Publications

@article{pmid36987566,

title = {Delay in Surgery and Papillary Thyroid Cancer Survival in the United States: a SEER-Medicare Analysis},

author = {Natalia Chaves and Jordan M Broekhuis and Scott C Fligor and Reagan A Collins and Anna M Modest and Sumedh Kaul and Benjamin C James},

doi = {10.1210/clinem/dgad163},

issn = {1945-7197},

year  = {2023},

date = {2023-09-18},

urldate = {2023-03-01},

journal = {J Clin Endocrinol Metab},

volume = {108},

number = {10},

pages = {2589-2596},

abstract = {INTRODUCTION: Delays in surgery and their impact on survival in papillary thyroid cancer (PTC) is unclear. We sought to investigate the association between time to surgery and survival in patients with PTC.nnMETHODS: A total of 8,170 Medicare beneficiaries with PTC who underwent thyroidectomy were identified within the SEER-Medicare linked data files between 1999-2018. Disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meir analysis, and Cox proportional hazards models were specified to estimate the association between time to surgery and survival.nnRESULTS: Among 8,170 patients with PTC, mean age 69.3 (SD+/- 11.4), 89.8% had surgery within the first 90 days, 7.8% had surgery 91-180 days from diagnosis, and 2.4% had surgery after 180 days. Increasing time to surgery was associated with increased mortality for OS in the \>180-day group (aHR 1.24, 95% CI 1.01-1.53). Moreover, on stratification by summary stage, those with localized disease in the 91-180-day group increased risk by 25% (aHR 1.25 95%CI 1.05-1.51) and delaying over 180 days increased risk by 61% (aHR 1.61 95%CI 1.19-2.18) in OS. Those with localized disease in the \>180-day group had almost four times the estimated rate of DSS mortality (aHR3.51 95%CI 1.68-7.32). When stratified by T stage, those with T2 disease in the \>180 days group had double the estimated rate of all-cause mortality (aHR 2.0, 95% CI 1.1-3.3) and almost triple the estimated rate of disease-specific mortality (aHR 2.7, 95% CI 1.05-6.8).nnCONCLUSIONS: Delays in surgery for PTC may impact OS and DSS in localized disease, prior to nodal metastasis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37703336,

title = {Estimates of Hepatitis C Seroprevalence and Viremia in State Prison Populations in the United States},

author = {Anne C Spaulding and Shanika S Kennedy and Jeffery Osei and Ebrima Sidibeh and Isabella V Batina and Jagpreet Chhatwal and Matthew J Akiyama and Lara B Strick},

doi = {10.1093/infdis/jiad227},

issn = {1537-6613},

year  = {2023},

date = {2023-09-13},

urldate = {2023-09-01},

journal = {J Infect Dis},

volume = {228},

number = {Supplement_3},

pages = {S160--S167},

abstract = {BACKGROUND: Prior studies demonstrate that eliminating hepatitis C virus (HCV) in the United States (US) heavily depends on treating incarcerated persons. Knowing the scope of the carceral HCV epidemic by state will help guide national elimination efforts.nnMETHODS: Between 2019 and 2023, all state prison systems received surveys requesting data on hepatitis C antibody and viremic prevalence. We supplemented survey information with publicly available HCV data to corroborate responses and fill in data gaps.nnRESULTS: Weighting HCV prevalence by state prison population size, we estimate that 15.2% of the US prison population is HCV seropositive and 8.7% is viremic; 54.9% of seropositive persons have detectable RNA. Applying prevalence estimates to the total prison population at year-end 2021, 91 090 persons with HCV infection resided in a state prison.nnCONCLUSIONS: With updated and more complete HCV data from all 50 states, HCV prevalence in state prisons is nearly 9-fold higher than the US general population. The heterogeneity in HCV prevalence by state prison system may reflect variable exposure before arrest and/or differences in treatment availability during incarceration. Elimination of HCV in the country depends on addressing the carceral epidemic, and one of the first steps is understanding the size of the problem.},

keywords = {},

pubstate = {published},

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@article{pmid37703345,

title = {Hepatitis C Elimination in Moldova Is Feasible and Cost-Saving: A Modeling Study},

author = {Alec Aaron and Huaiyang Zhong and Lindsey Hiebert and Yueran Zhuo and Madeline Adee and Angela Paraschiv and Silvia Stratulat and John W Ward and Jagpreet Chhatwal},

doi = {10.1093/infdis/jiad138},

issn = {1537-6613},

year  = {2023},

date = {2023-09-13},

urldate = {2023-09-01},

journal = {J Infect Dis},

volume = {228},

number = {Supplement_3},

pages = {S189--S197},

abstract = {BACKGROUND: Moldova, an upper-middle-income country in Eastern Europe, is facing a high burden of hepatitis C virus (HCV). Our objective was to assist the National Agency of Public Health of Moldova in planning to achieve the World Health Organization's HCV elimination goals by 2030.nnMETHODS: This study adapted a previously developed microsimulation model to simulate the HCV epidemic in Moldova from 2004 to 2050. Model outcomes included temporal trends in HCV infection, prevalence, mortality, and total cost of care, including screening and treatment. We evaluated scenarios that could eliminate HCV by 2030.nnRESULTS: Multiple strategies could lead to HCV elimination in Moldova by 2030. A realistic scenario of a 20% annual screening and 80% treatment rate would require 2.75 million individuals to be screened and 65 000 treated by 2030. Compared to 2015, this program will reduce HCV incidence by 98% and HCV-related deaths by 72% in 2030. Between 2022 and 2030, this strategy would cost $17.5 million for HCV screening and treatment. However, by 2050, the health system would save \>$85 million compared to no investment in elimination efforts.nnCONCLUSIONS: HCV elimination in Moldova is feasible and can be cost saving, but requires resources to scale HCV screening and treatment.},

keywords = {},

pubstate = {published},

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}

@article{pmid37753604,

title = {Understanding the dynamics emerging from the interplay among poor mental wellbeing, energy balance-related behaviors, and obesity prevalence in adolescents: A simulation-based study},

author = {Anaely Aguiar and Furkan \"{O}nal and Gaironeesa Hendricks and Laurence Blanchard and Eduard Romanenko and Anne-Siri Fismen and Emmanuel Nwosu and Sondre Herstad and Natalie Savona and Janetta Harbron and C\'{e}cile Knai and Oddrun Samdal and Harry Rutter and Nanna Lien and Mohammad S Jalali and Birgit Kopainsky},

doi = {10.1111/obr.13628},

issn = {1467-789X},

year  = {2023},

date = {2023-09-01},

journal = {Obes Rev},

volume = {24 Suppl 2},

pages = {e13628},

abstract = {Both obesity and poor mental wellbeing have a high prevalence in European youth. Adolescents in six countries identified mental wellbeing factors as main drivers of youth obesity through systems mapping. This study sought to (1) explore the dynamics of the interplay between poor mental wellbeing, energy balance-related behaviors, and adolescent overweight and obesity prevalence and (2) test the effect of intervention point scenarios to reduce adolescent obesity. Drawing on the youth-generated systems maps and a literature synthesis, we built a simulation model that represents the links from major feedback pathways for poor mental wellbeing to changes in dietary, physical activity, and sleep behaviors. The model was calibrated using survey data from Norway, expert input, and literature and shows a good fit between simulated behavior and available statistical data. The simulations indicate that adolescent mental wellbeing is harmed by socio-cultural pressures and stressors, which trigger reinforcing feedback mechanisms related to emotional/binge eating, lack of motivation to engage in physical activity, and sleep difficulty. Targeting a combination of intervention points that support a 25% reduction of pressure on body image and psychosocial stress showed potentially favorable effects on mental wellbeing-doubling on average for boys and girls and decreasing obesity prevalence by over 4%.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37722825,

title = {Aetiology, ejection fraction and mortality in chronic heart failure: a mediation analysis},

author = {Josef Fritz and Katrin Belovari and Hanno Ulmer and Marc-Michael Zaruba and Moritz Messner and Maria Ungericht and Uwe Siebert and Frank Ruschitzka and Axel Bauer and Gerhard Poelzl},

doi = {10.1136/heartjnl-2023-322803},

issn = {1468-201X},

year  = {2023},

date = {2023-09-01},

journal = {Heart},

abstract = {OBJECTIVE: Clinical decision making in chronic heart failure (CHF) is based primarily on left ventricular ejection fraction (LVEF), and only secondarily on aetiology of the underlying disease. Our aim was to investigate the mediating role of LVEF in the relationship between aetiology and mortality.nnMETHODS: Using data of 2056 Austrian patients with CHF (mean age 57.2 years; mean follow-up 8.8 years), effects of aetiology on LVEF and overall mortality were estimated using multivariable-adjusted linear and Cox regression models. In causal mediation analyses, we decomposed the total effect of aetiology on mortality into direct and indirect (mediated through LVEF) effects.nnRESULTS: For the analysed aetiologies (dilated (DCM, n=1009) and hypertrophic (HCM, n=89) cardiomyopathy; ischaemic (IHD, n=529) and hypertensive (HHD, n=320) heart disease; cardiac amyloidosis (CA, n=109)), the effect of LVEF on mortality was similar (HR=1.07, 95% CI 1.04 to 1.10; p=0.718). HCM and CA were associated with significantly higher, and IHD and DCM with significantly lower LVEF compared with other aetiologies. Compared with respective other aetiologies, the corresponding total effect HRs for mortality were 0.77 (95% CI 0.67 to 0.89), 0.47 (95% CI 0.25 to 0.88), 1.40 (95% CI 1.21 to 1.62), 0.79 (95% CI 0.67 to 0.95) and 2.36 (95% CI 1.81 to 3.08) for DCM, HCM, IHD, HHD and CA, respectively. CA had the highest mortality despite a HR of 0.74 (95% CI 0.65 to 0.83). For all other aetiologies, <20% of the total mortality effects were mediated through LVEF.nnCONCLUSIONS: The direct effect of aetiology on mortality dominates the indirect effect through LVEF. Therefore, clarification of aetiology is as important as measurement of LVEF.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{pmid37660758,

title = {Dynamics of colorectal cancer screening in low and middle-income countries: A modeling analysis from Thailand},

author = {Peeradon Wongseree and Zeynep Hasgul and Borwornsom Leerapan and Cherdsak Iramaneerat and Pochamana Phisalprapa and Mohammad S Jalali},

doi = {10.1016/j.ypmed.2023.107694},

issn = {1096-0260},

year  = {2023},

date = {2023-09-01},

journal = {Prev Med},

pages = {107694},

abstract = {BACKGROUND: Low and middle-income countries face constraints for early colorectal cancer (CRC) detection, including restricted access to care and low colonoscopy capacity. Considering these constraints, we studied strategies for increasing access to early CRC detection and reducing CRC progression and mortality rates in Thailand.nnMETHODS: We developed a system dynamics model to simulate CRC death and progression trends. We analyzed the impacts of increased access to screening via fecal immunochemical test and colonoscopy, improving access to CRC diagnosis among symptomatic individuals, and their combination.nnRESULTS: Projecting the status quo (2023-2032), deaths per 100 K people increase from 87.5 to 115.4, and CRC progressions per 100 K people rise from 131.8 to 159.8. In 2032, improved screening access prevents 2.5 CRC deaths and 2.5 progressions per 100 K people, with cumulative prevented 7 K deaths and 9 K progressions, respectively. Improved symptom evaluation access prevents 7.5 CRC deaths per 100 K with no effect on progression, totaling 35 K saved lives. A combined approach prevents 9.3 deaths and 1.8 progressions per 100 K, or 41 K and 7 K cumulatively. The combined strategy prevents most deaths; however, there is a tradeoff: It prevents fewer CRC progressions than screening access improvement. Increasing the current annual colonoscopy capacity (200K) to sufficient capacity (681 K), the combined strategy achieves the best results, preventing 15.0 CRC deaths and 10.3 CRC progressions per 100 K people, or 54 K and 30 K cumulatively.nnCONCLUSION: Until colonoscopy capacity increases, enhanced screening and symptom evaluation are needed simultaneously to curb CRC deaths, albeit not the best strategy for CRC progression prevention.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{pmid37256423,

title = {Screening for colorectal cancer : A recommendation statement of the Austrian National Committee for Cancer Screening},

author = {Gerald Gartlehner and Eva Schernhammer and Sigurd F Lax and Matthias Preusser and Herbert Bachler and Harald Tietzer and Maria Kletecka-Pulker and Helga Turnher and Uwe Siebert},

doi = {10.1007/s00508-023-02209-0},

issn = {1613-7671},

year  = {2023},

date = {2023-09-01},

urldate = {2023-05-01},

journal = {Wien Klin Wochenschr},

volume = {135},

issue = {17-18},

pages = {447-445},

abstract = {BACKGROUND: Colorectal cancer is the fourth most common cancer in Austria. To date, colorectal cancer screening in Austria remains opportunistic and includes colonoscopy or stool-based blood tests. The Austrian National Committee for Cancer Screening developed evidence-based recommendations for a nationwide organized colorectal cancer screening program.nnMETHODS: The methodological framework followed the approach of the United States Preventive Services Task Force. The evidence base underlying the newly developed recommendations comprised a review of the existing published evidence and a decision analytic model tailored to the Austrian context. Using a structured process, committee members considered 1) the magnitude of the net benefit of each screening strategy, 2) the certainty of evidence, and 3) the level of acceptance of the interventions among the target population.nnRECOMMENDATIONS: The Austrian National Committee for Cancer Screening recommends the implementation of a nationwide organized colorectal cancer screening program for all adults aged 45-75 years. For persons 65 years or older, screening decisions should occur on an individual basis in accordance with a person's overall health, prior screening history, and preferences. Specifically, the committee recommends either a 10-year screening colonoscopy or biennial fecal immunochemical tests with colonoscopy following a positive result, with both screening strategies considered equivalent. Each citizen should be able to make an informed decision about their preferred screening method. Switching between the two screening strategies should be possible. Following an unremarkable colonoscopy, screening by fecal immunochemical test (FIT) is only required after 10 years. Screening recommendations apply only to asymptomatic persons at average risk for colorectal cancer. The screening program must be pilot tested, and accompanied by a public information campaign, formative evaluation, quality assurance, and data collection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{pmid37196759,

title = {Increasing the initiation of antiretroviral therapy through optimal placement of diagnostic technologies for pediatric HIV in Zimbabwe: a modeling analysis},

author = {Melike Yildirim and Karen A Webb and Andrea L Ciaranello and Alyssa K Amick and Angela Mushavi and Anesu Chimwaza and Anneke Claypool and Tendayi Murape and Nicole C McCann and Clare F Flanagan and Mohammad S Jalali},

doi = {10.1016/j.ijid.2023.05.013},

issn = {1878-3511},

year  = {2023},

date = {2023-09-01},

urldate = {2023-09-01},

journal = {Int J Infect Dis},

volume = {134},

pages = {31-38},

abstract = {OBJECTIVES: Point-of-care (POC) devices for infant HIV testing provide timely result-return and increase ART initiation. We aimed to optimally locate POC devices to increase 30-day ART initiation in Matabeleland South, Zimbabwe.nnMETHODS: We developed an optimization model to identify locations for limited POC devices at health facilities, maximizing the number of infants who receive HIV test results and initiate ART within 30 days of testing. We compared location-optimization model results to non-model-based decision heuristics, which are more practical and less data intensive. Heuristics assign POC devices based on demand, test positivity, laboratory result-return probability, and POC machine functionality.nnRESULTS: With current placement of 11 existing POC machines, 37% of all tested infants with HIV were projected to receive results, 35% to initiate ART within 30 days of testing. With optimal placement of existing machines, 46% were projected to receive results and 44% to initiate ART within 30 days, retaining 3 machines in current locations, moving 8 to new facilities. Relocation based on the highest POC device functionality would be the best-performing heuristic decision (44% receiving results and 42% initiating ART withing 30 days), although it still would not perform as well as the optimization-based approach.nnCONCLUSION: Optimal and ad-hoc heuristic relocation of limited POC machines would increase timely result-return and ART initiation, without further, often costly, interventions. Location-optimization can enhance decision-making regarding placement of medical technologies for HIV care.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Swan2023,

title = {Confirmatory Factor Analysis and Measurement Invariance of the Functional Assessment of Cancer Therapy Lung Cancer Utility Index (FACT-LUI)},

author = {J. Shannon Swan and Michelle M. Langer},

doi = {10.1177/23814683231186992},

issn = {2381-4683},

year  = {2023},

date = {2023-08-27},

urldate = {2023-07-00},

journal = {MDM Policy \& Practice},

volume = {8},

number = {2},

pages = {23814683231186992},

publisher = {SAGE Publications},

abstract = {\<jats:p\> Background. A portion of the Functional Assessment of Cancer Therapy-Lung (FACT-L) instrument contributed to a previously published utility index, the FACT Lung Utility Index or FACT-LUI. Six FACT items representing lung cancer quality of life covered fatigue, pain, dyspnea, cough, anxiety, and depression. Two FACT items had been previously combined by the index authors into one for nausea and/or appetite loss, resulting in 7 final domains. Methods. The objective was to perform measurement invariance testing within a confirmatory factor analysis (CFA) framework to support the feasibility of using the FACT-LUI for non\textendashpreference-based psychometric applications. The original index patients comprised group 1, and similar FACT patient data ( n = 249) from another published study comprised group 2. One 2-factor model and two 1-factor CFA models were evaluated to assess measurement invariance across groups, using varying degrees of item parceling and a small number of residual covariances, all justified by the literature. Results. The 1-factor models were most optimal. A 1-factor model with 1 pair of items parceled showed invariance to the partial scalar level using usual fit criteria across groups, requiring 2 unconstrained intercepts. A 1-factor model with 3 pairs of justified parcels showed full configural, metric, and scalar invariance across groups. Conclusions. The FACT-LUI items fit a partially to fully invariant 1-factor model, suggesting feasibility for non\textendashpreference-based applications. Implications. Results suggest useful incorporation of the FACT-LUI into clinical trials with no substantial increased respondent burden, allowing preference-based and other psychometric applications from the same index items. \</jats:p\>\<jats:sec\>\<jats:title\>Highlights\</jats:title\>\<jats:p\> This work suggests that in addition to being originally designed for use as a utility index, the 7 FACT-LUI items together also fit simple CFA and measurement invariance models. This less expected result indicates that these items as a group are also potentially useful in non\textendashpreference-based applications. Clinical trials can make for challenging decisions concerning which patient-reported outcome measures to include without being burdensome. However, the literature suggests a need for improved reporting of quality of life in lung cancer in particular as well as cancer in general. Inclusion of more disease-specific items such as the FACT-LUI may allow for information gathering of both preference-based and non\textendashpreference-based data with less demand on patients, similar to what has been done with some generic instruments. \</jats:p\>\</jats:sec\>},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37561981,

title = {The Cholangiocarcinoma in the Young (CITY) Study: Tumor Biology, Treatment Patterns, and Survival Outcomes in Adolescent Young Adults With Cholangiocarcinoma},

author = {Leontios Pappas and Islam Baiev and Stephanie Reyes and Andrea Grace Bocobo and Apurva Jain and Kristen Spencer and Tri Minh Le and Osama E Rahma and Jordan Maurer and Jen Stanton and Karen Zhang and Anaemy Danner De Armas and Thomas T Deleon and Marc Roth and Mary Linton B Peters and Andrew X Zhu and Kylie Boyhen and Christine VanCott and Tushar Patel and Lewis R Roberts and Stacie Lindsey and Nora Horick and Jochen K Lennerz and A John Iafrate and Laura Williams Goff and Kabir Mody and Mitesh J Borad and Rachna T Shroff and Milind M Javle and R Katie Kelley and Lipika Goyal},

doi = {10.1200/PO.22.00594},

issn = {2473-4284},

year  = {2023},

date = {2023-08-01},

journal = {JCO Precis Oncol},

volume = {7},

pages = {e2200594},

abstract = {PURPOSE: Increased awareness of the distinct tumor biology for adolescents and young adults (AYAs) with cancer has led to improvement in outcomes for this population. However, in cholangiocarcinoma (CCA), a paucity of data exist on the AYA population. To our knowledge, we present the largest study to date on AYA disease biology, treatment patterns, and survival outcomes in CCA.nnMETHODS: A multi-institutional cohort of patients with CCA diagnosed with intrahepatic cholangiocarcinoma (ICC) or extrahepatic cholangiocarcinoma (ECC) was used for analysis. Retrospective chart review was conducted on patients who were 50 years old and younger (young; n = 124) and older than 50 years (older; n = 723).nnRESULTS: Among 1,039 patients screened, 847 patients met eligibility (72% ICC, 28% ECC). Young patients had a larger median tumor size at resection compared with older patients (4.2  3.6 cm;  .048), more commonly had N1 disease (65%  43%;  .040), and were more likely to receive adjuvant therapy (odds ratio, 4.0; 95% CI, 1.64 to 9.74). Tumors of young patients were more likely to harbor an  fusion,  mutation, or  mutation ( .05 for each). Young patients were more likely to receive palliative systemic therapy (96%  69%;  .001), targeted therapy (23%  8%;  .001), and treatment on a clinical trial (31%  19%;  .004). Among patients who presented with advanced disease, young patients had a higher median overall survival compared with their older counterparts (17.7  13.5 months; 95% CI, 12.6 to 22.6  11.4 to 14.8;  .049).nnCONCLUSION: Young patients with CCA had more advanced disease at resection, more commonly received both adjuvant and palliative therapies, and demonstrated improved survival compared with older patients. Given the low clinical trial enrollment and poor outcomes among some AYA cancer populations, data to the contrary in CCA are highly encouraging.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{pmid37060168,

title = {Optimizing outcomes in heart failure: 2022 and beyond},

author = {Ewa A Jankowska and Tomas Andersson and Claudia Kaiser-Albers and Biykem Bozkurt and Ovidiu Chioncel and Andrew J S Coats and Loreena Hill and Friedrich Koehler and Lars H Lund and Theresa McDonagh and Marco Metra and Clemens Mittmann and Wilfried Mullens and Uwe Siebert and Scott D Solomon and Maurizio Volterrani and John J V McMurray},

doi = {10.1002/ehf2.14363},

issn = {2055-5822},

year  = {2023},

date = {2023-08-01},

journal = {ESC Heart Fail},

volume = {10},

number = {4},

pages = {2159--2169},

abstract = {Although the development of therapies and tools for the improved management of heart failure (HF) continues apace, day-to-day management in clinical practice is often far from ideal. A Cardiovascular Round Table workshop was convened by the European Society of Cardiology (ESC) to identify barriers to the optimal implementation of therapies and guidelines and to consider mitigation strategies to improve patient outcomes in the future. Key challenges identified included the complexity of HF itself and its treatment, financial constraints and the perception of HF treatments as costly, failure to meet the needs of patients, suboptimal outpatient management, and the fragmented nature of healthcare systems. It was discussed that ongoing initiatives may help to address some of these barriers, such as changes incorporated into the 2021 ESC HF guideline, ESC Heart Failure Association quality indicators, quality improvement registries (e.g. EuroHeart), new ESC guidelines for patients, and the universal definition of HF. Additional priority action points discussed to promote further improvements included revised definitions of HF 'phenotypes' based on trial data, the development of implementation strategies, improved affordability, greater regulator/payer involvement, increased patient education, further development of patient-reported outcomes, better incorporation of guidelines into primary care systems, and targeted education for primary care practitioners. Finally, it was concluded that overarching changes are needed to improve current HF care models, such as the development of a standardized pathway, with a common adaptable digital backbone, decision-making support, and data integration, to ensure that the model 'learns' as the management of HF continues to evolve.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{pmid37079205,

title = {Assessing the Complex General Surgical Oncology Pipeline: Trends in Race and Ethnicity Among US Medical Students, General Surgery Residents, and Complex General Surgical Oncology Trainees},

author = {Reagan A Collins and Salma A Sheriff and Christopher Yoon and Adrianne N Cobb and Anai N Kothari and Lisa A Newman and Lesly A Dossett and Alliric I Willis and Sandra L Wong and Callisia N Clarke},

doi = {10.1245/s10434-023-13499-z},

issn = {1534-4681},

year  = {2023},

date = {2023-08-01},

journal = {Ann Surg Oncol},

volume = {30},

number = {8},

pages = {4579--4586},

abstract = {BACKGROUND: Cancer incidence is expected to increase in coming decades, disproportionately so among minoritized communities. Racially and ethnically concordant care is essential to addressing disparities in cancer outcomes within at-risk groups. Here, we assess trends in racial and ethnic representation of medical students (MS), general surgery (GS) residents, and complex general surgical oncology (CGSO) fellows.nnMETHODS: This is a retrospective review of data from the American Association of Medical Colleges and the Accreditation Council of Medical Education (ACGME) from 2015 to 2020. Self-reported race and ethnicity was obtained for MS, GS, and CGSO trainees. Race and ethnicity proportions were compared with respective representation in the 2020 US Census. Mann-Kendall, Wilcoxon rank sum, and linear regression were used to assess trends, as appropriate.nnRESULTS: A total of 316,448 MS applicants, 128,729 MS matriculants, 27,574 GS applicants, 46,927 active GS residents, 710 CGSO applicants, and 659 active CGSO fellows were included. With every progressive stage in training, there was a smaller proportion of URM active trainees than applicants. Further, URM, Hispanic/Latino, and Black/African American trainees were significantly underrepresented compared with 2020 Census data. While the proportion of White CGSO fellows increased over time (54.5-69.2%, p = 0.009), the proportion of Black/African American and Hispanic/Latino (URM) CGSO fellows did not significantly change over the study period, though URM representation was lower in 2020 as compared with 2015.nnDISCUSSION: From 2015 to 2020, minority representation decreased at every advancing stage in surgical oncology training. Efforts to address barriers for URM applicants to CGSO fellowships are needed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37191861,

title = {ASO Visual Abstract: Assessing the Complex General Surgical Oncology Pipeline-Trends in Race and Ethnicity Among US Medical Students, General Surgery Residents, and Complex General Surgical Oncology Trainees},

author = {Reagan A Collins and Salma A Sheriff and Christopher Yoon and Adrianne N Cobb and Anai N Kothari and Lisa A Newman and Lesly A Dossett and Alliric I Willis and Sandra L Wong and Callisia N Clarke},

doi = {10.1245/s10434-023-13609-x},

issn = {1534-4681},

year  = {2023},

date = {2023-08-01},

urldate = {2023-05-01},

journal = {Ann Surg Oncol},

volume = {30},

issue = {8},

pages = {4587-4588},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36799870,

title = {Long-Term Effects of Increasing Buprenorphine Treatment Seeking, Duration, and Capacity on Opioid Overdose Fatalities: A Model-Based Analysis},

author = {Erin J Stringfellow and Tse Yang Lim and Catherine DiGennaro and Ziyuan Zhang and Pritika Paramasivam and Benjamin Bearnot and Keith Humphreys and Mohammad S Jalali},

doi = {10.1097/ADM.0000000000001153},

issn = {1935-3227},

year  = {2023},

date = {2023-08-01},

urldate = {2023-02-01},

journal = {J Addict Med},

volume = {17},

issue = {4},

pages = {439-446},

abstract = {OBJECTIVES: Because buprenorphine treatment of opioid use disorder reduces opioid overdose deaths (OODs), expanding access to care is an important policy and clinical care goal. Policymakers must choose within capacity limitations whether to expand the number of people with opioid use disorder who are treated or extend duration for existing patients. This inherent tradeoff could be made less acute with expanded buprenorphine treatment capacity.



METHODS: To inform such decisions, we used a validated simulation model to project the effects of increasing buprenorphine treatment-seeking, average episode duration, and capacity (patients per provider) on OODs in the United States from 2023 to 2033, varying the start time to assess the effects of implementation delays.



RESULTS: Results show that increasing treatment duration alone could cost lives in the short term by reducing capacity for new admissions yet save more lives in the long term than accomplished by only increasing treatment seeking. Increasing provider capacity had negligible effects. The most effective 2-policy combination was increasing capacity and duration simultaneously, which would reduce OODs up to 18.6% over a decade. By 2033, the greatest reduction in OODs (≥20%) was achieved when capacity was doubled and average duration reached 2 years, but only if the policy changes started in 2023. Delaying even a year diminishes the benefits. Treatment-seeking increases were equally beneficial whether they began in 2023 or 2025 but of only marginal benefit beyond what capacity and duration achieved.



CONCLUSIONS: If policymakers only target 2 policies to reduce OODs, they should be to increase capacity and duration, enacted quickly and aggressively.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37461007,

title = {A multimorbidity model for estimating health outcomes from the syndemic of injection drug use and associated infections in the United States},

author = {John J Chiosi and Peter P Mueller and Jagpreet Chhatwal and Andrea L Ciaranello},

doi = {10.1186/s12913-023-09773-1},

issn = {1472-6963},

year  = {2023},

date = {2023-07-17},

urldate = {2023-07-01},

journal = {BMC Health Serv Res},

volume = {23},

number = {1},

pages = {760},

abstract = {BACKGROUND: Fatal drug overdoses and serious injection-related infections are rising in the US. Multiple concurrent infections in people who inject drugs (PWID) exacerbate poor health outcomes, but little is known about how the synergy among infections compounds clinical outcomes and costs. Injection drug use (IDU) converges multiple epidemics into a syndemic in the US, including opioid use and HIV. Estimated rates of new injection-related infections in the US are limited due to widely varying estimates of the number of PWID in the US, and in the absence of clinical trials and nationally representative longitudinal observational studies of PWID, simulation models provide important insights to policymakers for informed decisions.nnMETHODS: We developed and validated a MultimorbiditY model to Reduce Infections Associated with Drug use (MYRIAD). This microsimulation model of drug use and associated infections (HIV, hepatitis C virus [HCV], and severe bacterial infections) uses inputs derived from published data to estimate national level trends in the US. We used Latin hypercube sampling to calibrate model output against published data from 2015 to 2019 for fatal opioid overdose rates. We internally validated the model for HIV and HCV incidence and bacterial infection hospitalization rates among PWID. We identified best fitting parameter sets that met pre-established goodness-of-fit targets using the Pearson's chi-square test. We externally validated the model by comparing model output to published fatal opioid overdose rates from 2020.nnRESULTS: Out of 100 sample parameter sets for opioid use, the model produced 3 sets with well-fitting results to key calibration targets for fatal opioid overdose rates with Pearson's chi-square test ranging from 1.56E-5 to 2.65E-5, and 2 sets that met validation targets. The model produced well-fitting results within validation targets for HIV and HCV incidence and serious bacterial infection hospitalization rates. From 2015 to 2019, the model estimated 120,000 injection-related overdose deaths, 17,000 new HIV infections, and 144,000 new HCV infections among PWID.nnCONCLUSIONS: This multimorbidity microsimulation model, populated with data from national surveillance data and published literature, accurately replicated fatal opioid overdose, incidence of HIV and HCV, and serious bacterial infections hospitalization rates. The MYRIAD model of IDU could be an important tool to assess clinical and economic outcomes related to IDU behavior and infections with serious morbidity and mortality for PWID.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37014086,

title = {Urban and Rural Surgical Practice Patterns for Papillary Thyroid Carcinoma},

author = {Reagan A Collins and Natalia Chaves and Gillian Lee and Jordan M Broekhuis and Benjamin C James},

doi = {10.1089/thy.2022.0711},

issn = {1557-9077},

year  = {2023},

date = {2023-07-01},

journal = {Thyroid},

volume = {33},

number = {7},

pages = {849--857},

abstract = { The 2015 American Thyroid Association (ATA) guidelines shifted recommendations toward less aggressive management of papillary thyroid cancer (PTC). Subsequently, several studies demonstrated a trend in performing thyroid lobectomy (TL) over total thyroidectomy (TT). However, regional variation has persisted without a clear indication of what factors may be influencing practice variation. We aimed to evaluate the surgical management of PTC in patients in rural and urban settings to assess trends of TL compared with TT following the implementation of the 2015 ATA guidelines.  A retrospective cohort analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2019 of patients with localized PTC <4 cm who underwent TT or TL. Patients were classified as living in urban or rural counties based on the 2013 Rural-Urban Continuum Codes. Procedures performed from 2004 to 2015 were categorized as preguidelines, while those performed from 2016 to 2019 were categorized as postguidelines. Chi-square, Student's -test, logistic regression, and Cochran-Mantel-Haenszel test were used.  A total of 89,294 cases were included in the study. Eighty thousand one hundred and fifty (89.8%) were from urban settings and 9144 (9.2%) were from rural settings. Patients from rural settings were older (52 vs. 50 years,  < 0.001) and had smaller nodules ( < 0.001). On adjusted analysis, patients in rural areas were less likely to undergo TT (adjusted odds ratio 0.81, confidence interval [CI] 0.76-0.87). Before the 2015 guidelines, patients in urban settings had a 24% higher odds of undergoing TT compared with those in rural settings (odds ratio 1.24, CI 1.16-1.32,  < 0.001). There was no difference in the proportions of TT and TL based on setting following guideline implementation ( = 0.185).  The 2015 ATA guidelines led to a change in overall practice in surgical management of PTC toward increasing TL. While urban and rural practice variation existed before 2015, both settings had an increase in TL following the guideline change, emphasizing the importance of clinical practice guidelines to ensure best practice in both rural and urban settings.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37454978,

title = {NordICC trial results in line with expected colorectal cancer mortality reduction after colonoscopy: a modelling study},

author = {Danica M N van den Berg and Pedro Nascimento de Lima and Amy B Knudsen and Carolyn M Rutter and David Weinberg and Iris Lansdorp-Vogelaar and },

doi = {10.1053/j.gastro.2023.06.035},

issn = {1528-0012},

year  = {2023},

date = {2023-07-01},

journal = {Gastroenterology},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@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}

}

@article{pmid37392171,

title = {Updated COVID-19 clearance time among patients with cancer in the Delta and Omicron waves},

author = {Zachary M Avigan and Rodrigo Paredes and Leora S Boussi and Barbara D Lam and Meghan E Shea and Matthew J Weinstock and Mary Linton B Peters},

doi = {10.1002/cam4.6311},

issn = {2045-7634},

year  = {2023},

date = {2023-07-01},

journal = {Cancer Med},

abstract = {BACKGROUND: COVID-19 infection delays therapy and in-person evaluation for oncology patients, but clinic clearance criteria are not clearly defined.nnMETHODS: We conducted a retrospective review of oncology patients with COVID-19 at a tertiary care center during the Delta and Omicron waves and compared clearance strategies.nnRESULTS: Median clearance by two consecutive negative tests was 32.0 days (Interquartile Range [IQR] 22.0-42.5, n = 153) and was prolonged in hematologic malignancy versus solid tumors (35.0 days for hematologic malignancy, 27.5 days for solid tumors, p = 0.01) and in patients receiving B-cell depletion versus other therapies. Median clearance by single negative test was reduced to 23.0 days (IQR 16.0-33.0), with recurrent positive rate 25.4% in hematologic malignancy versus 10.6% in solid tumors (p = 0.02). Clearance by a predefined waiting period required 41 days until an 80% negative rate.nnCONCLUSIONS: COVID-19 clearance remains prolonged in oncology patients. Single-negative test clearance can balance delays in care with risk of infection in patients with solid tumors.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37081811,

title = {Guidance on the use of complex systems models for economic evaluations of public health interventions},

author = {Penny R Breeze and Hazel Squires and Kate Ennis and Petra Meier and Kate Hayes and Nik Lomax and Alan Shiell and Frank Kee and Frank de Vocht and Martin O'Flaherty and Nigel Gilbert and Robin Purshouse and Stewart Robinson and Peter J Dodd and Mark Strong and Suzy Paisley and Richard Smith and Andrew Briggs and Lion Shahab and Jo-An Occhipinti and Kenny Lawson and Thomas Bayley and Robert Smith and Jennifer Boyd and Visakan Kadirkamanathan and Richard Cookson and Monica Hernandez-Alava and Christopher H Jackson and Amanda Karapici and Franco Sassi and Peter Scarborough and Uwe Siebert and Eric Silverman and Luke Vale and Cathal Walsh and Alan Brennan},

doi = {10.1002/hec.4681},

issn = {1099-1050},

year  = {2023},

date = {2023-07-01},

journal = {Health Econ},

volume = {32},

number = {7},

pages = {1603--1625},

abstract = {To help health economic modelers respond to demands for greater use of complex systems models in public health. To propose identifiable features of such models and support researchers to plan public health modeling projects using these models. A working group of experts in complex systems modeling and economic evaluation was brought together to develop and jointly write guidance for the use of complex systems models for health economic analysis. The content of workshops was informed by a scoping review. A public health complex systems model for economic evaluation is defined as a quantitative, dynamic, non-linear model that incorporates feedback and interactions among model elements, in order to capture emergent outcomes and estimate health, economic and potentially other consequences to inform public policies. The guidance covers: when complex systems modeling is needed; principles for designing a complex systems model; and how to choose an appropriate modeling technique. This paper provides a definition to identify and characterize complex systems models for economic evaluations and proposes guidance on key aspects of the process for health economics analysis. This document will support the development of complex systems models, with impact on public health systems policy and decision making.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37040047,

title = {Adoption of Robotic Adrenalectomy: A Two-Institution Study of Surgeon Learning Curve},

author = {Reagan A Collins and Tracy S Wang and Sophie Dream and Carmen C Sol\'{o}rzano and Colleen M Kiernan},

doi = {10.1245/s10434-023-13406-6},

issn = {1534-4681},

year  = {2023},

date = {2023-07-01},

urldate = {2023-04-01},

journal = {Ann Surg Oncol},

volume = {30},

issue = {7},

pages = {4167-4178},

abstract = {BACKGROUND: Robotic adrenalectomy is feasible and safe, yet concerns over increased operative times and the learning curve (LC) for proficiency have limited its adoption. This study aimed to assess the LC for robotic adrenalectomy.nnMETHODS: This is a two-institution retrospective review of consecutive unilateral minimally invasive adrenalectomies performed by four high-volume adrenal surgeons between 2007 and 2022. Two surgeons transitioned from laparoscopic to robotic adrenalectomy, and two surgeons adopted the approach, with proctoring, after completion of fellowship training without robotic experience. Operative time and complications were analyzed. Multivariable regression was used to identify factors associated with operative time. The number of cases required to overcome the LC was determined using the LC-cumulative-sum (LC-CUSUM) analysis.nnRESULTS: Of 457 adrenalectomies, 182 (40%) were laparoscopic and 275 (60%) robotic. The robotic approach was associated with shorter median operative time (106 vs 119 min; p = 0.002), fewer complications (6% vs 13%; p = 0.018), and fewer conversions to open adrenalectomy (1% vs 4%; p = 0.030), with no difference between the senior and junior surgeons. On adjusted analysis, factors associated with increased operative time were male sex (p \< 0.001), BMI \> 30 kg/m (p \< 0.001), and higher gland weight (p \< 0.001). The LC-CUSUM analysis showed proficiency after 8-29 procedures. Compared with the first 10 cases, there was a mean reduction in operative time of 14 min after 10-20 cases, 28 min after 20-30 cases, and 29 min after \> 30 cases, regardless of surgeon experience.nnDISCUSSION: With dedicated teams and proctoring, robotic adrenalectomy can be safely adopted at high-volume centers with a minimal LC.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37040051,

title = {ASO Visual Abstract: Adoption of Robotic Adrenalectomy: A Two-Institution Study of Surgeon Learning Curve},

author = {Reagan A Collins and Tracy S Wang and Sophie Dream and Carmen C Sol\'{o}rzano and Colleen M Kiernan},

doi = {10.1245/s10434-023-13492-6},

issn = {1534-4681},

year  = {2023},

date = {2023-07-01},

urldate = {2023-07-01},

journal = {Ann Surg Oncol},

volume = {30},

issue = {7},

pages = {4179},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36948424,

title = {Randomized Trial of Facilitated Adherence to Screening Colonoscopy vs Sequential Fecal-Based Blood Test},

author = {Ann G Zauber and Sidney J Winawer and Michael J O'Brien and Glenn M Mills and John I Allen and Andrew D Feld and Paul A Jordan and Martin Fleisher and Irene Orlow and Reinier G S Meester and Iris Lansdorp-Vogelaar and Carolyn M Rutter and Amy B Knudsen and Margaret Mandelson and Aasma Shaukat and Robin B Mendelsohn and Anne I Hahn and Stephanie M Lobaugh and Brittany Soto Palmer and Victoria Serrano and Julie R Kumar and Sara E Fischer and Jennifer C Chen and Sharon Bayuga-Miller and Deborah Kuk and Kelli O'Connell and Timothy R Church},

doi = {10.1053/j.gastro.2023.03.206},

issn = {1528-0012},

year  = {2023},

date = {2023-07-01},

urldate = {2023-03-01},

journal = {Gastroenterology},

volume = {165},

issue = {1},

pages = {252-266},

abstract = {BACKGROUND \& AIMS: Colorectal cancer (CRC) screening guidelines include screening colonoscopy and sequential high-sensitivity fecal occult blood testing (HSgFOBT), with expectation of similar effectiveness based on the assumption of similar high adherence. However, adherence to screening colonoscopy compared with sequential HSgFOBT has not been reported. In this randomized clinical trial, we assessed adherence and pathology findings for a single screening colonoscopy vs sequential and nonsequential HSgFOBTs.nnMETHODS: Participants aged 40-69 years were enrolled at 3 centers representing different clinical settings. Participants were randomized into a single screening colonoscopy arm vs sequential HSgFOBT arm composed of 4-7 rounds. Initial adherence to screening colonoscopy and sequential adherence to HSgFOBT, follow-up colonoscopy for positive HSgFOBT tests, crossover to colonoscopy, and detection of advanced neoplasia or large serrated lesions (ADN-SERs) were measured.nnRESULTS: There were 3523 participants included in the trial; 1761 and 1762 participants were randomized to the screening colonoscopy and HSgFOBT arms, respectively. Adherence was 1473 (83.6%) for the screening colonoscopy arm vs 1288 (73.1%) for the HSgFOBT arm after 1 round (relative risk [RR], 1.14; 95% CI, 1.10-1.19; P ≤ .001), but only 674 (38.3%) over 4 sequential HSgFOBT rounds (RR, 2.19; 95% CI, 2.05-2.33). Overall adherence to any screening increased to 1558 (88.5%) in the screening colonoscopy arm during the entire study period and 1493 (84.7%) in the HSgFOBT arm (RR, 1.04; 95% CI, 1.02-1.07). Four hundred thirty-six participants (24.7%) crossed over to screening colonoscopy during the first 4 rounds. ADN-SERs were detected in 121 of the 1473 participants (8.2%) in the colonoscopy arm who were adherent to protocol in the first 12 months of the study, whereas detection of ADN-SERs among those who were not sequentially adherent (n = 709) to HSgFOBT was subpar (0.6%) (RR, 14.72; 95% CI, 5.46-39.67) compared with those who were sequentially adherent (3.3%) (n = 647) (RR, 2.52; 95% CI, 1.61-3.98) to HSgFOBT in the first 4 rounds. When including colonoscopies from HSgFOBT patients who were never positive yet crossed over (n = 1483), 5.5% of ADN-SERs were detected (RR, 1.50; 95% CI, 1.15-1.96) in the first 4 rounds.nnCONCLUSIONS: Observed adherence to sequential rounds of HSgFOBT was suboptimal compared with a single screening colonoscopy. Detection of ADN-SERs was inferior when nonsequential HSgFOBT adherence was compared with sequential adherence. However, the greatest number of ADN-SERs was detected among those who crossed over to colonoscopy and opted to receive a colonoscopy. The effectiveness of an HSgFOBT screening program may be enhanced if crossover to screening colonoscopy is permitted.nnCLINICALTRIALS: gov, Number: NCT00102011.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36216684,

title = {Improving Prostate Cancer Detection With MRI: A Multi-Reader, Multi-Case Study Using Computer-Aided Detection (CAD)},

author = {Mark A Anderson and Sarah Mercaldo and Ryan Chung and Ethan Ulrich and Randall W Jones and Mukesh Harisinghani},

doi = {10.1016/j.acra.2022.09.009},

issn = {1878-4046},

year  = {2023},

date = {2023-07-01},

urldate = {2022-10-01},

journal = {Acad Radiol},

volume = {30},

issue = {7},

pages = {1340-1349},

abstract = {RATIONALE AND OBJECTIVES: To evaluate whether addition of a computer-aided diagnostic (CAD) generated MRI series improves detection of clinically significant prostate cancer.



MATERIALS AND METHODS: Nine radiologists retrospectively interpreted 150 prostate MRI examinations without and then with an additional random forest-based CAD model-generated MRI series. Characteristics of biopsy negative versus positive (Gleason ≥ 7 adenocarcinoma) groups were compared using the Wilcoxon test for continuous and Pearson's chi-squared test for categorical variables. The diagnostic performance of readers was compared without versus with CAD using MRMC methods to estimate the area under the receiver operator characteristic curve (AUC). Inter-reader agreement was assessed using weighted inter-rater agreement statistics. Analyses were repeated in peripheral and transition zone subgroups.



RESULTS: Among 150 men with median age 67 ± 7.4 years, those with clinically significant prostate cancer were older (68 ± 7.6 years vs. 66 ± 7.0 years; p \< .02), had smaller prostate volume (43.9 mL vs. 60.6 mL; p \< .001), and no difference in prostate specific antigen (PSA) levels (7.8 ng/mL vs. 6.9 ng/mL; p = .08), but higher PSA density (0.17 ng/mL/cc vs. 0.10 ng/mL/cc; p \< .001). Inter-rater agreement (IRA) for PI-RADS scores was moderate without CAD and significantly improved to substantial with CAD (IRA = 0.47 vs. 0.65; p \< .001). CAD also significantly improved average reader AUC (AUC = 0.72, vs. AUC = 0.67; p = .02).



CONCLUSION: Addition of a random forest method-based, CAD-generated MRI image series improved inter-reader agreement and diagnostic performance for detection of clinically significant prostate cancer, particularly in the transition zone.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37679137,

title = {Deep reinforcement learning framework for controlling infectious disease outbreaks in the context of multi-jurisdictions},

author = {Seyedeh Nazanin Khatami and Chaitra Gopalappa},

doi = {10.3934/mbe.2023640},

issn = {1551-0018},

year  = {2023},

date = {2023-06-01},

journal = {Math Biosci Eng},

volume = {20},

number = {8},

pages = {14306--14326},

abstract = {In the absence of pharmaceutical interventions, social distancing and lockdown have been key options for controlling new or reemerging respiratory infectious disease outbreaks. The timely implementation of these interventions is vital for effectively controlling and safeguarding the economy.Motivated by the COVID-19 pandemic, we evaluated whether, when, and to what level lockdowns are necessary to minimize epidemic and economic burdens of new disease outbreaks. We formulated the question as a sequential decision-making Markov Decision Process and solved it using deep Q-network algorithm. We evaluated the question under two objective functions: a 2-objective function to minimize economic burden and hospital capacity violations, suitable for diseases with severe health risks but with minimal death, and a 3-objective function that additionally minimizes the number of deaths, suitable for diseases that have high risk of mortality.A key feature of the model is that we evaluated the above questions in the context of two-geographical jurisdictions that interact through travel but make autonomous and independent decisions, evaluating under cross-jurisdictional cooperation and non-cooperation. In the 2-objective function under cross-jurisdictional cooperation, the optimal policy was to aim for shutdowns at 50 and 25% per day. Though this policy avoided hospital capacity violations, the shutdowns extended until a large proportion of the population reached herd immunity. Delays in initiating this optimal policy or non-cooperation from an outside jurisdiction required shutdowns at a higher level of 75% per day, thus adding to economic burdens. In the 3-objective function, the optimal policy under cross-jurisdictional cooperation was to aim for shutdowns of up to 75% per day to prevent deaths by reducing infected cases. This optimal policy continued for the entire duration of the simulation, suggesting that, until pharmaceutical interventions such as treatment or vaccines become available, contact reductions through physical distancing would be necessary to minimize deaths. Deviating from this policy increased the number of shutdowns and led to several deaths.In summary, we present a decision-analytic methodology for identifying optimal lockdown strategy under the context of interactions between jurisdictions that make autonomous and independent decisions. The numerical analysis outcomes are intuitive and, as expected, serve as proof of the feasibility of such a model. Our sensitivity analysis demonstrates that the optimal policy exhibits robustness to minor alterations in the transmission rate, yet shows sensitivity to more substantial deviations. This finding underscores the dynamic nature of epidemic parameters, thereby emphasizing the necessity for models trained across a diverse range of values to ensure effective policy-making.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37365514,

title = {Decision-analytic evaluation of the comparative effectiveness and cost-effectiveness of strategies to prevent breast and ovarian cancer in German women with BRCA-1/2 mutations},

author = {L\'{a}ra R Hallsson and Gaby Sroczynski and Jutta Engel and Uwe Siebert},

doi = {10.1186/s12885-023-10956-6},

issn = {1471-2407},

year  = {2023},

date = {2023-06-01},

journal = {BMC Cancer},

volume = {23},

number = {1},

pages = {590},

abstract = {BACKGROUND: Women with inherited mutations in the BRCA1 or BRCA2 genes have increased lifetime risks for developing breast and/or ovarian cancer and may develop these cancers around the age of 30 years. Therefore, prevention of breast and ovarian cancer in these women may need to start relatively early in life. In this study we systematically evaluate the long-term effectiveness and cost effectiveness of different prevention strategies for breast and ovarian cancer in women with BRCA-1/2 mutation in Germany.nnMETHODS: A decision-analytic Markov model simulating lifetime breast and ovarian cancer development in BRCA-1/2 carriers was developed. Different strategies including intensified surveillance (IS), prophylactic bilateral mastectomy (PBM), and prophylactic bilateral salpingo-oophorectomy (PBSO) alone or in combination at different ages were evaluated. German clinical, epidemiological, and economic (in 2022 Euro) data were used. Outcomes included cancer incidences, mortality, life years (LYs), quality-adjusted life years (QALYs), and discounted incremental cost-effectiveness ratios (ICER). We adopted the German health-care system perspective and discounted costs and health effects with 3% annually.nnRESULTS: All intervention strategies are more effective and less costly than IS alone. Prevention with PBM plus PBSO at age 30 maximizes life expectancy with 6.3 LYs gained, whereas PBM at age 30 with delayed PBSO at age 35 improves quality of life with 11.1 QALYs gained, when compared to IS alone. A further delay of PBSO was associated with lower effectiveness. Both strategies are cost effective with ICERs significantly below 10,000 EUR/LYG or QALY.nnCONCLUSION: Based on our results, PBM at age 30 plus PBSO between age 30 and 40 prolongs life and is cost effective in women with BRCA-1/2 mutations in Germany. Serial preventive surgeries with delayed PBSO potentially improve quality of life for women. However, delaying PBM and/or PBSO further may lead to increased mortality and reduced QALYs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36607832,

title = {Determinants of low health-related quality of life in patients with myelodysplastic syndromes: EUMDS Registry study},

author = {Igor Stojkov and Annette Conrads-Frank and Ursula Rochau and Marjan Arvandi and Karin A Koinig and Michael Schomaker and Moshe Mittelman and Pierre Fenaux and David Bowen and Guillermo F Sanz and Luca Malcovati and Saskia Langemeijer and Ulrich Germing and Krzysztof Madry and Agn\`{e}s Guerci-Bresler and Dominic J Culligan and Ioannis Kotsianidis and Laurence Sanhes and Juliet Mills and Sibylle Puntscher and Daniela Schmid and Corine van Marrewijk and Alexandra Smith and Fabio Efficace and Theo de Witte and Reinhard Stauder and Uwe Siebert},

doi = {10.1182/bloodadvances.2022008360},

issn = {2473-9537},

year  = {2023},

date = {2023-06-01},

journal = {Blood Adv},

volume = {7},

number = {12},

pages = {2772--2783},

abstract = {Patients with myelodysplastic syndromes (MDS) frequently experience a significant symptom burden, which reduces health-related quality of life (HRQoL). We aimed to identify determinants of low HRQoL in patients recently diagnosed with MDS, for guiding early intervention strategies. We evaluated longitudinal data in 2205 patients with MDS during their first year after diagnosis. Median values of EQ-5D 3-level (EQ-5D-3L) index (0.78) and visual analog scale (VAS) score (0.70) were used as thresholds for low HRQoL. In addition, the 5 dimensions of EQ-5D-3L were analyzed for impairments (any level vs "no problem" category). After multiple imputation of missing values, we used generalized estimating equations (GEE) to estimate odds ratios (OR) for univariable determinant screening (P < .15), and to subsequently derive multivariable models for low HRQoL with 95% confidence intervals (CI). Multivariable GEE analysis showed the following independent determinants (OR, 95% CI) for low EQ-5D index: increased age (60-75 years: 1.33, 1.01-1.75; >75: 1.84, 1.39-2.45), female sex (1.70, 1.43-2.03), high serum ferritin level (≥1000 vs ≤300 μg/L: 1.41, 1.06-1.87), comorbidity burden (per unit: 1.11, 1.02-1.20), and reduced Karnofsky performance status (KPS, per 10 units: 0.62, 0.58-0.67). For low VAS score, additional determinants were transfusion dependence (1.53, 1.03-2.29), low hemoglobin <10 g/dL (1.34, 1.12-1.61), and high body mass index (≥30 vs 23-29.9 kg/m2: 1.26, 1.02-1.57). Sex, KPS, comorbidity burden, hemoglobin count, and transfusion burden were determinants for all EQ-5D dimensions. Low HRQoL is determined by multiple factors, which should be considered in the management and shared decision making of patients with MDS. This trial was registered at www.clinicaltrials.gov as #NCT00600860.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37294571,

title = {Estimated Reductions in Opioid Overdose Deaths With Sustainment of Public Health Interventions in 4 US States},

author = {Jagpreet Chhatwal and Peter P Mueller and Qiushi Chen and Neeti Kulkarni and Madeline Adee and Gary Zarkin and Marc R LaRochelle and Amy B Knudsen and Carolina Barbosa},

doi = {10.1001/jamanetworkopen.2023.14925},

issn = {2574-3805},

year  = {2023},

date = {2023-06-01},

journal = {JAMA Netw Open},

volume = {6},

number = {6},

pages = {e2314925},

abstract = {IMPORTANCE: In 2021, more than 80 000 US residents died from an opioid overdose. Public health intervention initiatives, such as the Helping to End Addiction Long-term (HEALing) Communities Study (HCS), are being launched with the goal of reducing opioid-related overdose deaths (OODs).nnOBJECTIVE: To estimate the change in the projected number of OODs under different scenarios of the duration of sustainment of interventions, compared with the status quo.nnDESIGN, SETTING, AND PARTICIPANTS: This decision analytical model simulated the opioid epidemic in the 4 states participating in the HCS (ie, Kentucky, Massachusetts, New York, and Ohio) from 2020 to 2026. Participants were a simulated population transitioning from opioid misuse to opioid use disorder (OUD), overdose, treatment, and relapse. The model was calibrated using 2015 to 2020 data from the National Survey on Drug Use and Health, the US Centers for Disease Control and Prevention, and other sources for each state. The model accounts for reduced initiation of medications for OUD (MOUDs) and increased OODs during the COVID-19 pandemic.nnEXPOSURE: Increasing MOUD initiation by 2- or 5-fold, improving MOUD retention to the rates achieved in clinical trial settings, increasing naloxone distribution efforts, and furthering safe opioid prescribing. An initial 2-year duration of interventions was simulated, with potential sustainment for up to 3 additional years.nnMAIN OUTCOMES AND MEASURES: Projected reduction in number of OODs under different combinations and durations of sustainment of interventions.nnRESULTS: Compared with the status quo, the estimated annual reduction in OODs at the end of the second year of interventions was 13% to 17% in Kentucky, 17% to 27% in Massachusetts, 15% to 22% in New York, and 15% to 22% in Ohio. Sustaining all interventions for an additional 3 years was estimated to reduce the annual number of OODs at the end of the fifth year by 18% to 27% in Kentucky, 28% to 46% in Massachusetts, 22% to 34% in New York, and 25% to 41% in Ohio. The longer the interventions were sustained, the better the outcomes; however, these positive gains would be washed out if interventions were not sustained.nnCONCLUSIONS AND RELEVANCE: In this decision analytical model study of the opioid epidemic in 4 US states, sustained implementation of interventions, including increased delivery of MOUDs and naloxone supply, was found to be needed to reduce OODs and prevent deaths from increasing again.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36436793b,

title = {Disability-Adjusted Life-Years for Drug Overdose Crisis and COVID-19 Are Comparable During the Two Years of Pandemic in the United States},

author = {Qiushi Chen and Paul M Griffin and Sarah S Kawasaki},

doi = {10.1016/j.jval.2022.11.010},

issn = {1524-4733},

year  = {2023},

date = {2023-06-01},

journal = {Value Health},

volume = {26},

number = {6},

pages = {796--801},

abstract = {OBJECTIVES: The drug overdose crisis with shifting patterns from primarily opioid to polysubstance uses and COVID-19 infections are 2 concurrent public health crises in the United States, affecting the population of sizes in different magnitudes (approximately < 10 million for substance use disorder [SUD] and drug overdoses vs 80 million for COVID-19 within 2 years of the pandemic). Our objective is to compare the relative scale of disease burden for the 2 crises within a common framework, which could help inform policy makers with resource allocation and prioritization strategies.nnMETHODS: We calculated disability-adjusted life-years (DALYs) for SUD (including opioids and stimulants) and COVID-19 infections, respectively. We collected estimates for SUD prevalence, overdose deaths, COVID-19 cases and deaths, disability weights, and life expectancy from multiple publicly available sources. We then compared age distributions of estimated DALYs.nnRESULTS: We estimated a total burden of 13.83 million DALYs for SUD and drug overdoses and 15.03 million DALYs for COVID-19 in 2 years since March 2020. COVID-19 burden was dominated by the fatal burden (> 95% of total DALYs), whereas SUD burden was attributed to both fatal (53%) and nonfatal burdens (47%). The highest disease burden was among individuals aged 30 to 39 years for SUD (27%) and 50 to 64 years for COVID-19 (31%).nnCONCLUSIONS: Despite the smaller size of the affected population, SUD and drug overdoses resulted in comparable disease burden with the COVID-19 pandemic. Additional resources supporting evidence-based interventions in prevention and treatment may be warranted to ameliorate SUD and drug overdoses during both the pandemic and postpandemic recovery.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37204402,

title = {Effectiveness of HCC surveillance programs using multitarget blood test: A modeling study},

author = {Jagpreet Chhatwal and Sumeyye Samur and Ju Dong Yang and Lewis R Roberts and Mindie H Nguyen and A Burak Ozbay and Turgay Ayer and Neehar D Parikh and Amit G Singal},

doi = {10.1097/HC9.0000000000000146},

issn = {2471-254X},

year  = {2023},

date = {2023-05-19},

urldate = {2023-06-01},

journal = {Hepatol Commun},

volume = {7},

number = {6},

pages = {e0146},

abstract = {BACKGROUND: The effectiveness of ultrasound-based surveillance for HCC in patients with cirrhosis is limited by suboptimal sensitivity for early tumor detection and poor adherence. Emerging blood-based biomarkers have been proposed as an alternative surveillance strategy. We aimed to evaluate the comparative effectiveness of a multitarget HCC blood test (mt-HBT)-with and without improved adherence-against ultrasound-based HCC surveillance.nnMETHODS: We developed a Markov-based mathematical model that simulated a virtual trial in patients with compensated cirrhosis comparing potential surveillance strategies: biannual surveillance using ultrasound, ultrasound plus AFP, and mt-HBT with or without improved adherence (+10% increase). We used published data to inform underlying liver disease progression rates, HCC tumor growth patterns, performance characteristics of surveillance modalities, and efficacy of treatments. Primary outcomes of interest were the number of early-stage HCCs detected and life years gained.nnRESULTS: Per 100,000 patients with cirrhosis, mt-HBT detected 1680 more early-stage HCCs than ultrasound alone and 350 more early-stage HCCs than ultrasound + AFP, yielding an additional 5720 and 1000 life years, respectively. mt-HBT with improved adherence detected 2200 more early-stage HCCs than ultrasound and 880 more early-stage HCCs than ultrasound + AFP, yielding an additional 8140 and 3420 life years, respectively. The number of screening tests needed to detect one HCC case was 139 with ultrasound, 122 with ultrasound + AFP, 119 with mt-HBT, and 124 with mt-HBT with improved adherence.nnCONCLUSIONS: mt-HBT is a promising alternative to ultrasound-based HCC surveillance, particularly given anticipated improved adherence with blood-based biomarkers could increase HCC surveillance effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37321128,

title = {Patient' and social aspects related to complementary mistletoe therapy in patients with breast cancer: A systematic review commissioned by the German agency for Health Technology Assessment},

author = {Caroline Steigenberger and Petra Schnell-Inderst and Magdalena Flatscher-Th\"{o}ni and Lisa-Maria Plank and Uwe Siebert},

doi = {10.1016/j.ejon.2023.102338},

issn = {1532-2122},

year  = {2023},

date = {2023-05-07},

urldate = {2023-05-01},

journal = {Eur J Oncol Nurs},

volume = {65},

pages = {102338},

abstract = {PURPOSE: To mitigate side effects of conventional cancer care and improve quality of life, many patients with breast cancer in German-speaking countries opt for mistletoe therapy in addition to standard treatment. To understand the value for users, we evaluated the domain "Patient and Social aspects" in a health technology assessment on complementary mistletoe therapy in patients with breast cancer.nnMETHODS: A systematic review was conducted according to PRISMA guidelines. Fifteen electronic databases and the internet were searched. Qualitative studies were analyzed using qualitative content analysis; quantitative studies were systematically summarized in evidence tables.nnRESULTS: Seventeen studies out of 1203 screened publications with 4765 patients and 869 healthcare professionals were included in the review. The median proportion of patients using mistletoe therapy was 26.7% (range: 7.3-46.3%). Predictors for use were younger age and higher educational level. Main reasons for patients' use of mistletoe therapy were to leave nothing untried and to be actively involved in the treatment process. Reasons against use were related to a lack of knowledge or uncertainty regarding effectiveness and safety. Physicians mainly aimed to support the patient's physical condition as main reason for use and a lack of resources and knowledge as main reason against use.nnCONCLUSION: Mistletoe therapy was commonly used in the treatment of breast cancer despite a lack of scientific knowledge among patients and physicians. Transparent communication on motivation for use and its potential effect enables realistic expectations. Relatively small samples of mistletoe therapy users limit the representativeness and validity of our results.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37204803,

title = {Cost-effectiveness of Increasing Buprenorphine Treatment Initiation, Duration, and Capacity Among Individuals Who Use Opioids},

author = {Anneke L Claypool and Catherine DiGennaro and W Alton Russell and Melike F Yildirim and Alan F Zhang and Zuri Reid and Erin J Stringfellow and Benjamin Bearnot and Bruce R Schackman and Keith Humphreys and Mohammad S Jalali},

doi = {10.1001/jamahealthforum.2023.1080},

issn = {2689-0186},

year  = {2023},

date = {2023-05-05},

urldate = {2023-05-01},

journal = {JAMA Health Forum},

volume = {4},

number = {5},

pages = {e231080},

abstract = {IMPORTANCE: Buprenorphine is an effective and cost-effective medication to treat opioid use disorder (OUD), but is not readily available to many people with OUD in the US. The current cost-effectiveness literature does not consider interventions that concurrently increase buprenorphine initiation, duration, and capacity.nnOBJECTIVE: To conduct a cost-effectiveness analysis and compare interventions associated with increased buprenorphine treatment initiation, duration, and capacity.nnDESIGN AND SETTING: This study modeled the effects of 5 interventions individually and in combination using SOURCE, a recent system dynamics model of prescription opioid and illicit opioid use, treatment, and remission, calibrated to US data from 1999 to 2020. The analysis was run during a 12-year time horizon from 2021 to 2032, with lifetime follow-up. A probabilistic sensitivity analysis on intervention effectiveness and costs was conducted. Analyses were performed from April 2021 through March 2023. Modeled participants included people with opioid misuse and OUD in the US.nnINTERVENTIONS: Interventions included emergency department buprenorphine initiation, contingency management, psychotherapy, telehealth, and expansion of hub-and-spoke narcotic treatment programs, individually and in combination.nnMAIN OUTCOMES AND MEASURES: Total national opioid overdose deaths, quality-adjusted life years (QALYs) gained, and costs from the societal and health care perspective.nnRESULTS: Projections showed that contingency management expansion would avert 3530 opioid overdose deaths over 12 years, more than any other single-intervention strategy. Interventions that increased buprenorphine treatment duration initially were associated with an increased number of opioid overdose deaths in the absence of expanded treatment capacity. With an incremental cost- effectiveness ratio of $19 381 per QALY gained (2021 USD), the strategy that expanded contingency management, hub-and-spoke training, emergency department initiation, and telehealth was the preferred strategy for any willingness-to-pay threshold from $20 000 to $200 000/QALY gained, as it was associated with increased treatment duration and capacity simultaneously.nnCONCLUSION AND RELEVANCE: This modeling analysis simulated the effects of implementing several intervention strategies across the buprenorphine cascade of care and found that strategies that were concurrently associated with increased buprenorphine treatment initiation, duration, and capacity were cost-effective.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36533539,

title = {Breast cancer risk for women with diabetes and the impact of metformin: A meta-analysis},

author = {Yifan Lu and Ali Hajjar and Vincent L Cryns and Amy Trentham-Dietz and Ronald E Gangnon and Brandy M Heckman-Stoddard and Oguzhan Alagoz},

doi = {10.1002/cam4.5545},

issn = {2045-7634},

year  = {2023},

date = {2023-05-01},

journal = {Cancer Med},

volume = {12},

number = {10},

pages = {11703--11718},

abstract = {BACKGROUND: Diabetes mellitus has been associated with increased breast cancer (BC) risk; however, the magnitude of this effect is uncertain. This study focused on BC risk for women with type 2 diabetes mellitus (T2DM).nnMETHODS: Two separate meta-analyses were conducted (1) to estimate the relative risk (RR) of BC for women with T2DM and (2) to evaluate the risk of BC for women with T2DM associated with the use of metformin, a common diabetes treatment. In addition, subgroup analyses adjusting for obesity as measured by body mass index (BMI) and menopausal status were also performed. Studies were identified via PubMed/Scopus database and manual search through April 2021.nnRESULTS: A total of 30 and 15 studies were included in the first and second meta-analyses, respectively. The summary RR of BC for women with T2DM was 1.15 (95% confidence interval [CI], 1.09-1.21). The subgroup analyses adjusting BMI and adjusting BMI and menopause resulted in a summary RR of 1.22 (95% CI, 1.15-1.30) and 1.20 (95% CI, 1.05-1.36), respectively. For women with T2DM, the summary RR of BC was 0.82 (95% CI, 0.60-1.12) for metformin users compared with nonmetformin users.nnCONCLUSIONS: Women with T2DM were more likely to be diagnosed with BC and this association was strengthened by adjusting for BMI and menopausal status. No statistically significant reduction of BC risk was observed among metformin users.nnIMPACT: These two meta-analyses can inform decision-making for women with type 2 diabetes regarding their use of metformin and the use of screening mammography for early detection of breast cancer.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37142815,

title = {CheckList for EvaluAtion of Radiomics research (CLEAR): a step-by-step reporting guideline for authors and reviewers endorsed by ESR and EuSoMII},

author = {Burak Kocak and Bettina Baessler and Spyridon Bakas and Renato Cuocolo and Andrey Fedorov and Lena Maier-Hein and Nathaniel Mercaldo and Henning M\"{u}ller and Fanny Orlhac and Daniel Pinto Dos Santos and Arnaldo Stanzione and Lorenzo Ugga and Alex Zwanenburg},

doi = {10.1186/s13244-023-01415-8},

issn = {1869-4101},

year  = {2023},

date = {2023-05-01},

journal = {Insights Imaging},

volume = {14},

number = {1},

pages = {75},

abstract = {Even though radiomics can hold great potential for supporting clinical decision-making, its current use is mostly limited to academic research, without applications in routine clinical practice. The workflow of radiomics is complex due to several methodological steps and nuances, which often leads to inadequate reporting and evaluation, and poor reproducibility. Available reporting guidelines and checklists for artificial intelligence and predictive modeling include relevant good practices, but they are not tailored to radiomic research. There is a clear need for a complete radiomics checklist for study planning, manuscript writing, and evaluation during the review process to facilitate the repeatability and reproducibility of studies. We here present a documentation standard for radiomic research that can guide authors and reviewers. Our motivation is to improve the quality and reliability and, in turn, the reproducibility of radiomic research. We name the checklist CLEAR (CheckList for EvaluAtion of Radiomics research), to convey the idea of being more transparent. With its 58 items, the CLEAR checklist should be considered a standardization tool providing the minimum requirements for presenting clinical radiomics research. In addition to a dynamic online version of the checklist, a public repository has also been set up to allow the radiomics community to comment on the checklist items and adapt the checklist for future versions. Prepared and revised by an international group of experts using a modified Delphi method, we hope the CLEAR checklist will serve well as a single and complete scientific documentation tool for authors and reviewers to improve the radiomics literature.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37128666,

title = {Umbrella review and meta-analysis of reconstructed individual patient data of mortality following conventional endovascular and open surgical repair of infrarenal abdominal aortic aneurysm},

author = {Vladica M Veli\v{c}kovi\'{c} and Daniel Carradice and Jonathan R Boyle and Mohamad Hamady and Trevor Cleveland and Simon Neequaye and Aleksandra Ignjatovi\'{c} and Dragana Bogdanovi\'{c} and Jelena Savovic and Uwe Siebert},

doi = {10.1080/14779072.2023.2207009},

issn = {1744-8344},

year  = {2023},

date = {2023-05-01},

urldate = {2023-05-01},

journal = {Expert Rev Cardiovasc Ther},

volume = {21},

number = {5},

pages = {347-356},

abstract = {OBJECTIVES: This umbrella review aims to quality assess published meta-analyses, conduct a de-novo meta-analysis of the available randomized control trials (RCTs), and test the hypothesis that there is a long-term difference in mortality between OSR and EVAR.nnMETHODS: A systematic search was conducted in MEDLINE and EMBASE's bibliographic databases (June 2022). Data were extracted using standardized extraction forms. The methodological quality of publications was assessed using the ROBIS tool. Data were analyzed with 'one-stage' and 'two-stage' approaches.nnRESULTS: According to two-stage analysis, EVAR has significantly favorable mortality for up to four years (increasing evidence). Subsequently, until the longest available time period, there is no difference between EVAR and OSR; all the results are statistically non-significant.In one stage analysis, the Cox model demonstrated a non-significant (weak evidence) hazard ratio of 1.03 (95% confidence interval [CI]: 0.94-1.12) in favor of OSR. The best-fitting parametric model (generalized gamma), leads to an hazard ratio of 0.97 (95% CI: 0.93-1.01) in favor of EVAR, with the results approaching significance (weak evidence).nnCONCLUSION: The results of this umbrella systematic review and meta-analysis failed to demonstrate any difference in long-term mortality following planned EVAR, compared with OSR of infrarenal AAA.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36960710,

title = {A Comprehensive Study on the Diagnosis and Management of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features},

author = {Bayan A Alzumaili and Lauren N Krumeich and Reagan Collins and Timothy Kravchenko and Emad I Ababneh and Adam S Fisch and William C Faquin and Vania Nos\'{e} and Maria Martinez-Lage and Gregory W Randolph and Rajshri M Gartland and Carrie C Lubitz and Peter M Sadow},

doi = {10.1089/thy.2023.0035},

issn = {1557-9077},

year  = {2023},

date = {2023-05-01},

journal = {Thyroid},

volume = {33},

number = {5},

pages = {566--577},

abstract = { Since the noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTPs) was introduced in 2016, most retrospective studies have included cases diagnosed as encapsulated follicular variant of papillary thyroid carcinoma. We investigate a cohort diagnosed with NIFTP at resection.  Retrospective institutional cohort of NIFTP from 2016 to 2022, including clinical, cytological, and molecular data for 319 cases (6.6% of thyroid surgeries, 183 cases as NIFTP-only).  The patient cohort had unifocal or multifocal thyroid nodules. Female:male ratio was 2.7:1, mean age was 52 years and median NIFTP size was 2.1 cm. NIFTP was associated with multiple nodules in 23% patients ( = 73) and 12% of NIFTP were multifocal ( = 39). Fine needle aspiration (FNA) of NIFTP ( = 255) were designated as nondiagnostic = 5%, benign = 13%, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) = 49%, follicular neoplasm/suspicious for follicular neoplasm (FN/SFN) = 17%, suspicious for malignancy = 12%, or malignant = 4%. Molecular alterations were identified in 93% ( = 114),  or -like. Thyroid Imaging Reporting and Data System (TI-RADS) score 4 was recorded in 50% of NIFTP, followed by scores 3 and 5 (26% and 20%, respectively). We also investigated the factors associated with extent of surgery. In our NIFTP-only group ( = 183), 66% were identified after hemithyroidectomy (HT) and 34% after total thyroidectomy (TT). On univariate analysis, TT patients demonstrated higher Bethesda category by FNA, more often had aberrant preoperative thyroid function, and/or underwent an FNA of additional nodule(s). With multivariable regression, Bethesda V NIFTP, in the presence of other nodules being evaluated by FNA and aberrant preoperative thyroid function, independently predicts TT. Bethesda II NIFTP correlated significantly with HT. Fifty-two patients (28%) with NIFTP-only had at least one postoperative surveillance ultrasound. In the NIFTP-only cohort, no HT patients had completion thyroidectomy or received postoperative radioactive iodine. No recurrence or metastases were recorded with median follow-up of 35 months (6-76 months;  = 120).  Given this large cohort of NIFTP, including a large subset of isolated NIFTP-only, some with >6 years of follow-up and no tumor recurrences, consensus practical guidelines are needed for adequate postoperative management. Given the American Thyroid Association (ATA) provides guidelines for management of low-risk malignancies, guidance regarding that for borderline/biologically uncertain tumors, including NIFTP, is a reasonable next step.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37105689,

title = {Monitoring multidimensional aspects of quality of life after cancer immunotherapy: protocol for the international multicentre, observational QUALITOP cohort study},

author = {Petra C Vinke and Marc Combalia and Geertruida H de Bock and Cl\'{e}mence Leyrat and Anne Mea Spanjaart and Stephane Dalle and Maria Gomes da Silva and Aurore Fouda Essongue and Aur\'{e}lie Rabier and Myriam Pannard and Mohammad S Jalali and Amal Elgammal and Mike Papazoglou and Mohand-Said Hacid and Catherine Rioufol and Marie-Jos\'{e} Kersten and Martijn Gh van Oijen and Erick Suazo-Zepeda and Ananya Malhotra and Emmanuel Coquery and Am\'{e}lie Anota and Marie Preau and Mathieu Fauvernier and Elsa Coz and Susana Puig and Delphine Maucort-Boulch},

doi = {10.1136/bmjopen-2022-069090},

issn = {2044-6055},

year  = {2023},

date = {2023-04-27},

urldate = {2023-04-01},

journal = {BMJ Open},

volume = {13},

number = {4},

pages = {e069090},

abstract = {INTRODUCTION: Immunotherapies, such as immune checkpoint inhibitors and chimeric antigen receptor T-cell therapy, have significantly improved the clinical outcomes of various malignancies. However, they also cause immune-related adverse events (irAEs) that can be challenging to predict, prevent and treat. Although they likely interact with health-related quality of life (HRQoL), most existing evidence on this topic has come from clinical trials with eligibility criteria that may not accurately reflect real-world settings. The QUALITOP project will study HRQoL in relation to irAEs and its determinants in a real-world study of patients treated with immunotherapy.nnMETHODS AND ANALYSIS: This international, observational, multicentre study takes place in France, the Netherlands, Portugal and Spain. We aim to include about 1800 adult patients with cancer treated with immunotherapy in a specifically recruited prospective cohort, and to additionally obtain data from historical real-world databases (ie, databiobanks) and medical administrative registries (ie, national cancer registries) in which relevant data regarding other adult patients with cancer treated with immunotherapy has already been stored. In the prospective cohort, clinical health status, HRQoL and psychosocial well-being will be monitored until 18 months after treatment initiation through questionnaires (at baseline and 3, 6, 12 and 18 months thereafter), and by data extraction from electronic patient files. Using advanced statistical methods, including causal inference methods, artificial intelligence algorithms and simulation modelling, we will use data from the QUALITOP cohort to improve the understanding of the complex relationships among treatment regimens, patient characteristics, irAEs and HRQoL.nnETHICS AND DISSEMINATION: All aspects of the QUALITOP project will be conducted in accordance with the Declaration of Helsinki and with ethical approval from a suitable local ethics committee, and all patients will provide signed informed consent. In addition to standard dissemination efforts in the scientific literature, the data and outcomes will contribute to a smart digital platform and medical data lake. These will (1) help increase knowledge about the impact of immunotherapy, (2) facilitate improved interactions between patients, clinicians and the general population and (3) contribute to personalised medicine.nnTRIAL REGISTRATION NUMBER: NCT05626764.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37040087,

title = {Molecular Profiling and Treatment Pattern Differences between Intrahepatic and Extrahepatic Cholangiocarcinoma},

author = {Kristen Spencer and Leontios Pappas and Islam Baiev and Jordan Maurer and Andrea Grace Bocobo and Karen Zhang and Apurva Jain and Anaemy Danner De Armas and Stephanie Reyes and Tri Minh Le and Osama E Rahma and Jennifer Stanton and Thomas T DeLeon and Marc Roth and Mary Linton B Peters and Andrew X Zhu and Jochen K Lennerz and A John Iafrate and Kylie Boyhen and Christine VanCott and Lewis R Roberts and Stacie Lindsey and Nora Horick and Laura Williams Goff and Kabir Mody and Mitesh J Borad and Rachna T Shroff and R Katie Kelley and Milind M Javle and Lipika Goyal},

doi = {10.1093/jnci/djad046},

issn = {1460-2105},

year  = {2023},

date = {2023-04-11},

urldate = {2023-04-01},

journal = {J Natl Cancer Inst},

abstract = {BACKGROUND: Treatment patterns for intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC) differ, but limited studies exist comparing them. This study examines differences in molecular profiling rates and treatment patterns in these populations, focusing on use of adjuvant, liver-directed, targeted, and investigational therapies.nnMETHODS: This multi-center collaboration included patients with ICC or ECC treated at one of eight participating institutions. Retrospective data were collected on risk factors, pathology, treatments, and survival. Comparative statistical tests were two-sided.nnRESULTS: Among 1,039 patients screened, 847 patients met eligibility (ICC = 611, ECC = 236). Patients with ECC were more likely than those with ICC to present with early-stage disease (53.8% vs 28.0%), undergo surgical resection (55.1% vs 29.8%), and receive adjuvant chemoradiation (36.5% vs 4.2%), (all p \< 0.00001). However, they were less likely to undergo molecular profiling (50.3% vs 64.3%) or receive liver directed therapy (17.9% vs 35.7%), targeted therapy (4.7% vs 18.9%), and clinical trial therapy (10.6% vs 24.8%), (all p \< 0.001). In patients with recurrent ECC after surgery, the molecular profiling rate was 64.5%. Patients with advanced ECC had a shorter median overall survival than those with advanced ICC (11.8 vs 15.1 months, p \< 0.001).nnCONCLUSIONS: Patients with advanced ECC have low rates of molecular profiling, possibly in part due to insufficient tissue. They also have low rates of targeted therapy use and clinical trial enrollment. While these rates are higher in advanced ICC, the prognosis for both subtypes of cholangiocarcinoma remains poor, and a pressing need exists for new effective targeted therapies and broader access to clinical trials.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}