without statistical difference (Table). Pts with age < 50 and 50-65 years old had better ORRs compared to pts with age >65 (58.3%, 85.7% and 42.1% respectively, P=0.036). Left-sided tumors had a trend toward higher ORRs compared to right-sided tumors (83.3% vs 51.5% P=0.086). Gender and BRAF status were not predictors of response. BRAF mutations were more common in right-sided tumors (29.6% vs 11.1% respectively) and in older patients. Conclusions: Our data suggest that MSI-H CRC pts aged 50-65 treated with ICIs, have improved ORR compared to pts > 65; pts with left-sided tumors have a trend toward improved ORR compared to those with right sided tumors. [Table: see text]
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Ort, E. M., P. Confer, and G. A. Otterson. "Retrospective analysis of pulmonary neuroendocrine/carcinoid tumors at Ohio State University." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 18176. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.18176.
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18176 Background: Neuroendocrine tumors are a unique malignant neoplasm which can arise from the respiratory tree. Bronchial neuroendocrine tumors account for 25% of all neuroendocrine tumors, but only about 1–2% of all lung cancers. The epidemiology, clinical behavior, treatment, and prognosis of carcinoid tumors differ from other lung malignancies in significant ways. Located most often in the major bronchi, these tumors secrete neuroendocrine granules such as serotonin, histamine, and prostaglandins. Classic carcinoid syndrome (diarrhea, flushing, palpitations, wheezing), however, is rare in these patients. Treatment is primarily surgical resection for cure. The purpose of our study was to identify the experience with these malignancies at our institution and compare it to other series. Methods: A total of 64 patients were identified using diagnostic codes via our institutional cancer registry from 1980–2006. Poorly-differentiated neuroendocrine tumors and small cell lung cancer cases were excluded from analysis. Data collected included survival after diagnosis, staging, epidemiologic characteristics, and treatment. Additional variables included smoking history, laterality, and tumor staging. Results: The patient age distribution ranged from 17 years old to 82 years old, with a median age of 57 years old. Most of the patients were female (73%). Tobacco use is variable in carcinoid - 54% of our patients were never smokers, whereas 17% were previous smokers, 20% were current smokers, and history was unknown in 7%. Staging was unknown in over half of the patients. Treatment was generally surgical; lobectomy (40%) was the most common intervention, followed by wedge resection (17%), radiation therapy (14%), bronchial sleeve resections (3.5%), and pneumonectomies (3.5%). Survival was generally good - at the time of last contact, 50 patients (78%) were still alive with a median follow up of 39 months since diagnosis. Conclusion: Neuroendocrine tumors of the bronchial tree remain a unique and uncommon malignancy among lung cancers. The findings at our medical center are consistent with reported series as far as epidemiologic characteristics, treatments, and outcomes. The future direction of non-surgical therapy in this malignancy remains investigational. No significant financial relationships to disclose.
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Oulkhouir, Youssef, Emmanuel Bergot, Jeannick Madelaine, and Boris Stchepinsky. "Management of lung cancer in elderly population: A mono-centric retrospective study at University Hospital of Caen, Normandy, France." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e21573-e21573. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e21573.
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e21573 Background: Lung cancer is one of the leading causes of death worldwide and its incidence is increasing in the elderly patient population. Management of these population is not as well codified as that of younger patients due to their under-representation in clinical trials. The objective of this study is to assess the clinical characteristics, diagnostics and treatments in our population at the University Hospital of Caen (CHU). Methods: It was a retrospective monocentric study including all patients over 75 years old who were diagnosed with a lung cancer between January 1, 2014 and December 31, 2017 in our center of Caen. We analyzed epidemiological, clinical and therapeutic criteria. We evaluated the overall survival and according to the type of treatment used, the identification of factors of poor prognosis. Adverse events in that specific population of patients were analyzed. We also looked at the correlation between length of hospitalization and survival data. Results: 132 patients aged 75 to 95 years were included, with a large predominance of men. Almost 90% of our patients had comorbidities. The median survival of the entire population was 7 months. Factors identified as significantly influencing survival are the initiation of a specific cancer treatment, performans status, undernutrition, presence of comorbidities, age, stage of disease, and hospitalization at diagnosis. 58.9% of our patients received treatment including 60% chemotherapy and 17.7% surgery. 52% of patients treated with chemotherapy had Grade 3-4 toxicities. None of the patients treated with targeted therapy had any major side effects. 67.4% of our patients were hospitalized for diagnosis. The percentage of survival time spent in hospital is also significantly higher in the best supportive care group with a rate of 69% versus 25%. 14 patients had a diagnosis of early stage lung cancer. Surgery and radiotherapy were performed and were well tolerated. Conclusions: The elderly population with lung cancer managed in our center is highly diagnosed at an advanced stage and has many associated comorbidities affecting survival. Performans status, nutritional condition and inaugural hospitalization are factors of poor prognosis leading to exclusive palliative care. However, in early stages disease radical treatment good be performed and be well tolerated.
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Barst, Robin J., Jeffrey R. Fineman, Michael A. Gatzoulis, and Richard A. Krasuski. "Pulmonary Arterial Hypertension in Adults with Congenital Heart Disease." Advances in Pulmonary Hypertension 6, no. 3 (August 1, 2007): 142–48. http://dx.doi.org/10.21693/1933-088x-6.3.142.
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This discussion was moderated by Robyn J. Barst, MD, Professor of Pediatrics, Divisions of Pediatric Cardiology at Columbia University College of Physicians and Surgeons and Cornell Medical Center, and Director of New York Presbyterian Pulmonary Hypertension Center at Columbia University Medical Center, New York, New York. Panel members included Jeffrey R. Fineman, MD, Pediatric Critical Care Specialist and Associate Investigator of the Cardiovascular Research Institute, University of California, San Francisco; John Granton, MD, Assistant Professor of Medicine, University of Toronto, Pulmonary Arterial Hypertension Programme, University Health Network, Toronto, Ontario; Michael A. Gatzoulis, MD, PhD, Professor of Cardiology, Congenital Heart Disease, and Consultant Cardiologist and Director of the Adult Congenital Heart Centre at the Royal Brompton Hospital and the National Heart and Lung Institute, Imperial College School of Medicine, London, UK; and Richard A. Krasuski, MD, Director of Adult Congenital Heart Disease Services, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
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Badve, Sunil S., Rachel Dougherty, Michael Balatico, Kenneth A. Kesler, Patrick Loehrer, and Yesim Gökmen-Polar. "Thymic Carcinomas and Second Malignancies: A Single-Center Review." Cancers 13, no. 10 (May 19, 2021): 2472. http://dx.doi.org/10.3390/cancers13102472.
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Thymic carcinomas account for less than 0.01% of new cancer diagnoses annually and are more aggressive than thymomas. Autoimmune disorders have been associated with thymomas and only recently with thymic carcinomas. Second malignancies are well described after thymomas. The aim of this study was to analyze the incidence of second malignancies in patients with thymic carcinomas. All cases of thymic carcinomas were identified from the pathology archives of Indiana University. Histological materials were reviewed and further correlated with clinical data to identify incidence of second cancers in patients with thymic carcinomas. Histological material was available for review in 92 cases of thymic carcinoma. Clinical data were available for 85 patients. Fourteen of these (16.5%) patients had a second malignancy; these included small cell lung carcinoma, “testicular cancer”, embryonal carcinoma, seminoma, breast carcinoma (two cases), prostatic adenocarcinoma, Hodgkin’s lymphoma, thyroid carcinoma, bladder carcinoma (two cases), renal cell carcinoma, and melanoma. The latter could precede, be concurrent with, or follow the diagnosis thymic carcinoma. The incidence of second cancers in patients with thymic carcinomas is similar to that reported for thymomas. Abnormalities in immunological surveillance may be responsible for this high incidence of second malignancies in thymic tumors.
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Blayney, D. W., G. Miela, D. Markstrom, D. Hanauer, K. McNiff, and M. Neuss. "Measuring quality with the Quality Oncology Practice Initiative (QOPI) at a university comprehensive cancer center." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 6535. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.6535.
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6535 Background: QOPI is a tool which measures adherence to both guidelines and to process for use in quality improvement. QOPI was designed and pilot tested predominately in physician office practices [Neuss et al, JCO 23:6233]. We tested QOPI at UMCCC, a large, hospital-based, academic cancer center, where medical documents are stored in a free-text electronic record, in a paper-based hospital record, and in clinic charts. In 2006, 136 physicians and 58 mid-level practitioners provided 66,699 clinic visits and oversaw 37,500 infusion visits. Methods: The tumor registry selected consecutive cases of breast (BrCa), lung, and colorectal cancer (CRC), and lymphoma (L), diagnosed between minus 6 and minus 30 months from day 0 of each QOPI round. Forty charts with each tumor type and 40 deceased patient records were identified for each round. A clinical pharmacist accessed the pharmacy database to obtain drug data, and the tumor registrar abstracted the three other chart formats, using an electronic text search tool [Hanauer et al Proc ASCO 2006 abs 6080] for the electronic record. De-identified data were submitted to a secure, ASCO-hosted server, for analysis. Results: In the Spring 2006 round, 163 charts yielding 1641 measures required 148 hours of abstractor effort, for an average of 54 minutes (mins) per chart and 5.4 mins per measure. In the Fall, 2006 round, 236 charts yielding 2334 measures required 256.5 hours of effort for 65 mins per chart and 6.6 mins per measure. For comparison, a survey of QOPI practices for the Fall round yielded 29 mins per chart. UMCCC treatment (Rx) and process measures are shown in the table . Conclusions: Abstracting for QOPI measures, using abstractors not involved in patient care, is labor intensive but feasible at a large cancer center. QOPI has allowed UMCCC to assess concordance with guidelines and other quality measures, provides comparison data to other practices, and identifies processes for improvement. The evolution of QOPI will include data transfer from electronic records. [Table: see text] [Table: see text]
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Palos, G. R., Q. C. Shi, T. Mendoza, G. Mobley, Y. Zhang, V. Valero, J. Hurley, X. S. Wang, and C. S. Cleeland. "Differences in lung cancer symptom severity by tertiary cancer center vs. centers treating underserved patients." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 19577. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.19577.
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19577 Background: Understanding how differences in treatment site and ethnic/racial background affect the severity and outcomes of symptoms related to advanced lung cancer is critical to providing optimal symptom management. This analysis investigated the differences in the severity of symptoms among patients receiving treatment for advanced non-small cell lung cancer (NSCLC) at three different treatment centers. Methods: We compared changes in ratings of 139 patients diagnosed with NSCLC over the course of their chemotherapy regimen for symptoms and their interference on daily activities. Eligible patients had to be diagnosed with Stage III or IV NSCLC and treated at Jackson Memorial - Dade County, LBJ - Harris County or The University of Texas M. D. Anderson Cancer Center. Data were collected using telephone and pen-paper versions of the M. D. Anderson Symptom Inventory Lung Chemotherapy Module. Mixed modeling analysis was used to examine the differences in self-reported symptom severity between black, non-Hispanic, Latino/Hispanic and white, non-Hispanic patients. Results: A total of 56 patients from all sites, matched by age and gender, were included in this sub-analysis. Because this was a relatively small sample, we combined the non-Hispanic, black (27%) and Latino/Hispanic (14%) groups to form the minority group vs. the majority group (59%). Median follow-up was 24 weeks. Inclusion of the treatment site in the model resulted in losing the effect for ethnicity for the majority of symptoms. Significant higher ratings were found for fatigue and drowsiness in white, non-Hispanic patients when compared to the minority group. We found that treatment site (tertiary vs. center treating underserved) was a significant predictor for differences in symptom severity scores. Greater symptom severity ratings were found in patients seen at centers treating the underserved for pain, sleep, fatigue, nausea, shortness of breath, appetite, drowsy, dry mouth, and numbness. Conclusions: These findings suggest that receiving treatment at a center caring for the medically underserved is associated with greater symptom burden in patients with advanced lung cancer. These results underscore the need for additional studies. No significant financial relationships to disclose.
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Liu, Shuo, Chunxue Wang, Gary Green, Hanjing Zhuo, Kathleen D. Liu, Kirsten N. Kangelaris, Antonio Gomez, et al. "Peripheral blood leukocyte telomere length is associated with survival of sepsis patients." European Respiratory Journal 55, no. 1 (October 16, 2019): 1901044. http://dx.doi.org/10.1183/13993003.01044-2019.
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Shorter peripheral blood leukocyte (PBL) telomere length (TL) has been associated with poor outcomes in various chronic lung diseases. Whether PBL-TL is associated with survival from critical illness was tested in this study.We analysed data from a prospective observational cohort study of 937 critically ill patients at Vanderbilt University Medical Center (VUMC). PBL-TL was measured using quantitative PCR of DNA isolated from PBLs. Findings were validated in an independent cohort of 394 critically ill patients with sepsis admitted to the University of California San Francisco (UCSF).In the VUMC cohort, shorter PBL-TL was associated with worse 90-day survival (adjusted hazard ratio (aHR) 1.3, 95% CI 1.1–1.6 per 1 kb TL decrease; p=0.004); in subgroup analyses, shorter PBL-TL was associated with worse 90-day survival for patients with sepsis (aHR 1.5, 95% CI 1.2–2.0 per 1 kb TL decrease; p=0.001), but not trauma. Although not associated with development of acute respiratory distress syndrome (ARDS), among ARDS subjects, shorter PBL-TL was associated with more severe ARDS (OR 1.7, 95% CI 1.2–2.5 per 1 kb TL decrease; p=0.006). The associations of PBL-TL with survival (adjusted HR 1.6, 95% CI 1.2–2.1 per 1 kb TL decrease; p=0.003) and risk for developing severe ARDS (OR 2.5, 95% CI 1.1–6.3 per 1 kb TL decrease; p=0.044) were validated in the UCSF cohort.Short PBL-TL is strongly associated with worse survival and more severe ARDS in critically ill patients, especially patients with sepsis. These findings suggest that telomere dysfunction may contribute to outcomes from critical illness.
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McCormack, S., A. Pleister, D. Young, P. Confer, and G. A. Otterson. "A single institution experience of lung cancer treatment in octogenarians." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 18141. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.18141.
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18141 Background: In the NCI’s SEER database nearly 15% of NSCLC patients were = 80 years during the years 1973–2003. As the “elderly” population increases, the percentage of octogenarians with NSCLC will increase. To better understand this population we investigated the patient and tumor characteristics and treatment modalities by stage in octogenarians with NSCLC over a recent 5 year period at The Ohio State University Medical Center. Methods: Patients aged 80 years and older with biopsy-proven NSCLC seen between 1998–2003 were included in the analysis. 74 patients met criteria for study. Data was gathered from the cancer registry and chart reviews. Characteristics included stage, histology, treatment, and co-morbid conditions (pulmonary and non-pulmonary co-morbidities, weight loss, and ECOG PS). PS was either explicitly stated or inferred from the records, or recorded as “unknown” when PS could not be determined. Results: The 74 patients averaged 82.8 years of age (range 80–91), with 53% males and 47% females (83 years of age with 56% males and 44% females from the SEER database). 46% of patients had “surgical” disease (Stage IA, IB, and IIB), 20.3% had stage III disease, 29.7% had stage IV disease, and 4.0% had indeterminate staging. 82.4% of “surgical” disease patients received some variety of treatment (70.6% surgery[S], 23.5% radiation[RT], and 12.5% chemo[Ch]); 80% of stage III patients received treatment (53.3% S, 40% RT, and 33.3% Ch); 50% of stage IV patients received treatment (0% S, 31.8% RT, and 40.9% Ch). Patients with an ECOG PS of 0–1, 2, 3–4, or “unknown” equaled 44.6%, 20.3%, 16.2%, and 18.9% respectively with 81.8%, 100%, 41.7%, and 78.6% of these patients receiving treatment. Conclusions: There is little data on treatment of the ‘extreme elderly.‘ Our analysis of this subset of the elderly reveals that most octogenarians seen at a referral center can receive treatment. The majority of “surgical” disease octogenarians received surgical resection of their primary tumor and the majority of all patients received some treatment. Further studies of outcomes based on staging, co-morbidities, and PS will be important in this population. Additional studies of this population in non-referral centers are of interest. No significant financial relationships to disclose.
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Das, Satya, Chanjuan Shi, Tatsuki Koyama, Yi Huang, Raul S. Gonzalez, Kamran Idrees, Christina Edwards Bailey, and Jordan Berlin. "Peritoneal carcinomatosis (PC) in well-differentiated (WD) small-intestinal neuroendocrine tumor (SI-NET) patients (Pts) with mesenteric tumor deposits (MTDs)." Journal of Clinical Oncology 37, no. 4_suppl (February 1, 2019): 194. http://dx.doi.org/10.1200/jco.2019.37.4_suppl.194.
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194 Background: Although WD SI-NETs are typically biologically indolent, they tend to metastasize. PC is a dreaded regional metastatic complication in pts with SI-NETs and contributes to significant morbidity and mortality. Risk factors for PC development in these pts are not well studied, however one factor may be MTD presence. Our analysis is the first to suggest an association between MTD presence and PC in this pt subgroup. Methods: We performed a retrospective analysis on 191 WD SI-NET samples from Vanderbilt University Medical Center with mesenteric masses identified on gross pathology or radiographic review. Of 138 samples with suspected MTDs, 79 were confirmed definitively by detailed pathologic review and 59 were considered likely based on descriptions from surgical pathology reports. We assessed whether pts in our cohort with MTDs had greater rates of PC compared to those without MTDs. We also assessed what other patient determinants were associated with PC and the prognostic role of these determinants. Results: Pts with suspected MTDs had an odds ratio (OR) of 3.9 for PC compared to pts without MTDs. Rates of PC in pts with definitive MTDs and those with likely MTDs were not significantly different (OR 1, p = 1.00). Although suspected MTD presence was not associated with poorer OS (p = 0.97), pts with confirmed MTDs had a trend toward poorer overall survival (OS) than pts with likely MTDs (p = 0.05). PC was a negative prognostic factor in all pts with regards to OS (p = 0.044). Conclusions: SI-NET pts with MTDs appear to have significantly increased rates of PC compared to those without mesenteric deposits. We believe this observation merits prospective evaluation given its potential therapeutic implications. If confirmed prospectively, pts with MTDs could benefit from earlier use of cytoreductive therapies to hinder development of PC. [Table: see text]
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Trinh, Vincent Quoc-Huy, Chanjuan Shi, Jordan Berlin, and Satya Das. "Validating enhancer signature classifications (ESCs) in pancreatic neuroendocrine tumors (PNETs)." Journal of Clinical Oncology 38, no. 4_suppl (February 1, 2020): 627. http://dx.doi.org/10.1200/jco.2020.38.4_suppl.627.
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627 Background: Predicting recurrence risk (RR) for resected (res) PNET patients (pts) is challenging using existing pathologic criteria. Better predictive models to tailor surveillance for individual pts are needed. A recent study suggests expression patterns of the transcriptomic/epigenomic enhancers ARX and PDX1 may predict RR. In this study, distant metastases occurred almost exclusively in ARX+/PDX1- tumors. Our primary objective was to validate ESCs within our institutional cohort. Methods: We used a tissue microarray generated from res localized PNETs at Vanderbilt University Medical Center (VUMC) between 2002-2012. Clinical, pathological, and outcomes data were extracted from records. Immunohistochemistry was performed with PDX1 by Novus and ARX by Sigma. Patients were grouped as double-positives (DP), ARX+/PDX1-, ARX-/PDX1+ and double-negatives (DN). Time-dependent ROC analysis was performed in R (v3.6.1; survivalROC v1.0.3) to determine ARX and PDX1 positivity. Comparative analyses were performed in SPSS v23.0 (Kruskal-Wallis, Freeman-Halton exact test, Log-rank). Primary outcomes were progression-free survival (PFS) and cancer-specific survival (CSS). Results: 61 PNET specimens had adequate tissue for analysis. Table shows PFS plus CSS data by ESC distribution. Pts with ARX+ (DP & ARX+/PDX1-) tumors were younger (P=0.015) and possessed larger tumors (P=0.065). Pts with ARX+ tumors demonstrated shorter PFS (log-rank P=0.006) and a trend toward lower CSS (log-rank P=0.09). Notably, pts with ARX-/PDX1+ and DN tumors had no deaths and only 1 progression event over a median follow-up period of 91 months (m). Conclusions: Building upon earlier data that ARX+ res PNETs are more likely to relapse, we demonstrate that pts with such tumors have diminished PFS and a trend toward diminished CSS. ESCs need prospective validation but carry the potential to guide surveillance for res PNET patients. [Table: see text]
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Wang-Gillam, Andrea, Kristina Williams, Silvia Novello, Feng Gao, Giorgio V. Scagliotti, and Ramaswamy Govindan. "Time to Activate Lung Cancer Clinical Trials and Patient Enrollment: A Representative Comparison Study Between Two Academic Centers Across the Atlantic." Journal of Clinical Oncology 28, no. 24 (August 20, 2010): 3803–7. http://dx.doi.org/10.1200/jco.2010.28.1824.
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Purpose Activation of clinical trials is a lengthy process. We studied the procedures and time required to activate lung cancer clinical trials in a US academic center compared with a European center. Methods A retrospective review was performed of all thoracic oncology therapeutic trials submitted for regulatory review between 2001 and 2008 at Washington University School of Medicine (WUSM; St Louis, MO) and the University of Torino (UT; Torino, Italy). A process map was drafted by both institutions to establish the order of required events. Results We reviewed 137 therapeutic thoracic oncology trials from WUSM (n = 83) and UT (n = 54). The median times from submission to opening a trial were 163 days for WUSM and 112.5 days for UT (P = .048). The median times for regulatory approval were 75 days for WUSM and 31 days for UT (P < .001). The difference is more pronounced in a homogeneous subset of phase II, industrial-sponsored trials for the median calendar time from submission to opening a trial (239.5 days for WUSM v 112.5 days for UT; P < .001) and time for regulatory approval (99 days for WUSM v 13.5 days for UT; P < .001). The median number of patients accrued at WUSM was 7.4 patients per study compared with an average of 37 patients per study at UT. The proportion of trials that enrolled 20 patients or more represented 22.2% of trials at UT but only 1.1% of trials at WUSM. Conclusion It takes additional steps and significantly longer time to activate a therapeutic thoracic clinical trial at a representative US site (WUSM) compared with a European site (UT).
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Das, Satya, Aman Chauhan, Liping Du, Katharine Thomas, Aasems Jacob, Aimee Schad, Shikha Jain, et al. "Validation of a clinical score (CS) for patients (pts) with well-differentiated neuroendocrine tumors (WD NETs) under consideration for peptide receptor radionuclide therapy (PRRT) with Lu 177 dotatate." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 4109. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.4109.
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4109 Background: Questions remain regarding when to sequence PRRT and how to categorize pts being considered for the treatment (tx). We previously developed a CS (comprised of 5 categories: available non-PRRT tx for tumor type, prior systemic tx, pt symptoms, tumor burden in critical organs and peritoneal carcinomatosis presence) at Vanderbilt Ingram Cancer Center (VICC) for pts being considered for PRRT to help answer these questions and demonstrated the score to be associated with progression-free survival (PFS) in pts receiving PRRT. Herein, we present the performance of the CS in a validation cohort (VC) and combined cohort (CC). Methods: Our original cohort (OC) included pts with progressive WD NETs (N = 122) under consideration for PRRT between 3/1/2016-3/17/2020 at VICC while our VC included pts under consideration for PRRT (N = 126) between 1/25/2017-11/18/2019 at Ochsner Medical Center (OMC) (N = 51), Markey Cancer Center (MCC) (N = 51) and Rush Medical Center (RMC) (N = 24). All pts in the OC were prospectively scored while pts in the VC were scored retrospectively, with the CS-assigning investigator blinded to patient outcomes. The primary outcome PFS, was estimated by the Kaplan‐Meier method; a Cox proportional‐hazards model adjusting for primary tumor site, tumor grade and number of PRRT doses administered (0, 1-2 or 3-4) was used to analyze effect of CS. Overall survival (OS) was a key secondary outcome. Results: In our VC, on multivariable (MV) analysis, for each 2-point increase in CS, the hazard ratio (HR) for PFS was 2.58 (95% confidence interval (CI) 1.62-4.11). On MV analysis, for each 2-point increase in CS, the HR for OS was 3.89 (95% CI 1.8-4.83). We combined the OC and VC for this analysis in order to increase the predictive power of our originally developed Cox proportional-hazards models. In our CC, of the 248 total pts, median pt age, CS and number of prior tx were 63.3 years, 4 (range 0-8) and 1 (range 0-7), respectively. The most represented primary tumor sites were small intestinal (N = 136), pancreatic (N = 58), unknown primary (N = 26) and lung (N = 14). A total of 140, 82 and 26 pts received 3-4, 0 or 1-2 doses of PRRT, respectively. On MV analysis, for each 2-point increase in CS, the HR for PFS was 2.52 (95% CI 1.90-3.35). On MV analysis, for each 2-point increase in CS, the HR for OS was 3.48 (95% CI 2.33-5.18). No interaction between PRRT doses administered and CS was observed. Conclusions: Increases in CS were strongly associated with worsening PFS and OS in our VC and CC, validating findings from our OC. Although we cannot determine whether the CS specifically predicts PRRT response or is prognostic based upon these data, it is the first presented clinical metric which can categorize pts with WD NETs under consideration for PRRT and estimate anticipated benefit from PRRT for pts.
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Hollenbeck, Brent. "Commentary on “Racial variation in the quality of surgical care for bladder cancer.” Barocas DA, Alvarez J, Koyama T, Anderson CB, Gray DT, Fowke JH, You C, Chang SS, Cookson MS, Smith JA Jr, Penson DF, Department of Urologic Surgery, Vanderbilt University, Nashville, Tennessee; Center for Surgical Quality and Outcomes Research, Vanderbilt University, Nashville, Tennessee." Urologic Oncology: Seminars and Original Investigations 34, no. 5 (May 2016): 251–52. http://dx.doi.org/10.1016/j.urolonc.2015.02.018.
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Angley, Gina P., Jean Anne Schnittker, and Anne Marie Tharpe. "Remote Hearing Aid Support: The Next Frontier." Journal of the American Academy of Audiology 28, no. 10 (November 2017): 893–900. http://dx.doi.org/10.3766/jaaa.16093.
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Background: In an effort to reduce health-care disparities, there has been a recent surge of interest in the remote provision of care. Audiologists have begun to provide screening, diagnostic, and rehabilitative services via telehealth technologies. Purpose: To evaluate the feasibility and perceived benefits of providing remote hearing aid follow-up appointments in a controlled clinical environment and in participants’ homes. Research Design: A descriptive quasi-experimental study was completed. Study Sample: The study consisted of two phases. The in-clinic phase included 50 adults with hearing loss who participated in remote hearing aid follow-up appointments at Vanderbilt University Medical Center. A subgroup of 21 adults from the original in-clinic phase plus one additional participant completed the in-home appointments. Data Collection and Analysis: All participants completed the Montreal Cognitive Assessment and study-designed questionnaires. All participants were asked to install proprietary distance support (DS) client software on a laptop or desktop computer and participate in hearing aid follow-up appointments. Results: The majority of participants in both groups installed the DS client software with no assistance other than written instructions, and indicated a preference for DS appointments over face-to-face appointments. Conclusion: On average, participants and the study audiologist were satisfied with remote hearing aid follow-up visits. Additional support might be needed for older patients with little confidence in their ability to interact with technology.
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Weeks, Hannah L., Cole Beck, Elizabeth McNeer, Michael L. Williams, Cosmin A. Bejan, Joshua C. Denny, and Leena Choi. "medExtractR: A targeted, customizable approach to medication extraction from electronic health records." Journal of the American Medical Informatics Association 27, no. 3 (January 16, 2020): 407–18. http://dx.doi.org/10.1093/jamia/ocz207.
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Abstract Objective We developed medExtractR, a natural language processing system to extract medication information from clinical notes. Using a targeted approach, medExtractR focuses on individual drugs to facilitate creation of medication-specific research datasets from electronic health records. Materials and Methods Written using the R programming language, medExtractR combines lexicon dictionaries and regular expressions to identify relevant medication entities (eg, drug name, strength, frequency). MedExtractR was developed on notes from Vanderbilt University Medical Center, using medications prescribed with varying complexity. We evaluated medExtractR and compared it with 3 existing systems: MedEx, MedXN, and CLAMP (Clinical Language Annotation, Modeling, and Processing). We also demonstrated how medExtractR can be easily tuned for better performance on an outside dataset using the MIMIC-III (Medical Information Mart for Intensive Care III) database. Results On 50 test notes per development drug and 110 test notes for an additional drug, medExtractR achieved high overall performance (F-measures >0.95), exceeding performance of the 3 existing systems across all drugs. MedExtractR achieved the highest F-measure for each individual entity, except drug name and dose amount for allopurinol. With tuning and customization, medExtractR achieved F-measures >0.90 in the MIMIC-III dataset. Discussion The medExtractR system successfully extracted entities for medications of interest. High performance in entity-level extraction provides a strong foundation for developing robust research datasets for pharmacological research. When working with new datasets, medExtractR should be tuned on a small sample of notes before being broadly applied. Conclusions The medExtractR system achieved high performance extracting specific medications from clinical text, leading to higher-quality research datasets for drug-related studies than some existing general-purpose medication extraction tools.
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Warner, Jeremy, Lucy L. Wang, Joseph Burden, Pam Carney, Scott Sobecki, and Mia Alyce Levy. "Measurement of mutation-specific survival as a real-time cancer care quality indicator." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 30. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.30.
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30 Background: As targeted therapies become widespread in the treatment of cancer, tracking clinical effectiveness as a function of mutation status, outside of the research setting, is needed. We evaluated whether mutation-specific survival statistics could be derived in a completely automated fashion from electronic medical record data sources, for quality assurance and purposes preparatory to research. Methods: Patients with cancer mutation analysis obtained for clinical care at Vanderbilt University up to June 2013 were included. Informatics algorithms were developed to automatically extract tumor mutation status, cancer type, date of diagnosis, and date of death or date of last contact using multiple structured and unstructured clinical data sources including billing codes, narrative pathology reports, and the Social Security Death Index. Survival was modeled using Cox proportional hazards, stratified by mutation type; mutations occurring less than 10 times were aggregated into an “Other” category. Results: 2,636 out of 3,115,904 patients had sufficient data for inclusion. Date of death was recorded for 32% of patients; overall median follow-up was 19 months. The median mutation-specific survival for lung cancer and melanoma patients is shown in the Table. For lung cancer patients, EGFR mutation was associated with superior survival (HR 0.7, 95% CI 0.5-1, p = 0.05). For melanoma patients, GNAQ mutation was associated with inferior survival (HR 2.2, 95% CI 1.3-3.8, p = 0.006) whereas BRAF mutation was not statistically significant (p = 0.32). Conclusions: It is feasible to create survival curves based on cancer mutation status in a fully automated fashion for quality assurance and purposes preparatory to research. Further iterative improvements in the data extraction algorithms are continuing; updates will be presented. Future work will enable stratification by mutation subtype, treatment exposure, staging, and demographics. [Table: see text]