Claudia graduated from Providence College in 2018 with a Bachelor of Arts in Mathematics. She joined the ITA in July of 2018 and currently works as a research associate under Dr. Pari V. Pandharipande and Dr. Amy B. Knudsen on colorectal, ovarian, and pancreatic cancer disease modeling.
Selected Publications
Seguin, Claudia L; Davidi, Barak; Peters, Mary Linton B; Eckel, Andrew; Harisinghani, Mukesh G; Goiffon, Reece J; Knudsen, Amy B; Pandharipande, Pari V
Ultrasound Surveillance of Small Incidentally Detected Gallbladder Polyps: Projected Benefits by Sex, Age, and Comorbidity Level Journal Article
In: J Am Coll Radiol, vol. S1546-1440, iss. 23, pp. 00475-1, 2023, ISSN: 1558-349X.
@article{pmid37406750,
title = {Ultrasound Surveillance of Small Incidentally Detected Gallbladder Polyps: Projected Benefits by Sex, Age, and Comorbidity Level},
author = {Claudia L Seguin and Barak Davidi and Mary Linton B Peters and Andrew Eckel and Mukesh G Harisinghani and Reece J Goiffon and Amy B Knudsen and Pari V Pandharipande},
doi = {10.1016/j.jacr.2023.05.015},
issn = {1558-349X},
year = {2023},
date = {2023-07-01},
urldate = {2023-07-01},
journal = {J Am Coll Radiol},
volume = {S1546-1440},
issue = {23},
pages = {00475-1},
abstract = {OBJECTIVE: Incidentally detected gallbladder polyps are commonly encountered when performing upper abdominal ultrasound. Our purpose was to estimate the life expectancy (LE) benefit of ultrasound-based gallbladder surveillance in patients with small (6-7 to <10 mm), incidentally detected gallbladder polyps, accounting for patient sex, age, and comorbidity level.nnMETHODS: We developed a decision-analytic Markov model to evaluate hypothetical cohorts of women and men with small gallbladder polyps, with varying age (66-80 years) and comorbidity level (none, mild, moderate, severe). Drawing from current evidence, in the base case, we assumed no increased risk of gallbladder cancer in patients with small gallbladder polyps. To estimate maximal possible LE gains from surveillance, we assumed perfect cancer control consequent to five years of surveillance. We varied key assumptions including cancer risk and test performance characteristics in sensitivity analysis.nnRESULTS: Projected LE gains from surveillance were < 3 days across most cohorts and scenarios evaluated. For 66- and 80-year-olds with no comorbidities, LE gains were 1.46 and 1.45 days, respectively, for women, and 0.67 and 0.75 days for men. With ten years of surveillance, LE gains increased to 2.94 days for 66-year-old women with no comorbidities (men: 1.35 days). If we assumed a 10% increase in gallbladder cancer risk among individuals with polyps, LE gains increased slightly to 1.60 days for 66-year-old women with no comorbidities (men: 0.74 days). Results were sensitive to test performance and surgical mortality.nnDISCUSSION: Even under unrealistic, optimistic assumptions of cancer control, ultrasound surveillance of incidentally detected small gallbladder polyps provided limited benefit.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Incidentally detected gallbladder polyps are commonly encountered when performing upper abdominal ultrasound. Our purpose was to estimate the life expectancy (LE) benefit of ultrasound-based gallbladder surveillance in patients with small (6-7 to <10 mm), incidentally detected gallbladder polyps, accounting for patient sex, age, and comorbidity level.nnMETHODS: We developed a decision-analytic Markov model to evaluate hypothetical cohorts of women and men with small gallbladder polyps, with varying age (66-80 years) and comorbidity level (none, mild, moderate, severe). Drawing from current evidence, in the base case, we assumed no increased risk of gallbladder cancer in patients with small gallbladder polyps. To estimate maximal possible LE gains from surveillance, we assumed perfect cancer control consequent to five years of surveillance. We varied key assumptions including cancer risk and test performance characteristics in sensitivity analysis.nnRESULTS: Projected LE gains from surveillance were < 3 days across most cohorts and scenarios evaluated. For 66- and 80-year-olds with no comorbidities, LE gains were 1.46 and 1.45 days, respectively, for women, and 0.67 and 0.75 days for men. With ten years of surveillance, LE gains increased to 2.94 days for 66-year-old women with no comorbidities (men: 1.35 days). If we assumed a 10% increase in gallbladder cancer risk among individuals with polyps, LE gains increased slightly to 1.60 days for 66-year-old women with no comorbidities (men: 0.74 days). Results were sensitive to test performance and surgical mortality.nnDISCUSSION: Even under unrealistic, optimistic assumptions of cancer control, ultrasound surveillance of incidentally detected small gallbladder polyps provided limited benefit.
Seguin, Claudia L; Davidi, Barak; Peters, Mary Linton B; Eckel, Andrew; Harisinghani, Mukesh G; Goiffon, Reece J; Knudsen, Amy B; Pandharipande, Pari V
Ultrasound Surveillance of Small, Incidentally Detected Gallbladder Polyps: Projected Benefits by Gender, Age, and Comorbidity Level Journal Article
In: J Am Coll Radiol, 2023, ISSN: 1558-349X.
@article{pmid37406750b,
title = {Ultrasound Surveillance of Small, Incidentally Detected Gallbladder Polyps: Projected Benefits by Gender, Age, and Comorbidity Level},
author = {Claudia L Seguin and Barak Davidi and Mary Linton B Peters and Andrew Eckel and Mukesh G Harisinghani and Reece J Goiffon and Amy B Knudsen and Pari V Pandharipande},
doi = {10.1016/j.jacr.2023.05.015},
issn = {1558-349X},
year = {2023},
date = {2023-07-01},
journal = {J Am Coll Radiol},
abstract = {OBJECTIVE: Incidentally detected gallbladder polyps are commonly encountered when performing upper abdominal ultrasound. Our purpose was to estimate the life expectancy (LE) benefit of ultrasound-based gallbladder surveillance in patients with small (6 to <10 mm), incidentally detected gallbladder polyps, accounting for patient gender, age, and comorbidity level.nnMETHODS: We developed a decision-analytic Markov model to evaluate hypothetical cohorts of women and men with small gallbladder polyps, with varying age (66-80 years) and comorbidity level (none, mild, moderate, severe). Drawing from current evidence, in the base case, we assumed no increased risk of gallbladder cancer in patients with small gallbladder polyps. To estimate maximal possible LE gains from surveillance, we assumed perfect cancer control consequent to 5 years of surveillance. We varied key assumptions including cancer risk and test performance characteristics in sensitivity analysis.nnRESULTS: Projected LE gains from surveillance were <3 days across most cohorts and scenarios evaluated. For 66- and 80-year-olds with no comorbidities, LE gains were 1.46 and 1.45 days, respectively, for women, and 0.67 and 0.75 days for men. With 10 years of surveillance, LE gains increased to 2.94 days for 66-year-old women with no comorbidities (men: 1.35 days). If we assumed a 10% increase in gallbladder cancer risk among individuals with polyps, LE gains increased slightly to 1.60 days for 66-year-old women with no comorbidities (men: 0.74 days). Results were sensitive to test performance and surgical mortality.nnDISCUSSION: Even under unrealistic, optimistic assumptions of cancer control, ultrasound surveillance of incidentally detected small gallbladder polyps provided limited benefit.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Incidentally detected gallbladder polyps are commonly encountered when performing upper abdominal ultrasound. Our purpose was to estimate the life expectancy (LE) benefit of ultrasound-based gallbladder surveillance in patients with small (6 to <10 mm), incidentally detected gallbladder polyps, accounting for patient gender, age, and comorbidity level.nnMETHODS: We developed a decision-analytic Markov model to evaluate hypothetical cohorts of women and men with small gallbladder polyps, with varying age (66-80 years) and comorbidity level (none, mild, moderate, severe). Drawing from current evidence, in the base case, we assumed no increased risk of gallbladder cancer in patients with small gallbladder polyps. To estimate maximal possible LE gains from surveillance, we assumed perfect cancer control consequent to 5 years of surveillance. We varied key assumptions including cancer risk and test performance characteristics in sensitivity analysis.nnRESULTS: Projected LE gains from surveillance were <3 days across most cohorts and scenarios evaluated. For 66- and 80-year-olds with no comorbidities, LE gains were 1.46 and 1.45 days, respectively, for women, and 0.67 and 0.75 days for men. With 10 years of surveillance, LE gains increased to 2.94 days for 66-year-old women with no comorbidities (men: 1.35 days). If we assumed a 10% increase in gallbladder cancer risk among individuals with polyps, LE gains increased slightly to 1.60 days for 66-year-old women with no comorbidities (men: 0.74 days). Results were sensitive to test performance and surgical mortality.nnDISCUSSION: Even under unrealistic, optimistic assumptions of cancer control, ultrasound surveillance of incidentally detected small gallbladder polyps provided limited benefit.
Peters, Mary Linton B.; Eckel, Andrew; Lietz, Anna; Seguin, Claudia; Mueller, Peter; Hur, Chin; Pandharipande, Pari V.
In: Pancreatology, vol. 22, iss. 6, pp. 760-769, 2022, ISSN: 1424-3903.
@article{PETERS2022,
title = {Genetic testing to guide screening for pancreatic ductal adenocarcinoma: Results of a microsimulation model},
author = {Mary Linton B. Peters and Andrew Eckel and Anna Lietz and Claudia Seguin and Peter Mueller and Chin Hur and Pari V. Pandharipande},
url = {https://www.sciencedirect.com/science/article/pii/S1424390322001703},
doi = {https://doi.org/10.1016/j.pan.2022.05.003},
issn = {1424-3903},
year = {2022},
date = {2022-09-22},
urldate = {2022-05-31},
journal = {Pancreatology},
volume = {22},
issue = {6},
pages = {760-769},
abstract = {Background
First-degree relatives (FDRs) of patients with pancreatic ductal adenocarcinoma (PDAC) have elevated PDAC risk, partially due to germline genetic variants. We evaluated the potential effectiveness of genetic testing to target MRI-based screening among FDRs.
Methods
We used a microsimulation model of PDAC, calibrated to Surveillance, Epidemiology, and End Results (SEER) data, to estimate the potential life expectancy (LE) gain of screening for each of the following groups of FDRs: indviduals who test positive for each of eight variants associated with elevated PDAC risk (e.g., BRCA2, CDKN2A); individuals who test negative; and individuals who do not test. Screening was assumed to take place if LE gains were achievable. We simulated multiple screening approaches, defined by starting age and frequency. Sensitivity analysis evaluated changes in results given varying model assumptions.
Results
For women, 92% of mutation carriers had projected LE gains from screening for PDAC, if screening strategies (start age, frequency) were optimized. Among carriers, LE gains ranged from 0.1 days (ATM + women screened once at age 70) to 510 days (STK11+ women screened annually from age 40). For men, LE gains were projected for all mutation carriers, ranging from 0.2 days (BRCA1+ men screened once at age 70) to 620 days (STK11+ men screened annually from age 40). For men and women who did not undergo genetic testing, or for whom testing showed no variant, screening yielded small LE benefit (0\textendash2.1 days).
Conclusions
Genetic testing of FDRs can inform targeted PDAC screening by identifying which FDRs may benefit.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background
First-degree relatives (FDRs) of patients with pancreatic ductal adenocarcinoma (PDAC) have elevated PDAC risk, partially due to germline genetic variants. We evaluated the potential effectiveness of genetic testing to target MRI-based screening among FDRs.
Methods
We used a microsimulation model of PDAC, calibrated to Surveillance, Epidemiology, and End Results (SEER) data, to estimate the potential life expectancy (LE) gain of screening for each of the following groups of FDRs: indviduals who test positive for each of eight variants associated with elevated PDAC risk (e.g., BRCA2, CDKN2A); individuals who test negative; and individuals who do not test. Screening was assumed to take place if LE gains were achievable. We simulated multiple screening approaches, defined by starting age and frequency. Sensitivity analysis evaluated changes in results given varying model assumptions.
Results
For women, 92% of mutation carriers had projected LE gains from screening for PDAC, if screening strategies (start age, frequency) were optimized. Among carriers, LE gains ranged from 0.1 days (ATM + women screened once at age 70) to 510 days (STK11+ women screened annually from age 40). For men, LE gains were projected for all mutation carriers, ranging from 0.2 days (BRCA1+ men screened once at age 70) to 620 days (STK11+ men screened annually from age 40). For men and women who did not undergo genetic testing, or for whom testing showed no variant, screening yielded small LE benefit (0–2.1 days).
Conclusions
Genetic testing of FDRs can inform targeted PDAC screening by identifying which FDRs may benefit.
First-degree relatives (FDRs) of patients with pancreatic ductal adenocarcinoma (PDAC) have elevated PDAC risk, partially due to germline genetic variants. We evaluated the potential effectiveness of genetic testing to target MRI-based screening among FDRs.
Methods
We used a microsimulation model of PDAC, calibrated to Surveillance, Epidemiology, and End Results (SEER) data, to estimate the potential life expectancy (LE) gain of screening for each of the following groups of FDRs: indviduals who test positive for each of eight variants associated with elevated PDAC risk (e.g., BRCA2, CDKN2A); individuals who test negative; and individuals who do not test. Screening was assumed to take place if LE gains were achievable. We simulated multiple screening approaches, defined by starting age and frequency. Sensitivity analysis evaluated changes in results given varying model assumptions.
Results
For women, 92% of mutation carriers had projected LE gains from screening for PDAC, if screening strategies (start age, frequency) were optimized. Among carriers, LE gains ranged from 0.1 days (ATM + women screened once at age 70) to 510 days (STK11+ women screened annually from age 40). For men, LE gains were projected for all mutation carriers, ranging from 0.2 days (BRCA1+ men screened once at age 70) to 620 days (STK11+ men screened annually from age 40). For men and women who did not undergo genetic testing, or for whom testing showed no variant, screening yielded small LE benefit (0–2.1 days).
Conclusions
Genetic testing of FDRs can inform targeted PDAC screening by identifying which FDRs may benefit.
Knudsen, Amy; Rutter, Carolyn M.; Peterse, Elisabeth F. P.; Lietz, Anna; Seguin, Claudia; Meester, Reinier G. S.; Perdue, Leslie A.; Lin, Jennifer S.; Siegel, Rebecca L.; Doria-Rose, V. Paul; Feuer, Eric J.; Zauber, Ann G.; Kuntz, Karen M.; Lansdorp-Vogelaar, Iris
Colorectal Cancer Screening: An Updated Modeling Study for the US Preventive Services Task Force Journal Article
In: JAMA, vol. 325, no. 19, pp. 1998-2011, 2021, ISSN: 0098-7484, ().
@article{knudsen2021,
title = {Colorectal Cancer Screening: An Updated Modeling Study for the US Preventive Services Task Force},
author = {Amy Knudsen and Carolyn M. Rutter and Elisabeth F. P. Peterse and Anna Lietz and Claudia Seguin and Reinier G. S. Meester and Leslie A. Perdue and Jennifer S. Lin and Rebecca L. Siegel and V. Paul Doria-Rose and Eric J. Feuer and Ann G. Zauber and Karen M. Kuntz and Iris Lansdorp-Vogelaar},
url = {https://doi.org/10.1001/jama.2021.5746},
doi = {10.1001/jama.2021.5746},
issn = {0098-7484},
year = {2021},
date = {2021-05-01},
journal = {JAMA},
volume = {325},
number = {19},
pages = {1998-2011},
abstract = {The US Preventive Services Task Force (USPSTF) is updating its 2016 colorectal cancer screening recommendations.To provide updated model-based estimates of the benefits, burden, and harms of colorectal cancer screening strategies and to identify strategies that may provide an efficient balance of life-years gained (LYG) from screening and colonoscopy burden to inform the USPSTF.Comparative modeling study using 3 microsimulation models of colorectal cancer screening in a hypothetical cohort of 40-year-old US individuals at average risk of colorectal cancer.Screening from ages 45, 50, or 55 years to ages 70, 75, 80, or 85 years with fecal immunochemical testing (FIT), multitarget stool DNA testing, flexible sigmoidoscopy alone or with FIT, computed tomography colonography, or colonoscopy. All persons with an abnormal noncolonoscopy screening test result were assumed to undergo follow-up colonoscopy. Screening intervals varied by test. Full adherence with all procedures was assumed.Estimated LYG relative to no screening (benefit), lifetime number of colonoscopies (burden), number of complications from screening (harms), and balance of incremental burden and benefit (efficiency ratios). Efficient strategies were those estimated to require fewer additional colonoscopies per additional LYG relative to other strategies.Estimated LYG from screening strategies ranged from 171 to 381 per 1000 40-year-olds. Lifetime colonoscopy burden ranged from 624 to 6817 per 1000 individuals, and screening complications ranged from 5 to 22 per 1000 individuals. Among the 49 strategies that were efficient options with all 3 models, 41 specified screening beginning at age 45. No single age to end screening was predominant among the efficient strategies, although the additional LYG from continuing screening after age 75 were generally small. With the exception of a 5-year interval for computed tomography colonography, no screening interval predominated among the efficient strategies for each modality. Among the strategies highlighted in the 2016 USPSTF recommendation, lowering the age to begin screening from 50 to 45 years was estimated to result in 22 to 27 additional LYG, 161 to 784 additional colonoscopies, and 0.1 to 2 additional complications per 1000 persons (ranges are across screening strategies, based on mean estimates across models). Assuming full adherence, screening outcomes and efficient strategies were similar by sex and race and across 3 scenarios for population risk of colorectal cancer.This microsimulation modeling analysis suggests that screening for colorectal cancer with stool tests, endoscopic tests, or computed tomography colonography starting at age 45 years provides an efficient balance of colonoscopy burden and life-years gained.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The US Preventive Services Task Force (USPSTF) is updating its 2016 colorectal cancer screening recommendations.To provide updated model-based estimates of the benefits, burden, and harms of colorectal cancer screening strategies and to identify strategies that may provide an efficient balance of life-years gained (LYG) from screening and colonoscopy burden to inform the USPSTF.Comparative modeling study using 3 microsimulation models of colorectal cancer screening in a hypothetical cohort of 40-year-old US individuals at average risk of colorectal cancer.Screening from ages 45, 50, or 55 years to ages 70, 75, 80, or 85 years with fecal immunochemical testing (FIT), multitarget stool DNA testing, flexible sigmoidoscopy alone or with FIT, computed tomography colonography, or colonoscopy. All persons with an abnormal noncolonoscopy screening test result were assumed to undergo follow-up colonoscopy. Screening intervals varied by test. Full adherence with all procedures was assumed.Estimated LYG relative to no screening (benefit), lifetime number of colonoscopies (burden), number of complications from screening (harms), and balance of incremental burden and benefit (efficiency ratios). Efficient strategies were those estimated to require fewer additional colonoscopies per additional LYG relative to other strategies.Estimated LYG from screening strategies ranged from 171 to 381 per 1000 40-year-olds. Lifetime colonoscopy burden ranged from 624 to 6817 per 1000 individuals, and screening complications ranged from 5 to 22 per 1000 individuals. Among the 49 strategies that were efficient options with all 3 models, 41 specified screening beginning at age 45. No single age to end screening was predominant among the efficient strategies, although the additional LYG from continuing screening after age 75 were generally small. With the exception of a 5-year interval for computed tomography colonography, no screening interval predominated among the efficient strategies for each modality. Among the strategies highlighted in the 2016 USPSTF recommendation, lowering the age to begin screening from 50 to 45 years was estimated to result in 22 to 27 additional LYG, 161 to 784 additional colonoscopies, and 0.1 to 2 additional complications per 1000 persons (ranges are across screening strategies, based on mean estimates across models). Assuming full adherence, screening outcomes and efficient strategies were similar by sex and race and across 3 scenarios for population risk of colorectal cancer.This microsimulation modeling analysis suggests that screening for colorectal cancer with stool tests, endoscopic tests, or computed tomography colonography starting at age 45 years provides an efficient balance of colonoscopy burden and life-years gained.
Omidvari, Amir-Houshang; Hazelton, William D; Lauren, Brianna N; Naber, Steffie K; Lee, Minyi; Ali, Ayman; Seguin, Claudia; Kong, Chung Yin; Richmond, Ellen; Rubenstein, Joel H; Luebeck, Georg E; Inadomi, John M; Hur, Chin; Lansdorp-Vogelaar, Iris
In: Gastroenterology, vol. 161, no. 2, pp. 487-494, 2021, ISSN: 1528-0012, ().
@article{Omidvari2021,
title = {The optimal age to stop endoscopic surveillance of Barrett's esophagus patients based on sex and comorbidity: a comparative cost-effectiveness analysis.},
author = {Amir-Houshang Omidvari and William D Hazelton and Brianna N Lauren and Steffie K Naber and Minyi Lee and Ayman Ali and Claudia Seguin and Chung Yin Kong and Ellen Richmond and Joel H Rubenstein and Georg E Luebeck and John M Inadomi and Chin Hur and Iris Lansdorp-Vogelaar},
url = {https://pubmed.ncbi.nlm.nih.gov/33974935/},
doi = {10.1053/j.gastro.2021.05.003},
issn = {1528-0012},
year = {2021},
date = {2021-05-01},
urldate = {2021-05-01},
journal = {Gastroenterology},
volume = {161},
number = {2},
pages = {487-494},
abstract = {Current guidelines recommend surveillance for non-dysplastic Barrett's esophagus (NDBE) patients but do not include a recommended age for discontinuing surveillance. This study aimed to determine the optimal age for last surveillance of NDBE patients stratified by sex and level of comorbidity. We used three independently developed models to simulate patients diagnosed with NDBE, varying in age, sex, and comorbidity level (no, mild, moderate, severe). All patients had received regular surveillance until their current age. We calculated incremental costs and quality-adjusted life-years (QALYs) gained from one additional endoscopic surveillance at the current age versus not performing surveillance at that age. We determined the optimal age to end surveillance as the age at which incremental cost-effectiveness ratio (ICER) of one more surveillance was just below the willingness-to-pay threshold of $100,000/QALY. The benefit of having one more surveillance endoscopy strongly depended on age, sex and comorbidity. For men with NDBE and severe comorbidity, one additional surveillance at age 80 years provided 4 more QALYs per 1,000 BE patients at an additional cost of $1,2 million, while for women with severe comorbidity the benefit at that age was 7 QALYs at a cost of $1.3 million. For men with no, mild, moderate and severe comorbidity, the optimal ages of last surveillance were 81, 80, 77 and 73 years, respectively. For women, these ages were lower: 75, 73, 73 and 69 years, respectively. Our comparative modeling analysis illustrates the importance of considering comorbidity status and sex when deciding upon the age to discontinue surveillance in patients with NDBE.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Current guidelines recommend surveillance for non-dysplastic Barrett's esophagus (NDBE) patients but do not include a recommended age for discontinuing surveillance. This study aimed to determine the optimal age for last surveillance of NDBE patients stratified by sex and level of comorbidity. We used three independently developed models to simulate patients diagnosed with NDBE, varying in age, sex, and comorbidity level (no, mild, moderate, severe). All patients had received regular surveillance until their current age. We calculated incremental costs and quality-adjusted life-years (QALYs) gained from one additional endoscopic surveillance at the current age versus not performing surveillance at that age. We determined the optimal age to end surveillance as the age at which incremental cost-effectiveness ratio (ICER) of one more surveillance was just below the willingness-to-pay threshold of $100,000/QALY. The benefit of having one more surveillance endoscopy strongly depended on age, sex and comorbidity. For men with NDBE and severe comorbidity, one additional surveillance at age 80 years provided 4 more QALYs per 1,000 BE patients at an additional cost of $1,2 million, while for women with severe comorbidity the benefit at that age was 7 QALYs at a cost of $1.3 million. For men with no, mild, moderate and severe comorbidity, the optimal ages of last surveillance were 81, 80, 77 and 73 years, respectively. For women, these ages were lower: 75, 73, 73 and 69 years, respectively. Our comparative modeling analysis illustrates the importance of considering comorbidity status and sex when deciding upon the age to discontinue surveillance in patients with NDBE.
Seguin, Claudia; Lietz, Anna; Wright, Jason D.; Wright, Alexi; Knudsen, Amy; Pandharipande, Pari
Surveillance in Older Women With Incidental Ovarian Cysts: Maximal Projected Benefits by Age and Comorbidity Level. Journal Article
In: Journal of the American College of Radiology : JACR, vol. 18, no. 1 PT A, pp. 10-18, 2021, ISSN: 1558-349X, ().
@article{Seguin2020,
title = {Surveillance in Older Women With Incidental Ovarian Cysts: Maximal Projected Benefits by Age and Comorbidity Level.},
author = {Claudia Seguin and Anna Lietz and Jason D. Wright and Alexi Wright and Amy Knudsen and Pari Pandharipande},
url = {https://pubmed.ncbi.nlm.nih.gov/33096089/},
doi = {10.1016/j.jacr.2020.09.048},
issn = {1558-349X},
year = {2021},
date = {2021-01-01},
journal = {Journal of the American College of Radiology : JACR},
volume = {18},
number = {1 PT A},
pages = {10-18},
abstract = {The aim of this study was to estimate effects on life expectancy (LE) of imaging-based ovarian surveillance after detection of incidental postmenopausal ovarian cysts, under different assumptions of patient age, comorbidity level, and cancer risk and detection. A decision-analytic Markov model was developed to estimate LE benefits. Hypothetical cohorts of postmenopausal women with simple ovarian cysts were evaluated, with varied age (66-80 years) and comorbidity level (none, mild, moderate, severe). For each cohort, imaging "follow-up" (2 years) and "no-follow-up" strategies were compared. Consistent with current evidence, increased cancer risk in patients with cysts was not assumed; however, incident ovarian cancers could be detected during follow-up. To estimate theoretical maximal LE gains from follow-up, perfect ovarian cancer detection and treatment during follow-up were assumed. This and other key assumptions were varied in sensitivity analysis. Projected LE gains from follow-up were limited. For 66-, 70-, 75-, and 80-year-old women with no comorbidities, LE gains were 5.1, 5.1, 4.5, and 3.7 days; with severe comorbidities, they were 3.5, 3.2, 2.7, and 2.1 days. With sensitivity of 50% for cancer detection, they were 3.7 days for 66-year-old women with no comorbidities and 1.3 days for 80-year-old women with severe comorbidities. When cancer risk for women with cysts was assumed to be elevated (1.1 times average risk), LE gains increased only modestly (5.6 and 2.3 days for analogous cohorts). Even in the circumstance of perfect ovarian cancer detection and treatment, surveillance of postmenopausal women (≥66 years of age) with simple cysts affords limited benefits, particularly in women with advanced age and comorbidities.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The aim of this study was to estimate effects on life expectancy (LE) of imaging-based ovarian surveillance after detection of incidental postmenopausal ovarian cysts, under different assumptions of patient age, comorbidity level, and cancer risk and detection. A decision-analytic Markov model was developed to estimate LE benefits. Hypothetical cohorts of postmenopausal women with simple ovarian cysts were evaluated, with varied age (66-80 years) and comorbidity level (none, mild, moderate, severe). For each cohort, imaging "follow-up" (2 years) and "no-follow-up" strategies were compared. Consistent with current evidence, increased cancer risk in patients with cysts was not assumed; however, incident ovarian cancers could be detected during follow-up. To estimate theoretical maximal LE gains from follow-up, perfect ovarian cancer detection and treatment during follow-up were assumed. This and other key assumptions were varied in sensitivity analysis. Projected LE gains from follow-up were limited. For 66-, 70-, 75-, and 80-year-old women with no comorbidities, LE gains were 5.1, 5.1, 4.5, and 3.7 days; with severe comorbidities, they were 3.5, 3.2, 2.7, and 2.1 days. With sensitivity of 50% for cancer detection, they were 3.7 days for 66-year-old women with no comorbidities and 1.3 days for 80-year-old women with severe comorbidities. When cancer risk for women with cysts was assumed to be elevated (1.1 times average risk), LE gains increased only modestly (5.6 and 2.3 days for analogous cohorts). Even in the circumstance of perfect ovarian cancer detection and treatment, surveillance of postmenopausal women (≥66 years of age) with simple cysts affords limited benefits, particularly in women with advanced age and comorbidities.
Pandharipande, Pari; Mercaldo, Nathaniel; Lietz, Anna; Seguin, Claudia L.; Neal, Chrishanae; Deville, Curtiland; Parikh, Jay R.; Sadigh, Gelareh; Sepulveda, Karla A.; Maturen, Katherine E.; Cox, Jan; Bansal, Swati; Macura, Katarzyna J.; Donelan, Karen
Identifying Barriers to Building a Diverse Physician Workforce: A National Survey of the ACR Membership Journal Article
In: Journal of the American College of Radiology, vol. 16, no. 8, pp. 1091-1101, 2019, ISSN: 1546-1440, ().
@article{PANDHARIPANDE2019,
title = {Identifying Barriers to Building a Diverse Physician Workforce: A National Survey of the ACR Membership},
author = {Pari Pandharipande and Nathaniel Mercaldo and Anna Lietz and Claudia L. Seguin and Chrishanae Neal and Curtiland Deville and Jay R. Parikh and Gelareh Sadigh and Karla A. Sepulveda and Katherine E. Maturen and Jan Cox and Swati Bansal and Katarzyna J. Macura and Karen Donelan},
url = {https://www.ncbi.nlm.nih.gov/pubmed/31173744},
doi = {https://doi.org/10.1016/j.jacr.2019.05.008},
issn = {1546-1440},
year = {2019},
date = {2019-08-01},
urldate = {2019-08-01},
journal = {Journal of the American College of Radiology},
volume = {16},
number = {8},
pages = {1091-1101},
abstract = {Purpose
The aim of this study was to identify potential barriers to building a diverse workforce in radiology and radiation oncology by conducting a national survey of physicians in these fields and studying their reported career experiences.
Methods
An electronic survey of ACR members (February 27, 2018, to April 26, 2018) was conducted in which physicians’ attitudes about their work environment, relationships, and culture were queried. The aim was to determine if responses differed by gender or race/ethnicity. In total, 900 invitations were issued; women were oversampled with the goal of equal representation. Descriptive summaries (proportions of yes/no responses) were calculated per item, per subgroup of interest. Logistic regression analysis was used to identify significant associations between gender and item-specific responses; it was not used in the race/ethnicity analysis because of the small sizes of many subgroups.
Results
The response rate was 51.2% (461 of 900). In total, 51.0% of respondents identified as women (235 of 461); the 9.5% (44 of 461) who identified as black or African American, Hispanic, or American Indian or Alaska Native were considered underrepresented minorities. Respondents’ mean age was 40.2 ± 10.4 years. Subgroups varied most in their reporting of unfair or disrespectful treatment. Women were significantly more likely than men to report such treatment attributable to gender (50.6% vs. 5.4%; odds ratio, 18.00; 95% confidence interval, 9.29-34.86; P .001), and 27.9% of underrepresented minorities compared with 2.6% of white non-Hispanic respondents reported such treatment attributable to race/ethnicity.
Conclusions
Women and underrepresented minorities disproportionately experience unfair or disrespectful treatment in the workplace. Addressing this problem is likely to be critically important for improving workforce diversity.},
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Purpose
The aim of this study was to identify potential barriers to building a diverse workforce in radiology and radiation oncology by conducting a national survey of physicians in these fields and studying their reported career experiences.
Methods
An electronic survey of ACR members (February 27, 2018, to April 26, 2018) was conducted in which physicians’ attitudes about their work environment, relationships, and culture were queried. The aim was to determine if responses differed by gender or race/ethnicity. In total, 900 invitations were issued; women were oversampled with the goal of equal representation. Descriptive summaries (proportions of yes/no responses) were calculated per item, per subgroup of interest. Logistic regression analysis was used to identify significant associations between gender and item-specific responses; it was not used in the race/ethnicity analysis because of the small sizes of many subgroups.
Results
The response rate was 51.2% (461 of 900). In total, 51.0% of respondents identified as women (235 of 461); the 9.5% (44 of 461) who identified as black or African American, Hispanic, or American Indian or Alaska Native were considered underrepresented minorities. Respondents’ mean age was 40.2 ± 10.4 years. Subgroups varied most in their reporting of unfair or disrespectful treatment. Women were significantly more likely than men to report such treatment attributable to gender (50.6% vs. 5.4%; odds ratio, 18.00; 95% confidence interval, 9.29-34.86; P .001), and 27.9% of underrepresented minorities compared with 2.6% of white non-Hispanic respondents reported such treatment attributable to race/ethnicity.
Conclusions
Women and underrepresented minorities disproportionately experience unfair or disrespectful treatment in the workplace. Addressing this problem is likely to be critically important for improving workforce diversity.
The aim of this study was to identify potential barriers to building a diverse workforce in radiology and radiation oncology by conducting a national survey of physicians in these fields and studying their reported career experiences.
Methods
An electronic survey of ACR members (February 27, 2018, to April 26, 2018) was conducted in which physicians’ attitudes about their work environment, relationships, and culture were queried. The aim was to determine if responses differed by gender or race/ethnicity. In total, 900 invitations were issued; women were oversampled with the goal of equal representation. Descriptive summaries (proportions of yes/no responses) were calculated per item, per subgroup of interest. Logistic regression analysis was used to identify significant associations between gender and item-specific responses; it was not used in the race/ethnicity analysis because of the small sizes of many subgroups.
Results
The response rate was 51.2% (461 of 900). In total, 51.0% of respondents identified as women (235 of 461); the 9.5% (44 of 461) who identified as black or African American, Hispanic, or American Indian or Alaska Native were considered underrepresented minorities. Respondents’ mean age was 40.2 ± 10.4 years. Subgroups varied most in their reporting of unfair or disrespectful treatment. Women were significantly more likely than men to report such treatment attributable to gender (50.6% vs. 5.4%; odds ratio, 18.00; 95% confidence interval, 9.29-34.86; P .001), and 27.9% of underrepresented minorities compared with 2.6% of white non-Hispanic respondents reported such treatment attributable to race/ethnicity.
Conclusions
Women and underrepresented minorities disproportionately experience unfair or disrespectful treatment in the workplace. Addressing this problem is likely to be critically important for improving workforce diversity.