Exclusion of people from oncology clinical trials based on functional status.

Background/aims: People with disability have higher rates of cancer, excluding skin cancer, compared with people without disability. Food and Drug Administration draft guidelines from 2024 address use of performance status criteria to determine eligibility for clinical trials, advocating for less restrictive thresholds. We examined the exclusion of people with disability from clinical trials based on performance status and other criteria.

Large Language Models to Identify Advance Care Planning in Patients With Advanced Cancer.

Context: Efficiently tracking Advance Care Planning (ACP) documentation in electronic heath records (EHRs) is essential for quality improvement and research efforts. The use of large language models (LLMs) offers a novel approach to this task.

Objectives: To evaluate the ability of LLMs to identify ACP in EHRs for patients with advanced cancer and compare performance to gold-standard manual chart review and natural language processing (NLP).

Using advanced imaging to measure bone density, compression fracture risk, and risk for construct failure after spine surgery.

Low bone mineral density (BMD) can predispose to vertebral body compression fractures and postoperative instrumentation failure. DEXA is considered the gold standard for measurement of BMD, however it is not obtained for all spine surgery patients preoperatively. There is a growing body of evidence suggesting that more routinely acquired spine imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI) can be opportunistically used to measure BMD.

Osteochondroma of the Tibial Tubercle Masquerading as Osgood-Shlatter Disease: A Case Report.

Background: Osteochondromas are a relatively common primary bone tumor, which may share common clinical features with Osgood-Schlatter disease (OSD). A limited number of cases have described tumors misdiagnosed as OSD.

Case Presentation: We report the case of an 11-year-old male with a sessile osteochondroma of the tibial tubercle and concomitant involvement of the distal extension and attachment of the patellar tendon into the tibial periosteum.

Natural language processing for automated surveillance of intraoperative neuromonitoring in spine surgery.

We sought to develop natural language processing (NLP) methods for automated detection and characterization of neuromonitoring documentation from free-text operative reports in patients undergoing spine surgery. We included 13,718 patients who received spine surgery at two tertiary academic medical centers between December 2000 - December 2020. We first validated a rule-based NLP method for identifying operative reports containing neuromonitoring documentation, comparing performance to standard administrative codes.

Why Disability Must Be Included in Medical School Diversification Efforts.

Individuals living with disabilities are underrepresented in the physician workforce, despite benefits of inclusion. This article describes how both ableism in admissions processes and expectations set by technical standards can perpetuate harm. The authors advocate for active attention to disability diversity and equity in medical school admissions.

US Physicians' Knowledge About The Americans With Disabilities Act And Accommodation Of Patients With Disability.

More than thirty years since the enactment of the Americans with Disabilities Act (ADA), people with disability continue to experience health care disparities. The ADA mandates that patients with disability receive reasonable accommodations. In our survey of 714 US physicians in outpatient practices, 35.

Physicians' Perceptions Of People With Disability And Their Health Care.

More than sixty-one million Americans have disabilities, and increasing evidence documents that they experience health care disparities. Although many factors likely contribute to these disparities, one little-studied but potential cause involves physicians' perceptions of people with disability. In our survey of 714 practicing US physicians nationwide, 82.

Exploring the Process of Cancer Care for Patients With Pre-Existing Mobility Disability.

Purpose: Approximately 13% of the US population report mobility disability. People with mobility disability experience healthcare disparities, including lower rates of cancer screening and substandard cancer care compared with nondisabled people. We explored clinicians' reports of aspects of diagnosing and treating three common cancer types among persons with pre-existing mobility disability.

Perspectives of Patients with Pre-existing Mobility Disability on the Process of Diagnosing Their Cancer.

Background: Mobility disability is the most common disability among adult Americans, estimated at 13.7% of the US population. Cancer prevalence is higher among people with mobility disability compared with the general population, yet people with disability experience disparities in cancer screening and treatment.

Associations Between Disability and Breast or Cervical Cancers, Accounting for Screening Disparities.

Introduction: Studies suggest that women with disability experience disparities in routine, high-value screening services, including mammograms and Papanicolaou (Pap) tests. However, few studies have explored whether women with disability have higher risks than other women of developing breast or cervical cancers.

Methods: The authors analyzed 2010, 2013, 2015, and 2018 National Health Interview Surveys, which involved civilian, noninstitutionalized US residents, and included supplemental surveys on cancer screening.

Exploring Cancer Treatment Experiences for Patients With Preexisting Mobility Disability.

Objective: We explored the process of cancer care for patients with preexisting mobility disability, focusing on treatment decisions and experiences.

Design: We recruited 20 participants with preexisting mobility disability, requiring use of an assistive device or assistance with activities of daily living, subsequently diagnosed with cancer (excluding skin cancers). We conducted open-ended individual interviews, which reached data saturation and were transcribed verbatim for conventional content analysis.

Exploring attitudes about developing cancer among patients with pre-existing mobility disability.

Objective: Mobility disability affects approximately 13.7% of the United States population, representing the most common disability type. People with mobility disability experience disparities in cancer screening and higher prevalence of some cancers compared to the general population.

Cross-Sectional Analysis of the Associations Between Four Common Cancers and Disability.

Background: Approximately 61 million Americans have a disability. Little research has explored whether disability is associated with subsequent diagnosis of cancer, the second-leading cause of death in the United States. The objective of this study was to explore associations between cancer and disability, focusing on 4 cancers that may present with nonspecific symptoms that could be conflated with aspects of disability, thus delaying cancer diagnoses.

Accommodating patients with obesity and mobility difficulties: Observations from physicians.

Background: Given the growing population of U.S. adults with obesity and mobility disability, physicians will need to accommodate these patients.

Challenges of Developing a Natural Language Processing Method With Electronic Health Records to Identify Persons With Chronic Mobility Disability.

Objective: To assess the utility of applying natural language processing (NLP) to electronic health records (EHRs) to identify individuals with chronic mobility disability.

Design: We used EHRs from the Research Patient Data Repository, which contains EHRs from a large Massachusetts health care delivery system. This analysis was part of a larger study assessing the effects of disability on diagnosis of colorectal cancer.

Knowledge Of Practicing Physicians About Their Legal Obligations When Caring For Patients With Disability.

Disability civil rights laws require equitable treatment of the approximately sixty-one million Americans with disability. However, federal reports and numerous research studies indicate that this diverse and growing population often experiences health care disparities. To examine one possible contributing factor, we interviewed practicing physicians to explore their knowledge of their obligations to accommodate patients with disability under federal civil rights law.