Publications by authors named "D L Veenstra"

Purpose: Limited evidence evaluates parents' perceptions of their child's clinical genomic sequencing (GS) results, particularly among individuals from medically underserved groups. Five Clinical Sequencing Evidence-Generating Research (CSER) consortium studies performed GS in children with suspected genetic conditions with high proportions of individuals from underserved groups to address this evidence gap.

Methods: Parents completed surveys of perceived understanding, personal utility, and test-related distress after GS result disclosure.

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Background: The introduction of cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6is) has transformed the treatment landscape for patients with hormone receptor positive (HR+) and human epidermal growth factor receptor 2 negative (HER2-) metastatic breast cancer (MBC). To our knowledge, no studies have quantified health care resource utilization (HRU) or economic burden following CDK4/6i initiation in the Medicare population.

Objective: To describe HRU and quantify health care costs among Medicare-enrolled patients with HR+ HER2- MBC treated with CDK4/6is in the first-line setting.

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Article Synopsis
  • Genomic screening for Lynch Syndrome (LS) and high polygenic risk scores (PRS) could improve colorectal cancer (CRC) screening by personalizing approaches for individuals based on their risk.
  • A Markov model analysis showed that screening 1,000 people with LS+PRS could prevent 1.36 CRC cases and 0.65 deaths when compared to standard screening methods.
  • The cost-effectiveness of this screening strategy was indicated by an incremental cost-effectiveness ratio of $124,415 per quality-adjusted life year (QALY), with a 69% chance of being cost-effective, especially when using a 90th percentile risk threshold.
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  • Family spillover effects, which impact family members and caregivers of patients, are often overlooked in health technology assessments (HTAs) and cost-effectiveness analyses (CEAs), despite formal value frameworks suggesting their importance.
  • The study aimed to create stakeholder-driven recommendations for effectively measuring and incorporating family spillover effects in the US healthcare evaluation processes while identifying potential research opportunities.
  • Through literature reviews and qualitative interviews with various healthcare stakeholders, several key themes emerged that emphasized the limitations of current practices and led to the formulation of 15 consensus-based recommendations for better integrating these effects into CEAs and HTAs.
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  • The study aims to understand how potential future cancer treatment innovations influence oncologists' current treatment decisions and discussions with patients.* -
  • An online survey with 201 oncologists revealed that a significant majority would discuss future treatments if they promised improved survival chances, especially if available soon.* -
  • The results suggest that acknowledging the potential benefits of future innovations could enhance treatment decision-making; thus, guidelines should incorporate this aspect for better patient care.*
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