Publications by authors named "L L Shepherd"

Objectives: This study aimed to (1) compare the agreement between triage acuity and emergency department (ED) patients' self-perceived medical severity and urgency, and (2) examine how health literacy, stress, and coping relate to patients' perceptions of medical need and urgency.

Methods: In this cross-sectional, observational study, 171 patients from a large acute care teaching hospital in Southwestern Ontario were recruited in autumn 2020. English-speaking adults (18 + years) with Canadian Triage Acuity Scale (CTAS) scores from 2 (emergent) to 5 (non-urgent) were included.

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NCIC-CTG MA.5 and DBCG 89D are symmetrically designed randomized trials comparing adjuvant cyclophosphamide, epirubicin, and fluorouracil with cyclophosphamide, methotrexate, and fluorouracil in high-risk breast cancer patients. In a joint analysis we evaluate the predictive value in terms of anthracycline benefit of molecular subtyping by PAM50.

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Background: Insufficient patient accrual is a major challenge in clinical trials and can result in underpowered studies, as well as exposing study participants to toxicity and additional costs, with limited scientific benefit. Real-world data can provide external controls, but insufficient accrual affects all arms of a study, not just controls. Studies that used generative models to simulate more patients were limited in the accrual scenarios considered, replicability criteria, number of generative models, and number of clinical trials evaluated.

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The role of germline genetics in adjuvant aromatase inhibitor (AI) treatment efficacy in ER-positive breast cancer is poorly understood. We employed a two-stage candidate gene approach to examine associations between survival endpoints and common germline variants in 753 endocrine resistance-related genes. For a discovery cohort, we screened the Breast Cancer Association Consortium database (n ≥ 90,000 cases) and retrieved 2789 AI-treated patients.

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