Oncology and Primary Care Involvement in Breast Cancer Survivorship Care More Than 5 Years After Initial Treatment.

Purpose: Very little is known about primary care involvement in the care of cancer survivors beyond the initial 5 years post-treatment when transitioning to primary care is guideline-recommended for many survivors.

Methods: The ICanCare study is a longitudinal survey of women diagnosed with breast cancer in 2014-2015 identified in the Georgia and Los Angeles SEER registries. Women were surveyed during initial treatment and again approximately 6 years later in survivorship (2021-2022; n = 1,412, 60% response rate).

Symptom burden and quality of life among patient and family caregiver dyads in advanced cancer.

Purpose: Symptom management among patients diagnosed with advanced cancer is a high priority in clinical care that often involves the support of a family caregiver. However, limited studies have examined parallel patient and caregiver symptom burden and associations with their own and each other's quality of life (QOL). This study seeks to identify patient and caregiver symptom clusters and investigate associations between identified clusters and demographic, clinical, and psychosocial factors (cognitive appraisals and QOL).

Genetic Counseling, Testing, and Family Communication Into Survivorship After Diagnosis of Breast Cancer.

Purpose: To examine receipt of genetic testing and communication with relatives about results into survivorship after diagnosis of breast cancer.

Methods: Women age 20-79 years diagnosed with early-stage breast cancer in 2014-2015 and reported to the Georgia and Los Angeles County SEER registries were surveyed approximately 7 months and 6 years after diagnosis (n = 1,412). We asked about genetic counseling, testing, and communication with relatives about results.

Germline Genetic Testing After Cancer Diagnosis.

Importance: Germline genetic testing is recommended by practice guidelines for patients diagnosed with cancer to enable genetically targeted treatment and identify relatives who may benefit from personalized cancer screening and prevention.

Objective: To describe the prevalence of germline genetic testing among patients diagnosed with cancer in California and Georgia between 2013 and 2019.

Design, Setting, And Participants: Observational study including patients aged 20 years or older who had been diagnosed with any type of cancer between January 1, 2013, and March 31, 2019, that was reported to statewide Surveillance, Epidemiology, and End Results registries in California and Georgia.

Increased Nerve Density Adversely Affects Outcome in Oral Cancer.

Purpose: Perineural invasion (PNI) in oral cavity squamous cell carcinoma (OSCC) is associated with poor survival. Because of the risk of recurrence, patients with PNI receive additional therapies after surgical resection. Mechanistic studies have shown that nerves in the tumor microenvironment promote aggressive tumor growth.

The Prevalence of Periodontitis Among US Adults with Multimorbidity Using NHANES Data 2011-2014.

Introduction: Often misperceived as solely a dental disease, periodontitis is a chronic condition characterized by inflammation of the support structures of the tooth and associated with chronic systemic inflammation and endothelial dysfunction. Despite affecting almost 40% of US adults 30 years of age or older, periodontitis is rarely considered when quantifying the multimorbidity (the presence of 2 or more chronic conditions in an individual) burden for our patients. Multimorbidity represents a major challenge for primary care and is associated with increasing health care expenditure and increased hospitalizations.

Socially Distanced Teaching: Faculty Feedback on Teaching During Telemedicine.

Background: The purpose of our study was to evaluate the perceptions of clinical faculty while working with medical students in a novel setting of virtual care following the COVID-19 pandemic.

Activity: A survey of faculty, fellows, and residents was conducted to assess educators' perceptions of virtual teaching before trying it and after 3 months of experience.

Results: Perceived effectiveness of teaching students acute care significantly improved as did perceived effectiveness of teaching chronic care.

Potentially Preventable Hospitalizations Among Older Adults: 2010-2014.

Purpose: We undertook a study to examine national trends in potentially preventable hospitalizations-those for ambulatory care-sensitive conditions that could have been avoided if patients had timely access to primary care-across 3,200 counties and various subpopulations of older adults in the United States.

Methods: We used 2010-2014 Medicare claims data to examine trends in potentially preventable hospitalizations among beneficiaries aged 65 years and older and developed heat maps to examine county-level variation. We used a generalized estimating equation and adjusted the model for demographics, comorbidities, dual eligibility (Medicare and Medicaid), ZIP code-level income, and county-level number of primary care physicians and hospitals.

Differences between frequent emergency department users in a secondary rural hospital and a tertiary suburban hospital in central Japan: a prevalence study.

Objectives: Although frequent emergency department (ED) use is a global issue, little research has been conducted in a country like Japan where universal health insurance is available. The study aims to (1) document the proportion of ED visits that are by frequent users and (2) describe the differences in characteristics of frequent ED users and other ED users including expenditures between a secondary and a tertiary hospital.

Design: A prevalence study for a period of 1 year.

Telemedicine versus face-to-face delivery of cognitive behavioral therapy for insomnia: a randomized controlled noninferiority trial.

Study Objectives: In a randomized controlled noninferiority trial, we compared face-to-face and telemedicine delivery (via the AASM SleepTM platform) of cognitive-behavioral therapy (CBT) for insomnia for improving insomnia/sleep and daytime functioning at posttreatment and 3-month follow-up. A secondary objective compared the modalities on treatment credibility, satisfaction, and therapeutic alliance.

Methods: A total of 65 adults with chronic insomnia (46 women, 47.

Review and Comparison of Computational Approaches for Joint Longitudinal and Time-to-Event Models.

Joint models for longitudinal and time-to-event data are useful in situations where an association exists between a longitudinal marker and an event time. These models are typically complicated due to the presence of shared random effects and multiple submodels. As a consequence, software implementation is warranted that is not prohibitively time consuming.

Provider Involvement in Care During Initial Cancer Treatment and Patient Preferences for Provider Roles After Initial Treatment.

Purpose: Patients report strong preferences regarding which provider-oncologist or primary care provider (PCP)-handles their primary care after initial cancer treatment (eg, other cancer screenings, preventive care, comorbidity management). Little is known about associations between provider involvement during initial cancer treatment and patient preferences for provider roles after initial treatment.

Methods: Women who received a diagnosis of early-stage breast cancer in 2014 to 2015 were identified from the Georgia and Los Angeles County SEER registries and surveyed (N = 2,502; 68% response rate).

Individual and Population Comparisons of Surgery and Radiotherapy Outcomes in Prostate Cancer Using Bayesian Multistate Models.

Importance: Whether surgery or radiotherapy is the preferred treatment for patients with localized prostate cancer continues to be debated, and randomized clinical trials cannot yet fully address this question. Furthermore, there may be heterogeneity in responses, and the optimal treatment for a patient will depend on his clinical and tumor characteristics.

Objectives: To use a unified statistical approach to compare the association of surgery and radiotherapy with both metastatic clinical failure (CF) and survival in localized prostate cancer and to develop an online calculator for individualized, treatment-specific outcome prediction.

Patient Preferences for Primary Care Provider Roles in Breast Cancer Survivorship Care.

Purpose Prior studies have suggested a need for greater clarity about provider roles in team-based cancer care; however, little is known about patients' preferences regarding which providers handle their care needs after primary cancer treatment. Methods We surveyed women with newly diagnosed stages 0 to II breast cancer who were treated in 2014 and 2015 as reported to the Georgia and Los Angeles SEER registries (N = 2,372; 68% response rate). Patient preferences regarding which provider handles the following care needs after treatment were ascertained: follow-up mammograms, screening for other cancers, general preventive care, and comorbidity management.