scholarly journals Informing esophagogastric cancer patients about treatment outcomes: development and evaluation study of a web-based tool and training (Preprint)

10.2196/27824 ◽  
2021 ◽  
Author(s):  
Loïs Francesca van de Water ◽  
Héctor G. van den Boorn ◽  
Florian Hoxha ◽  
Inge Henselmans ◽  
Mart M. Calff ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Cancer Patients ◽  
Evaluation Study ◽  
Web Based ◽  
Esophagogastric Cancer ◽  
And Training

scholarly journals Informing esophagogastric cancer patients about treatment outcomes: development of an online tool and training for physicians (Preprint)

2021 ◽  
Author(s):  
Loïs Francesca van de Water ◽  
Héctor G. van den Boorn ◽  
Florian Hoxha ◽  
Inge Henselmans ◽  
Mart M. Calff ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Communication Skills ◽  
Prediction Models ◽  
Skills Training ◽  
Communication Skills Training ◽  
Esophagogastric Cancer ◽  
And Training

BACKGROUND With the increasing use of shared decision making (SDM), esophagogastric cancer patients play a larger and more important role in the decision-making process. To be able to make well-informed decisions, patients need to be adequately informed about treatment options and their outcomes, namely survival, side effects or complications, and health related quality of life (HRQoL). Online tools and training programs can aid physicians in this complex task, however to date none of these are available for use in informing esophagogastric cancer patients about treatment outcomes. OBJECTIVE This study aims to develop and evaluate the feasibility of an online prediction tool and a supporting communication skills training to improve the manner in which physicians inform esophagogastric cancer patients on treatment outcomes. With improving the provision of treatment outcome information, we aim for information that is evidence-based, precise, and personalized to patient and tumor characteristics which is communicated in a way tailored to the individual information needs. METHODS An online prediction tool to be used during the consultation, named the Source tool, was designed using an iterative, user-centered approach. An accompanying communication skills training was developed based on specified learning objectives, literature and expert opinions. The Source tool was tested in several rounds: 1) a focus group (6 patients and survivors), 2) semi-structured patient interviews (5 patients), 3) think-aloud sessions (3 medical oncologists) and 4) expert interviews (6 field experts). In a final pilot study, the Source tool and training were tested as a combined intervention using 5 medical oncology fellows and 3 esophagogastric outpatients. RESULTS The Source tool contained personalized prediction models and data from meta-analyses concerning survival, treatment side effects/complications and quality of life. The treatment outcomes were visualized in a patient-friendly manner using pictographs, and bar and line graphs. The communication skills training consisted of a blended learning for clinicians comprised of an e-learning and two face-to-face sessions. Adjustments to improve both training and tool were made according to feedback from all testing rounds. CONCLUSIONS The Source tool and training could play an important role in informing esophagogastric patients in an evidence-based, precise, personalized and tailored manner about treatment outcomes. Preliminary evaluation results are promising and provide valuable input for further development and testing of both elements. However, patient’s remaining uncertainties and doctors’ old habits and variating trust in the prediction models might influence the effect of the tool and training on daily practice. To investigate the impact of the combined tool and training on information provision in the context of treatment decision-making, we are currently conducting a multicenter clinical trial (SOURCE, NCT04232735).

scholarly journals Identification of NOTCH4 mutation as a response biomarker for immune checkpoint inhibitor therapy

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Junyu Long ◽  
Dongxu Wang ◽  
Xu Yang ◽  
Anqiang Wang ◽  
Yu Lin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Small Cell ◽  
Small Cell Lung ◽  
Esophagogastric Cancer ◽  
Clinical Benefits

Abstract Background Immune checkpoint inhibitor (ICI) therapy elicits durable antitumor responses in patients with many types of cancer. Genomic mutations may be used to predict the clinical benefits of ICI therapy. NOTCH homolog-4 (NOTCH4) is frequently mutated in several cancer types, but its role in immunotherapy is still unclear. Our study is the first to study the association between NOTCH4 mutation and the response to ICI therapy. Methods We tested the predictive value of NOTCH4 mutation in the discovery cohort, which included non-small cell lung cancer, melanoma, head and neck squamous cell carcinoma, esophagogastric cancer, and bladder cancer patients, and validated it in the validation cohort, which included non-small cell lung cancer, melanoma, renal cell carcinoma, colorectal cancer, esophagogastric cancer, glioma, bladder cancer, head and neck cancer, cancer of unknown primary, and breast cancer patients. Then, the relationships between NOTCH4 mutation and intrinsic and extrinsic immune response mechanisms were studied with multiomics data. Results We collected an ICI-treated cohort (n = 662) and found that patients with NOTCH4 mutation had better clinical benefits in terms of objective response rate (ORR: 42.9% vs 25.9%, P = 0.007), durable clinical benefit (DCB: 54.0% vs 38.1%, P = 0.021), progression-free survival (PFS, hazard ratio [HR] = 0.558, P < 0.001), and overall survival (OS, HR = 0.568, P = 0.006). In addition, we validated the prognostic value of NOTCH4 mutation in an independent ICI-treated cohort (n = 1423). Based on multiomics data, we found that NOTCH4 mutation is significantly associated with enhanced immunogenicity, including a high tumor mutational burden, the expression of costimulatory molecules, and activation of the antigen-processing machinery, and NOTCH4 mutation positively correlates activated antitumor immunity, including infiltration of diverse immune cells and various immune marker sets. Conclusions Our findings indicated that NOTCH4 mutation serves as a novel biomarker correlated with a better response to ICI therapy.

scholarly journals Feasibility of Providing Web-Based Information to Breast Cancer Patients Prior to a Surgical Consult

2017 ◽  
Vol 33 (5) ◽  
pp. 1069-1074 ◽  
Author(s):  
Jordan G. Bruce ◽  
Jennifer L. Tucholka ◽  
Nicole M. Steffens ◽  
Jane E. Mahoney ◽  
Heather B. Neuman
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Web Based

scholarly journals Methods and applications for visualization of SNOMED CT concept sets

2014 ◽  
Vol 05 (01) ◽  
pp. 127-152 ◽  
Author(s):  
E. Sundvall ◽  
K.R. Gøeg ◽  
A.R. Højen
Keyword(s):  
Content Management ◽  
Graph Layout ◽  
Snomed Ct ◽  
Focus Group Interviews ◽  
Web Based ◽  
Hierarchical Relations ◽  
Potential Applications ◽  
Group Interviews ◽  
And Training ◽  
Selection Of

SummaryInconsistent use of SNOMED CT concepts may reduce comparability of information in health information systems. Terminology implementation should be approached by common strategies for navigating and selecting proper concepts. This study aims to explore ways of illustrating common pathways and ancestors of particular sets of concepts, to support consistent use of SNOMED CT and also assess potential applications for such visualizations.The open source prototype presented is an interactive web-based re-implementation of the terminology visualization tool TermViz that provides an overview of concepts and their hierarchical relations. It provides terminological features such as interactively rearranging graphs, fetching more concept nodes, highlighting least common parents and shared pathways in merged graphs etc.Four teams of three to four people used the prototype to complete a terminology mapping task and then, in focus group interviews, discussed the user experience and potential future tool usage. Potential purposes discussed included SNOMED CT search and training, consistent selection of concepts and content management.The evaluation indicated that the tool may be useful in many contexts especially if integrated with existing systems, and that the graph layout needs further tuning and development.Citation: Højen AR, Sundvall E, Gøeg KR. Methods and applications for visualization of SNOMED CT concept sets. Appl Clin Inf 2014; 5: 127–152http://dx.doi.org/10.4338/ACI-2013-09-RA-0071

scholarly journals Design of a Web-based Symptom Management Intervention for Cancer Patients

2009 ◽  
pp. 775-784
Author(s):  
Christine M. Newlon ◽  
Chin-Chun A. Hu ◽  
Renee M. Stratton ◽  
Anna M. McDaniel
Keyword(s):  
Cancer Patients ◽  
Symptom Management ◽  
Web Based ◽  
Management Intervention

scholarly journals In-session intimacy processes and treatment outcomes for 2 couple-focused interventions for prostate cancer patients and their spouses

2020 ◽  
Vol 2 (2) ◽  
pp. e19
Author(s):  
Sharon L. Manne ◽  
Deborah A. Kashy ◽  
David Kissane ◽  
Talia Zaider ◽  
Carolyn J. Heckman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Treatment Outcomes ◽  
Cancer Patients
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