Survival Benefit From Immunocheckpoint Inhibitors In Stage Iv Non-Small Cell Lung Cancer Patients With Brain Metastases: A National Cancer Database Propensity-Matched Analysis., Shinkichi Takamori, Takefumi Komiya Md, Emily Powell

PCI Publications and Projects

Immunocheckpoint inhibitors (ICIs) have become a standard pharmacological therapy in non-small cell lung cancer (NSCLC). Because brain metastases (BMs) have historically been listed as exclusion criteria in previous clinical trials involving ICIs in advanced NSCLC, the survival benefit from ICI in NSCLC patients with BMs remains unclear. The National Cancer Database was queried for stage IV NSCLC patients with or without BMs between 2014 and 2015. Overall survival (OS) of stage IV NSCLC patients who received immunotherapy and that of stage IV NSCLC patients who did not receive immunotherapy were compared according to the presence or absence of BMs. Multivariable …

Lipid Management In Patients With Endocrine Disorders: An Endocrine Society Clinical Practice Guideline., Connie B Newman, Michael J Blaha, Jeffrey B. Boord, Bertrand Cariou, Alan Chait, Henry G Fein, Henry N Ginsberg, Ira J Goldberg, M Hassan Murad, Savitha Subramanian, Lisa R Tannock

Hospital Medicine

OBJECTIVE: This guideline will provide the practicing endocrinologist with an approach to the assessment and treatment of dyslipidemia in patients with endocrine diseases, with the objective of preventing cardiovascular (CV) events and triglyceride-induced pancreatitis. The guideline reviews data on dyslipidemia and atherosclerotic cardiovascular disease (ASCVD) risk in patients with endocrine disorders and discusses the evidence for the correction of dyslipidemia by treatment of the endocrine disease. The guideline also addresses whether treatment of the endocrine disease reduces ASCVD risk.

CONCLUSION: This guideline focuses on lipid and lipoprotein abnormalities associated with endocrine diseases, including diabetes mellitus, and whether treatment of the …

Gastrointestinal Endoscopy In The Era Of Covid-19, Abhilash Perisetti, Hemant Goyal, Neil Sharma Md

PCI Publications and Projects

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which led to a worldwide pandemic that started in early 2020. Healthcare systems across the world encountered an unprecedented surge of COVID-19 patients resulting in more than half a million deaths globally. COVID-19 has affected multiple sub-specialties and procedure-related fields, including gastroenterology. Gastrointestinal (GI) endoscopy centers are specialized units where thousands of endoscopies are performed annually. A significant proportion of these procedures are affected due to the national and regional lockdowns across the globe. To adapt to this rapidly evolving situation, endoscopy centers have undergone significant changes …

Improving Social Determinants Of Health Screening Implementation Through Collaboration: Leveraging A Clinical-Academic Partnership., Bradley E. Iott Mph, Ms, Jessica Pater Phd, Ms, Shauna Wagner Bsn, Rn, Tammy Toscos Phd, Tiffany Veinot Phd, Mls

Health Services and Informatics Research

Problem Addressed and Project Purpose Motivated by the transition to value-based payment models, 1 there are growing efforts to capture information about patients’ social determinants of health (SDOH) in United States (US) healthcare and provide subsequent services targeted at those health-related social risk factors. The collection of data about social risk factors creates opportunities for healthcare providers to make referrals to social service agencies to address individual patients’ needs and to tailor treatment plans to individuals’ specific needs, a goal of precision health2,3. Hence, by accurately and appropriately collecting SDOH data from patients and actionably displaying these data to providers, …

Prevalence, Mechanisms, And Implications Of Gastrointestinal Symptoms In Covid-19, Abhilash Perisetti, Hemant Goyal, Mahesh Gajendran, Umesha Boregowda, Rupinder Mann, Neil Sharma Md

PCI Publications and Projects

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The infection started as an outbreak of pneumonia-like symptoms in Wuhan, China. Within a few weeks, it spread across the entire globe resulting in millions of cases and thousands of deaths. While respiratory symptoms and complications are well-defined and can be severe, non-respiratory symptoms of COVID-19 are increasingly being recognized. Gastrointestinal manifestations such as nausea, vomiting, diarrhea, and abdominal pain have been added to the list of common COVID-19 symptoms. Their prevalence has been increasing, probably due to increased recognition and experience with the pandemic. Furthermore, …

Technology And Workflow Recommendations To Improve Use Of Guideline Directed Medical Therapy For Heart Failure With Reduced Ejection Fraction., Roy Robertson Md, Ryan Ahmed, Tammy Toscos Phd, Victor P. Cornet Ms, Shauna Wagner, Sarah Colletta, Carly Daley, Michael Mirro Md

Health Services and Informatics Research

BACKGROUND: Optimal use of Guideline Directed Medical Therapy (GDMT) is the cornerstone of reducing mortality and morbidity in heart failure patients with reduced ejection fraction (HFrEF). Interventions targeted at increasing GDMT use are necessary to improve outcomes. Integration of a pharmacist in specialty clinics may improve GDMT use; However, the potential benefit may be underrealized due to constraints in technology use and workflow.

PROJECT INTENT: To understand existing processes and explore workflow optimization opportunities to enhance use of GDMT prescription for patients with HFrEF.

METHODOLOGY: Teams of 2 researchers performed contextual inquiry4 during in-situ, 2-hour observations with 5 physicians, 3 …

Prognostic Impact Of Single And Multiple Descriptors In Pathologically Staged T3n0m0 Non-Small Cell Lung Cancer, Takefumi Komiya Md, Emily Powell Phd, Shinkichi Takamori Md Phd

PCI Publications and Projects

Background

T components of the current 8th edition of lung cancer American Joint Commission on Cancer (AJCC) staging assignment include size of primary tumor and others such as chest wall invasion. The role of the presence of multiple T3 descriptors in prognosis remains unknown.

Materials and methods

Using National Cancer Database (NCDB) and of AJCC 7th edition, pathologically staged (R0) N0M0 non-small cell lung cancer (NSCLC) cases diagnosed in 2010-2016 were analyzed. Selected cases had primary size larger than 5cm or staged as T3 by AJCC 7th edition despite size <5cm. T3 descriptor status by 8th edition was defined as single descriptor (“T3-single”) as primary size 5-7cm or size <5cm and T3 per 7th edition (“T3-other”), or multiple descriptor (“T3-multi”) as presence of both descriptors. Survival analysis was performed with validation of multivariate analyses.

Results

Of the 108,632 surgically resected pathologically staged N0M0R0 NSCLC …

Scope Of Artificial Intelligence In Screening And Diagnosis Of Colorectal Cancer, Hemant Goyal Md, Rupinder Mann Md, Zainab Gandhi Mbbs, Abhilash Perisetti Md, Aman Ali Md, Khizar Amani Ali, Neil Sharma Md, Benjamin Tharian Md, Shreyas Saligram, Sumant Inamdar

PCI Publications and Projects

Globally, colorectal cancer is the third most diagnosed malignancy. It causes significant mortality and morbidity, which can be reduced by early diagnosis with an effective screening test. Integrating artificial intelligence (AI) and computer-aided detection (CAD) with screening methods have shown promising results for colorectal cancer screening. AI could provide a “second look” for endoscopists to decrease the rate of missed polyps during a colonoscopy. It can also improve detection and characterization of polyps by integration with colonoscopy, various advanced endoscopic modalities like magnifying narrow-band imaging, endocytoscopy, confocal endomicroscopy, laser-induced fluorescence spectroscopy, and magnifying chromoendoscopy. In this review, we have discussed …

Impact Of Immunotherapy Use In Patients With Stage Iv Pancreatic Carcinoma, Achuta K. Guddati, Takefumi Komiya Md, Sunny J. Patel, Neil Sharma Md, Emily Powell

PCI Publications and Projects

Background: Most patients with pancreatic cancer have non-resectable disease at the time of diagnosis and usually die within 6-12 months. Despite indications in other solid tumors, the role of immunotherapy (IO) is unknown for late stage, advanced pancreatic cancer.

Methods: Using the National Cancer Database (NCDB), cases of Stage IV pancreatic cancers diagnosed in the period of 2014-2016 with at least 30-day follow up were retrospectively analyzed. The following clinical demographics were included: age (younger than 70 vs. older than 70), sex (male vs. female), race (whites vs. others), insurance (uninsured vs. insured), type of institution …

First-In-Human Visone Heart Failure Study: Asymptomatic Diaphragmatic Stimulation For Chronic Heart Failure With Reduced Ejection Fraction: Case Report, Ana Jorbenadze, Nikoloz Shaburishvili, Michael Mirro Md, Facc, Fhrs, Faha, Michel Zuber, Paul Erne, Tamaz Shaburishvili

Parkview Heart Institute

Background

Asymptomatic Diaphragmatic Stimulation (ADS) is a novel device-based HF therapy under investigation. ADS gaited with the cardiac cycle transiently modulates intrathoracic pressure, thereby enhancing pre- and afterload, and stroke volume. It is hypothesized that ADS improves cardiac function and exercise tolerance in HFrEF patients.

Methods

HFrEF patients (15) underwent laparoscopic implantation of the VisONE ADS system (NCT03484780). Post-implant stimulation levels imperceptible to the patient are determined. At discharge, ADS therapy is turned on. Measures of cardiac function, HF status, QoL and adverse events are assessed every 3 months for 12 months.

Results

Results are presented from an initial patient …

Financial And Labor Benefits Of The Individual Tb Risk Assessment Model For Annual Tb Screening, Kristin Sims Mph Cic Cpps Fapic, Amy Gutierrez Rn, Msn

Infection Control

TB rates are at an all time low in the U.S. and serial TB testing is inefficient and burdensome. Here we describe a model to guide TB screening based on occupational and non-occupational risk. Facility-level risk is taken into account only to drive policy. This methodology will reduce the cost and labor burden of TB screening.

This poster was presented at the SHEA Decennial: 6th International Conference on Healthcare Associated Infections

Successful Pharmacist Intervention To Optimize Guideline Directed Medical Therapy In Heart Failure Patients, Roy Robertson Md, Kris Howard, Elizabeth Meisberger, Emily Keltner Bs, Ma, Mindy Flanagan, Shauna Wagner, Carly Daley, Tammy Toscos Phd

Health Services and Informatics Research

No abstract provided.

Nothing New Under The Sun: How Existing Screening Programs Can Inform The Design Of Social Determinants Of Health Screening In Health Care., Bradley Iott, Denise Anthony, Jessica Pater, Shauna Wagner, Tammy Toscos Phd, Tiffany Veinot

Health Services and Informatics Research

Research Objective Up to 80% of the factors contributing to an individual’s health status are social determinants of health (SDOH). As healthcare systems transition to value-based payment models which compensate providers for patient health outcomes, many have called for healthcare organizations to screen patients for SDOH-related social needs and for providers to consider them when providing medical care. Screening for social needs is expected to involve collecting information that may make patients feel vulnerable, creating a need to develop screening methods that emphasize patient comfort. Similarly, social needs screening may place burdens on providers that have limited training and time …

The Incidence Of Chemotherapy Extravasation In The Inpatient And Ambulatory Infusion Areas Of A Community Cancer Center, Nancy Ehmke Mn, Rn, Aocn

Nursing Active Studies

Few studies have been conducted in non-National Cancer Institute (non-NCI) designated cancer centers and even less have included both the inpatient and outpatient settings. This study is being conducted in order to establish a benchmark for the incidence of chemotherapy extravasation in an inpatient oncology unit and outpatient infusion center at a non-NCI-designated community cancer center. This retrospective review is to determine the common chemotherapy agents involved in extravasation, patient factors contributing to the extravasation, and severity of extravasations.

PI: Nancy Ehmke MN, RN, AOCN

Contact: nancy.ehmke@parkview.com

A Randomized Control Trial To Compare Npo Status Against A Specialized Pre-Cardiac Cath Diet, Carri Woods Mba, Msn, Rn, Michelle Wood Msn, Rn-Bc

Nursing Active Studies

The purpose of this research study is to identify best practice for NPO status prior to a cardiac catheterization through a comparative evaluation. This prospective, randomized control study will evaluate current standard of care NPO guidelines and a specialized pre-cardiac catheterization diet in low-medium risk patients undergoing elective cardiac catheterization.

PI: Carri Woods MBA, MSN, RN; Michelle Wood MSN, RN-BC

Contact: carri.woods@parkview.com; michelle.wood@parkview.com