Background: The evidence-based practice of active surveillance to monitor men with favorable-risk prostate cancer in lieu of initial definitive treatment is becoming more common. However, there are barriers to effective implementation, particularly in low-resource settings. Our goal is to assess the efficacy and feasibility of a health information technology registry for men on active surveillance at a safety-net hospital to ensure patients receive guideline-recommended care.
Methods: We developed an electronic registry for urology clinic staff to monitor men on active surveillance. The health information technology tool was developed using the Systems Engineering Initiative for Patient Safety model and iteratively tailored to the needs of the clinic by engaging providers in a co-design process. We will enroll all men at Zuckerberg San Francisco General Hospital and Trauma Center who choose active surveillance as a treatment strategy. The primary outcomes to be assessed during this non-randomized, pragmatic evaluation are number of days delayed beyond recommended date of follow-up testing, the proportion of men who are lost to follow-up, the cancer stage at active treatment, and the feasibility and acceptability of the clinic-wide intervention with clinic staff. Secondary outcomes include appointment adherence within 30 days of the scheduled date.
Discussion: Use of a customized electronic approach for monitoring men on active surveillance could improve patient outcomes. It may help reduce the number of men lost to follow-up and improve adherence to timely follow-up testing. Evaluating the adoption and efficacy of a customized registry in a safety-net setting may also demonstrate feasibility for implementation in diverse clinical contexts.
Trial Registration: ClinicalTrials.gov identifier NCT03553732, An Electronic Registry to Improve Adherence to Active Surveillance Monitoring at a Safety-net Hospital. Registered 11 June 2018.
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http://dx.doi.org/10.1186/s40814-019-0482-x | DOI Listing |
Background: (pneumococcus) causes invasive pneumococcal disease (IPD) and non-invasive acute respiratory infections (ARIs). Three pneumococcal conjugate vaccines (PCVs) are recommended in the United States with additional products in clinical trials. We aimed to estimate 1) proportions of IPD cases and pneumococcal ARIs caused by serotypes targeted by existing and pipeline PCVs and 2) annual U.
View Article and Find Full Text PDFFirst-line immune checkpoint inhibitor (ICI) combinations show responses in subsets of hepatocellular carcinoma (HCC) patients. Nearly half of HCCs are Wnt-active with mutations in (encoding for β-catenin), , or , and demonstrate limited benefit to ICI due to an immune excluded tumor microenvironment. We show significant tumor responses in multiple β-catenin-mutated immunocompetent HCC models to a novel siRNA encapsulated in lipid nanoparticle targeting (LNP-CTNNB1).
View Article and Find Full Text PDFFr J Urol
December 2024
Department of Urology, Univ. Lille, Lille, France. Electronic address:
Background: Active surveillance (AS) is the recommended approach for managing Grade-Group1 (GG1) prostate cancer (PCa). Incorporating MRI at entry improve patient selection and outcomes.
Objective: To evaluate long-term oncological outcomes of patients receiving AS selected with MRI at entry.
Am J Otolaryngol
December 2024
Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medicine, Technion, Haifa, Israel.
Objective: Given the good prognosis of low-risk papillary thyroid microcarcinomas (lrPTMCs), accurate risk stratification is valuable to optimize management: active surveillance (AS) vs. hemithyroidectomy (HT). BRAF positive lrPTMC is associated with increased recurrence risk; hence, AS was suggested for mutation-negative lrPTMC.
View Article and Find Full Text PDFTransfusion
December 2024
Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA.
Background: U.S. FDA's Center for Biologics Evaluation and Research (CBER) Biologics Effectiveness and Safety (BEST) Initiative leverages large electronic health records and administrative claims data to conduct active surveillance for CBER-regulated products.
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