Publications by authors named "Kuderer N"

Importance: With the growing use of large language models (LLMs) in education and health care settings, it is important to ensure that the information they generate is diverse and equitable, to avoid reinforcing or creating stereotypes that may influence the aspirations of upcoming generations.

Objective: To evaluate the gender representation of LLM-generated stories involving medical doctors, surgeons, and nurses and to investigate the association of varying personality and professional seniority descriptors with the gender proportions for these professions.

Design, Setting, And Participants: This is a cross-sectional simulation study of publicly accessible LLMs, accessed from December 2023 to January 2024.

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Unlocking the full potential of clinical trials through comprehensive CSR and IPD sharing can revolutionize cancer care, enhance safety evaluations, and reduce bias in systematic reviews. It is time for all stakeholders to embrace transparency and advance patient-centered outcomes.

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Purpose: Recognizing that receiving healthcare can be time intensive and burdensome, time toxicity has been conceptualized as the time spent by patients seeking healthcare. This study investigates the association between age at diagnosis and time toxicity for patients with Metastatic Breast Cancer (MBC) and identifies major components of care that confer the greatest time toxicity.

Methods: We conducted a retrospective cohort study among patients with MBC aged 67 or older using the SEER-Medicare database.

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Background: Patients with multiple myeloma (MM) may be on therapy for years, which can lead to financial toxicity (FinTox) or time toxicity (TimeTox). The prevalence, predictors, and quality of life (QOL) impacts of FinTox and TimeTox during different phases of MM treatment have not been characterized.

Patients And Methods: We conducted a single-center cross-sectional survey of patients with MM who had undergone transplantation.

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Objectives: To evaluate the effectiveness of safeguards to prevent large language models (LLMs) from being misused to generate health disinformation, and to evaluate the transparency of artificial intelligence (AI) developers regarding their risk mitigation processes against observed vulnerabilities.

Design: Repeated cross sectional analysis.

Setting: Publicly accessible LLMs.

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Article Synopsis
  • This study investigates the impact of COVID-19 on female patients with breast cancer, particularly focusing on underrepresented racial/ethnic populations from March 2020 to June 2021 in the US.
  • The analysis included 1,383 patients, revealing that older age and certain racial/ethnic groups (such as Black and Asian American/Pacific Islanders) showed higher odds of severe COVID-19 outcomes.
  • Key findings noted that factors like worse performance status, pre-existing health conditions, and active cancer significantly contributed to increased severity, while variables like Hispanic ethnicity and anti-cancer therapy type did not impact outcomes as much.
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Importance: The pharmaceutical industry has made substantial investments in developing processes for sharing individual-participant data (IPD) from clinical trials. However, the utility and completeness of shared IPD and supporting documents must be evaluated to ensure the potential for scientific advancements from the data sharing ecosystem can be realized.

Objective: To assess the utility and completeness of IPD and supporting documents provided from industry-sponsored clinical trials.

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Background: Prophylactic growth-factor therapy with granulocyte colony-stimulating factor (G-CSF) reduces the risk of febrile neutropenia (FN) in patients with breast cancer initiating myelosuppressive chemotherapy. However, little is known about the protective benefit early in the chemotherapy cycle.

Methods: To assess the relationship between G-CSF prophylaxis and incidence of FN/infection in week 1 versus beyond week 1 of the first chemotherapy cycle, a retrospective study was conducted using Medicare claims from 2005 through 2020 among patients with breast cancer initiating high-risk chemotherapy.

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Despite the importance of chemotherapy-associated adverse events in oncology practice and the broad range of interventions available to mitigate them, limited systematic efforts have been made to identify, critically appraise and summarize the totality of evidence on the effectiveness of these interventions. Herein, we review the most common long-term (continued beyond treatment) and late or delayed (following treatment) adverse events associated with chemotherapy and other anticancer treatments that pose major threats in terms of survival, quality of life and continuation of optimal therapy. These adverse effects often emerge during and continue beyond the course of therapy or arise among survivors in the months and years following treatment.

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Article Synopsis
  • The study investigates the impact of COVID-19 on female breast cancer patients using a large U.S. registry during 2020-2021, focusing on underrepresented racial/ethnic populations.
  • Key findings show that older age, being Black, Asian American/Pacific Islander, and having worse overall health significantly increase the severity of COVID-19 in these patients.
  • The overall hospitalization rate was 37% and mortality rate 9%, but these rates varied depending on the active status of breast cancer in patients.
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Purpose: To conduct an update of the ASCO venous thromboembolism (VTE) guideline.

Methods: After publication of potentially practice-changing clinical trials, identified through ASCO's signals approach to updating, an updated systematic review was performed for two guideline questions: perioperative thromboprophylaxis and treatment of VTE. PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) published between November 1, 2018, and June 6, 2022.

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Purpose: Although representing the majority of newly diagnosed cancers, patients with breast cancer appear less vulnerable to COVID-19 mortality compared with other malignancies. In the absence of patients on active cancer therapy included in vaccination trials, a contemporary real-world evaluation of outcomes during the various pandemic phases, as well as of the impact of vaccination, is needed to better inform clinical practice.

Methods: We compared COVID-19 morbidity and mortality among patients with breast cancer across prevaccination (February 27, 2020-November 30, 2020), Alpha-Delta (December 1, 2020-December 14, 2021), and Omicron (December 15, 2021-January 31, 2022) phases using OnCovid registry participants (ClinicalTrials.

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Article Synopsis
  • Older women with high-risk early breast cancer often struggle with the side effects of adjuvant chemotherapy, leading to lower relative dose intensity (RDI), which is critical for effective treatment.
  • A study analyzed data from the HOPE trial, focusing on women aged 65 and older, finding that 21% experienced low RDI, particularly those aged 76 and older, with poorer performance status, or treated with certain chemotherapy regimens.
  • Patients with low RDI had a 5-year overall survival rate of 80%, compared to 91% for those with adequate RDI, highlighting the need for identifying at-risk individuals to improve treatment outcomes.
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