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Using a Mobile Messenger Service as a Digital Diary to Capture Patients' Experiences Along Their Interorganizational Treatment Path in Gynecologic Oncology: Lessons Learned. 使用移动信使服务作为数字日记,记录妇科肿瘤患者在跨机构治疗过程中的经历:经验教训。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-07-29 DOI: 10.2196/52985
Eleonore Baum, Christian Thiel, Andrea Kobleder, Daniela Bernhardsgrütter, Ramona Engst, Carola Maurer, Antje Koller

A digital diary in the form of a mobile messenger service offers a novel method for data collection in cancer research. Little is known about the things to consider when using this data collection method in clinical research for patients with cancer. In this Viewpoint paper, we discuss the lessons we learned from using a qualitative digital diary method via a mobile messenger service for data collection in oncology care. The lessons learned focus on three main topics: (1) data quality, (2) practical aspects, and (3) data protection. We hope to provide useful information to other researchers who consider this method for their research with patients. First, in this paper, we argue that the interactive nature of a digital diary via a messenger service is very well suited for the phenomenological approach and produces high-quality data. Second, we discuss practical issues of data collection with a mobile messenger service, including participant and researcher interaction. Third, we highlight corresponding aspects around technicalities, particularly those regarding data security. Our views on data privacy and information security are summarized in a comprehensive checklist to inform fellow researchers on the selection of a suitable messenger service for different scenarios. In our opinion, a digital diary via a mobile messenger service can provide high-quality data almost in real time and from participants' daily lives. However, some considerations must be made to ensure that patient data are sufficiently protected. The lessons we learned can guide future qualitative research using this relatively novel method for data collection in cancer research.

移动信使服务形式的数字日记为癌症研究提供了一种新颖的数据收集方法。对于在癌症患者临床研究中使用这种数据收集方法时应注意的事项,人们知之甚少。在这篇视点论文中,我们讨论了通过移动信使服务使用定性数字日记方法收集肿瘤护理数据的经验教训。经验教训主要集中在三个方面:(1) 数据质量;(2) 实际操作;(3) 数据保护。我们希望能为其他考虑采用这种方法对患者进行研究的研究人员提供有用的信息。首先,在本文中,我们认为通过信使服务进行数字日记的互动性质非常适合现象学方法,并能产生高质量的数据。其次,我们讨论了使用移动信使服务收集数据的实际问题,包括参与者和研究人员之间的互动。第三,我们强调了技术方面的相应问题,特别是有关数据安全的问题。我们对数据隐私和信息安全的看法总结在一份全面的清单中,以便为研究人员选择适合不同情况的信使服务提供参考。我们认为,通过移动信使服务进行数字日记几乎可以实时提供来自参与者日常生活的高质量数据。但是,必须考虑到一些问题,以确保患者数据得到充分保护。我们学到的经验可以指导未来的定性研究,在癌症研究中使用这种相对新颖的方法收集数据。
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引用次数: 0
Artificial Intelligence-Based Co-Facilitator (AICF) for Detecting and Monitoring Group Cohesion Outcomes in Web-Based Cancer Support Groups: Single-Arm Trial Study. 基于人工智能的共同协调人 (AICF) 用于检测和监控基于网络的癌症互助小组中的小组凝聚力结果:单臂试验研究。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-07-22 DOI: 10.2196/43070
Yvonne W Leung, Elise Wouterloot, Achini Adikari, Jinny Hong, Veenaajaa Asokan, Lauren Duan, Claire Lam, Carlina Kim, Kai P Chan, Daswin De Silva, Lianne Trachtenberg, Heather Rennie, Jiahui Wong, Mary Jane Esplen

Background: Commonly offered as supportive care, therapist-led online support groups (OSGs) are a cost-effective way to provide support to individuals affected by cancer. One important indicator of a successful OSG session is group cohesion; however, monitoring group cohesion can be challenging due to the lack of nonverbal cues and in-person interactions in text-based OSGs. The Artificial Intelligence-based Co-Facilitator (AICF) was designed to contextually identify therapeutic outcomes from conversations and produce real-time analytics.

Objective: The aim of this study was to develop a method to train and evaluate AICF's capacity to monitor group cohesion.

Methods: AICF used a text classification approach to extract the mentions of group cohesion within conversations. A sample of data was annotated by human scorers, which was used as the training data to build the classification model. The annotations were further supported by finding contextually similar group cohesion expressions using word embedding models as well. AICF performance was also compared against the natural language processing software Linguistic Inquiry Word Count (LIWC).

Results: AICF was trained on 80,000 messages obtained from Cancer Chat Canada. We tested AICF on 34,048 messages. Human experts scored 6797 (20%) of the messages to evaluate the ability of AICF to classify group cohesion. Results showed that machine learning algorithms combined with human input could detect group cohesion, a clinically meaningful indicator of effective OSGs. After retraining with human input, AICF reached an F1-score of 0.82. AICF performed slightly better at identifying group cohesion compared to LIWC.

Conclusions: AICF has the potential to assist therapists by detecting discord in the group amenable to real-time intervention. Overall, AICF presents a unique opportunity to strengthen patient-centered care in web-based settings by attending to individual needs.

International registered report identifier (irrid): RR2-10.2196/21453.

背景:由治疗师主导的在线支持小组(OSG)是为癌症患者提供支持的一种经济有效的方式,通常作为支持性护理提供。OSG会议成功与否的一个重要指标是小组凝聚力;然而,由于基于文本的OSG缺乏非语言线索和人际互动,监测小组凝聚力可能具有挑战性。基于人工智能的共同主持人(AICF)旨在从对话中识别治疗结果并进行实时分析:本研究旨在开发一种方法来训练和评估 AICF 监测群体凝聚力的能力:AICF 采用文本分类方法提取对话中提及的群体凝聚力。人类评分员对数据样本进行了注释,并将其作为建立分类模型的训练数据。此外,还使用单词嵌入模型查找上下文相似的群组内聚表达,为注释提供进一步支持。AICF 的性能还与自然语言处理软件 Linguistic Inquiry Word Count (LIWC) 进行了比较:AICF 在从加拿大癌症聊天室获取的 80,000 条信息上进行了训练。我们对 34,048 条信息进行了 AICF 测试。人类专家对 6797 条(20%)信息进行了评分,以评估 AICF 对群体凝聚力进行分类的能力。结果表明,机器学习算法与人工输入相结合,可以检测出群体凝聚力,这是有效 OSGs 的一个具有临床意义的指标。在使用人工输入进行再训练后,AICF 的 F1 分数达到了 0.82。与LIWC相比,AICF在识别群体凝聚力方面的表现略胜一筹:AICF 有可能通过检测群体中的不和谐因素来协助治疗师进行实时干预。总之,AICF 提供了一个独特的机会,通过关注个人需求,在基于网络的环境中加强以患者为中心的护理:RR2-10.2196/21453。
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引用次数: 0
Assessing the Relationship Between Neighborhood Socioeconomic Disadvantage and Telemedicine Use Among Patients With Breast Cancer and Examining Differential Provisions of Oncology Services Between Telehealth and In-Person Visits: Quantitative Study. 评估邻里社会经济劣势与乳腺癌患者使用远程医疗之间的关系,并考察远程医疗与亲自就诊在提供肿瘤学服务方面的差异:定量研究。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-07-18 DOI: 10.2196/55438
Jincong Q Freeman, Fangyuan Zhao, Frederick M Howard, Rita Nanda, Olufunmilayo I Olopade, Dezheng Huo
<p><strong>Background: </strong>Since the COVID-19 pandemic began, we have seen rapid growth in telemedicine use. However, telehealth care and services are not equally distributed, and not all patients with breast cancer have equal access across US regions. There are notable gaps in existing literature regarding the influence of neighborhood-level socioeconomic status on telemedicine use in patients with breast cancer and oncology services offered through telehealth versus in-person visits.</p><p><strong>Objective: </strong>We assessed the relationship between neighborhood socioeconomic disadvantage and telemedicine use among patients with breast cancer and examined differential provisions of oncology services between telehealth and in-person visits.</p><p><strong>Methods: </strong>Neighborhood socioeconomic disadvantage was measured using the Area Deprivation Index (ADI), with higher scores indicating greater disadvantages. Telemedicine and in-person visits were defined as having had a telehealth and in-person visit with a provider, respectively, in the past 12 months. Multivariable logistic regression was performed to examine the association between ADI and telemedicine use. The McNemar test was used to assess match-paired data on types of oncology services comparing telehealth and in-person visits.</p><p><strong>Results: </strong>The mean age of the patients with breast cancer (n=1163) was 61.8 (SD 12.0) years; 4.58% (52/1161) identified as Asian, 19.72% (229/1161) as Black, 3.01% (35/1161) as Hispanic, and 72.78% (845/1161) as White. Overall, 35.96% (416/1157) had a telemedicine visit in the past 12 months. Of these patients, 65% (266/409) had a videoconference visit only, 22.7% (93/409) had a telephone visit only, and 12.2% (50/409) had visits by both videoconference and telephone. Higher ADI scores were associated with a lower likelihood of telemedicine use (adjusted odds ratio [AOR] 0.89, 95% CI 0.82-0.97). Black (AOR 2.38, 95% CI 1.41-4.00) and Hispanic (AOR 2.65, 95% CI 1.07-6.58) patients had greater odds of telemedicine use than White patients. Compared to patients with high school or less education, those with an associate's degree (AOR 2.67, 95% CI 1.33-5.35), a bachelor's degree (AOR 2.75, 95% CI 1.38-5.48), or a graduate or professional degree (AOR 2.57, 95% CI 1.31-5.04) had higher odds of telemedicine use in the past 12 months. There were no significant differences in providing treatment consultation (45/405, 11.1% vs 55/405, 13.6%; P=.32) or cancer genetic counseling (11/405, 2.7% vs 19/405, 4.7%; P=.14) between telehealth and in-person visits. Of the telemedicine users, 95.8% (390/407) reported being somewhat to extremely satisfied, and 61.8% (254/411) were likely or very likely to continue using telemedicine.</p><p><strong>Conclusions: </strong>In this study of a multiethnic cohort of patients with breast cancer, our findings suggest that neighborhood-level socioeconomic disparities exist in telemedicine use and that telehealt
背景:自 COVID-19 大流行以来,我们看到远程医疗的使用迅速增长。然而,远程医疗和服务的分布并不均衡,并非所有乳腺癌患者都能在美国各地区平等地获得远程医疗服务。关于邻里层面的社会经济状况对乳腺癌患者使用远程医疗的影响,以及通过远程医疗提供的肿瘤服务与亲自就诊的对比,现有文献存在明显的空白:我们评估了邻里社会经济劣势与乳腺癌患者使用远程医疗之间的关系,并研究了远程医疗与面对面就诊在提供肿瘤服务方面的差异:方法: 采用地区贫困指数(ADI)来衡量邻里的社会经济劣势,得分越高表示劣势越大。在过去 12 个月中,与医疗服务提供者进行过远程医疗和面对面就诊的人分别被定义为远程医疗和面对面就诊者。为研究 ADI 与远程医疗使用之间的关系,我们进行了多变量逻辑回归。采用 McNemar 检验来评估匹配配对的肿瘤服务类型数据,比较远程医疗和面对面就诊的情况:乳腺癌患者(n=1163)的平均年龄为 61.8 岁(SD 12.0);4.58%(52/1161)为亚裔,19.72%(229/1161)为黑人,3.01%(35/1161)为西班牙裔,72.78%(845/1161)为白人。总体而言,35.96%(416/1157)的患者在过去 12 个月内接受过远程医疗就诊。在这些患者中,65%(266/409)仅通过视频会议就诊,22.7%(93/409)仅通过电话就诊,12.2%(50/409)同时通过视频会议和电话就诊。ADI 分数越高,使用远程医疗的可能性越低(调整后的几率比 [AOR] 0.89,95% CI 0.82-0.97)。黑人(AOR 2.38,95% CI 1.41-4.00)和西班牙裔(AOR 2.65,95% CI 1.07-6.58)患者使用远程医疗的几率高于白人患者。与高中或以下学历的患者相比,拥有副学士学位(AOR 2.67,95% CI 1.33-5.35)、学士学位(AOR 2.75,95% CI 1.38-5.48)或研究生或专业学位(AOR 2.57,95% CI 1.31-5.04)的患者在过去 12 个月中使用远程医疗的几率更高。在提供治疗咨询(45/405,11.1% vs 55/405,13.6%;P=.32)或癌症遗传咨询(11/405,2.7% vs 19/405,4.7%;P=.14)方面,远程医疗与面对面就诊没有明显差异。在远程医疗用户中,95.8%(390/407)的人表示比较满意到非常满意,61.8%(254/411)的人可能或非常可能继续使用远程医疗:在这项针对多种族乳腺癌患者的研究中,我们的发现表明,在远程医疗的使用方面存在着邻里层面的社会经济差异,而远程医疗就诊可用于提供治疗咨询和癌症遗传咨询。肿瘤学项目应解决这些差异和需求,以改善医疗服务,实现患者群体的远程医疗公平。
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引用次数: 0
Do Measures of Real-World Physical Behavior Provide Insights Into the Well-Being and Physical Function of Cancer Survivors? Cross-Sectional Analysis. 现实世界中的体育行为测量是否有助于了解癌症幸存者的福祉和身体机能?横断面分析。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-07-15 DOI: 10.2196/53180
Shelby L Bachman, Emma Gomes, Suvekshya Aryal, David Cella, Ieuan Clay, Kate Lyden, Heather J Leach

Background: As the number of cancer survivors increases, maintaining health-related quality of life in cancer survivorship is a priority. This necessitates accurate and reliable methods to assess how cancer survivors are feeling and functioning. Real-world digital measures derived from wearable sensors offer potential for monitoring well-being and physical function in cancer survivorship, but questions surrounding the clinical utility of these measures remain to be answered.

Objective: In this secondary analysis, we used 2 existing data sets to examine how measures of real-world physical behavior, captured with a wearable accelerometer, were related to aerobic fitness and self-reported well-being and physical function in a sample of individuals who had completed cancer treatment.

Methods: Overall, 86 disease-free cancer survivors aged 21-85 years completed self-report assessments of well-being and physical function, as well as a submaximal exercise test that was used to estimate their aerobic fitness, quantified as predicted submaximal oxygen uptake (VO2). A thigh-worn accelerometer was used to monitor participants' real-world physical behavior for 7 days. Accelerometry data were used to calculate average values of the following measures of physical behavior: sedentary time, step counts, time in light and moderate to vigorous physical activity, time and weighted median cadence in stepping bouts over 1 minute, and peak 30-second cadence.

Results: Spearman correlation analyses indicated that 6 (86%) of the 7 accelerometry-derived measures of real-world physical behavior were not significantly correlated with Functional Assessment of Cancer Therapy-General total well-being or linked Patient-Reported Outcomes Measurement Information System-Physical Function scores (Ps≥.08). In contrast, all but one of the physical behavior measures were significantly correlated with submaximal VO2 (Ps≤.03). Comparing these associations using likelihood ratio tests, we found that step counts, time in stepping bouts over 1 minute, and time in moderate to vigorous activity were more strongly associated with submaximal VO2 than with self-reported well-being or physical function (Ps≤.03). In contrast, cadence in stepping bouts over 1 minute and peak 30-second cadence were not more associated with submaximal VO2 than with the self-reported measures (Ps≥.08).

Conclusions: In a sample of disease-free cancer survivors, we found that several measures of real-world physical behavior were more associated with aerobic fitness than with self-reported well-being and physical function. These results highlight the possibility that in individuals who have completed cancer treatment, measures of real-world physical behavior may provide additional information compared with self-reported and performance measures. To advance the approp

背景:随着癌症幸存者人数的增加,保持癌症幸存者与健康相关的生活质量成为当务之急。这就需要有准确可靠的方法来评估癌症幸存者的感觉和功能。由可穿戴传感器衍生出的真实世界数字测量方法为监测癌症幸存者的幸福感和身体功能提供了可能,但围绕这些测量方法的临床实用性的问题仍有待解答:在这项二次分析中,我们使用了两个现有的数据集,以完成癌症治疗的个体为样本,研究用可穿戴加速度计采集的真实世界身体行为指标与有氧健身、自我报告的幸福感和身体功能之间的关系:总体而言,86 名年龄在 21-85 岁之间的无病癌症幸存者完成了对幸福感和身体功能的自我报告评估,以及一项亚极限运动测试,该测试用于估算他们的有氧体能,量化为预测的亚极限摄氧量(VO2)。佩戴在大腿上的加速度计用于监测参与者在现实世界中 7 天的身体行为。加速度计数据被用来计算以下身体行为测量指标的平均值:久坐时间、步数、轻度和中度到剧烈运动时间、1 分钟内步频的时间和加权中位数,以及 30 秒的峰值步频:斯皮尔曼相关性分析表明,在 7 项加速度测量中,有 6 项(86%)与癌症治疗功能评估-总体健康状况或患者报告结果测量信息系统-身体功能评分无显著相关性(Ps≥.08)。与此相反,除一项外,其他所有身体行为测量指标均与亚极限 VO2 显著相关(Ps≤.03)。通过似然比检验比较这些相关性,我们发现步数、1 分钟以上的步频时间和中度至剧烈活动时间与最大氧饱和度下限的相关性比与自我报告的幸福感或身体功能的相关性更强(Ps≤.03)。与此相反,1 分钟以上的步频和 30 秒的峰值步频与最大氧饱和度下限的相关性并不比与自我报告的指标的相关性更高(Ps≥.08):在一个无病癌症幸存者样本中,我们发现,与自我报告的幸福感和身体功能相比,几种真实世界身体行为的测量方法与有氧健身的关联度更高。这些结果凸显了一种可能性,即对于已经完成癌症治疗的人来说,与自我报告和表现测量相比,真实世界身体行为测量可能会提供更多信息。为了推动在肿瘤临床研究中适当使用数字测量方法,有必要在具有代表性的大型癌症幸存者样本中开展进一步研究,评估真实世界身体行为在一段时间内的临床效用:试验注册:ClinicalTrials.gov NCT03781154;https://clinicaltrials.gov/ct2/show/NCT03781154。
{"title":"Do Measures of Real-World Physical Behavior Provide Insights Into the Well-Being and Physical Function of Cancer Survivors? Cross-Sectional Analysis.","authors":"Shelby L Bachman, Emma Gomes, Suvekshya Aryal, David Cella, Ieuan Clay, Kate Lyden, Heather J Leach","doi":"10.2196/53180","DOIUrl":"10.2196/53180","url":null,"abstract":"<p><strong>Background: </strong>As the number of cancer survivors increases, maintaining health-related quality of life in cancer survivorship is a priority. This necessitates accurate and reliable methods to assess how cancer survivors are feeling and functioning. Real-world digital measures derived from wearable sensors offer potential for monitoring well-being and physical function in cancer survivorship, but questions surrounding the clinical utility of these measures remain to be answered.</p><p><strong>Objective: </strong>In this secondary analysis, we used 2 existing data sets to examine how measures of real-world physical behavior, captured with a wearable accelerometer, were related to aerobic fitness and self-reported well-being and physical function in a sample of individuals who had completed cancer treatment.</p><p><strong>Methods: </strong>Overall, 86 disease-free cancer survivors aged 21-85 years completed self-report assessments of well-being and physical function, as well as a submaximal exercise test that was used to estimate their aerobic fitness, quantified as predicted submaximal oxygen uptake (VO<sub>2</sub>). A thigh-worn accelerometer was used to monitor participants' real-world physical behavior for 7 days. Accelerometry data were used to calculate average values of the following measures of physical behavior: sedentary time, step counts, time in light and moderate to vigorous physical activity, time and weighted median cadence in stepping bouts over 1 minute, and peak 30-second cadence.</p><p><strong>Results: </strong>Spearman correlation analyses indicated that 6 (86%) of the 7 accelerometry-derived measures of real-world physical behavior were not significantly correlated with Functional Assessment of Cancer Therapy-General total well-being or linked Patient-Reported Outcomes Measurement Information System-Physical Function scores (Ps≥.08). In contrast, all but one of the physical behavior measures were significantly correlated with submaximal VO<sub>2</sub> (Ps≤.03). Comparing these associations using likelihood ratio tests, we found that step counts, time in stepping bouts over 1 minute, and time in moderate to vigorous activity were more strongly associated with submaximal VO<sub>2</sub> than with self-reported well-being or physical function (Ps≤.03). In contrast, cadence in stepping bouts over 1 minute and peak 30-second cadence were not more associated with submaximal VO<sub>2</sub> than with the self-reported measures (Ps≥.08).</p><p><strong>Conclusions: </strong>In a sample of disease-free cancer survivors, we found that several measures of real-world physical behavior were more associated with aerobic fitness than with self-reported well-being and physical function. These results highlight the possibility that in individuals who have completed cancer treatment, measures of real-world physical behavior may provide additional information compared with self-reported and performance measures. To advance the approp","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patterns of Prescription Medication Use Before Diagnosis of Early Age-Onset Colorectal Cancer: Population-Based Descriptive Study. 早发性大肠癌确诊前的处方药使用模式:基于人群的描述性研究
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-07-12 DOI: 10.2196/50402
Vienna Cheng, Eric C Sayre, Vicki Cheng, Ria Garg, Sharlene Gill, Ameer Farooq, Mary A De Vera

Background: Colorectal cancer (CRC) is estimated to be the fourth most common cancer diagnosis in Canada (except for nonmelanoma skin cancers) and the second and third leading cause of cancer-related death in male and female individuals, respectively.

Objective: The rising incidence of early age-onset colorectal cancer (EAO-CRC; diagnosis at less than 50 years) calls for a better understanding of patients' pathway to diagnosis. Therefore, we evaluated patterns of prescription medication use before EAO-CRC diagnosis.

Methods: We used linked administrative health databases in British Columbia (BC), Canada, to identify individuals diagnosed with EAO-CRC between January 1, 2010, and December 31, 2016 (hereinafter referred to as "cases"), along with cancer-free controls (1:10), matched by age and sex. We identified all prescriptions dispensed from community pharmacies during the year prior to diagnosis and used the Anatomical Therapeutic Chemical Classification system Level 3 to group prescriptions according to the drug class. A parallel assessment was conducted for individuals diagnosed with average age-onset CRC (diagnosis at age 50 years and older).

Results: We included 1001 EAO-CRC cases (n=450, 45% female participants; mean 41.0, SD 6.1 years), and 12,989 prescriptions were filled in the year before diagnosis by 797 (79.7%) individuals. Top-filled drugs were antidepressants (first; n=1698, 13.1%). Drugs for peptic ulcer disease and gastroesophageal reflux disease (third; n=795, 6.1%) were more likely filled by EAO-CRC cases than controls (odds ratio [OR] 1.4, 95% CI 1.2-1.7) and with more frequent fills (OR 1.8, 95% CI 1.7-1.9). We noted similar patterns for topical agents for hemorrhoids and anal fissures, which were more likely filled by EAO-CRC cases than controls (OR 7.4, 95% CI 5.8-9.4) and with more frequent fills (OR 15.6, 95% CI 13.1-18.6).

Conclusions: We observed frequent prescription medication use in the year before diagnosis of EAO-CRC, including for drugs to treat commonly reported symptoms of EAO-CRC.

背景:据估计,结直肠癌(CRC)是加拿大第四大常见癌症(非黑色素瘤皮肤癌除外),也是男性和女性癌症相关死亡的第二和第三大原因:早发性结直肠癌(EAO-CRC;诊断年龄小于 50 岁)发病率的上升要求我们更好地了解患者的诊断途径。因此,我们对 EAO-CRC 诊断前的处方药使用模式进行了评估:我们使用加拿大不列颠哥伦比亚省(BC)的链接行政健康数据库,确定了 2010 年 1 月 1 日至 2016 年 12 月 31 日期间确诊为 EAO-CRC 的患者(以下简称 "病例"),以及按年龄和性别匹配的无癌症对照组(1:10)。我们确定了确诊前一年社区药房开具的所有处方,并使用解剖学治疗化学分类系统三级将处方按照药物类别分组。同时还对诊断为平均年龄发病的 CRC 患者(诊断年龄在 50 岁及以上)进行了评估:我们纳入了 1001 例 EAO-CRC 病例(n=450,女性参与者占 45%;平均 41.0 岁,SD 6.1 岁),其中 797 人(79.7%)在确诊前一年内服用了 12,989 种处方药。最常用的药物是抗抑郁药(第一位;n=1698,13.1%)。与对照组相比,EAO-CRC 病例更有可能服用治疗消化性溃疡病和胃食管反流病的药物(第三位,人数=795,占 6.1%)(几率比 [OR] 1.4,95% CI 1.2-1.7),而且服用频率更高(OR 1.8,95% CI 1.7-1.9)。我们注意到治疗痔疮和肛裂的外用药也有类似的情况,与对照组相比,EAO-CRC 病例更有可能使用外用药(OR 7.4,95% CI 5.8-9.4),而且使用频率更高(OR 15.6,95% CI 13.1-18.6):我们观察到,在确诊 EAO-CRC 之前的一年中,患者频繁使用处方药,包括治疗 EAO-CRC 常见症状的药物。
{"title":"Patterns of Prescription Medication Use Before Diagnosis of Early Age-Onset Colorectal Cancer: Population-Based Descriptive Study.","authors":"Vienna Cheng, Eric C Sayre, Vicki Cheng, Ria Garg, Sharlene Gill, Ameer Farooq, Mary A De Vera","doi":"10.2196/50402","DOIUrl":"10.2196/50402","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is estimated to be the fourth most common cancer diagnosis in Canada (except for nonmelanoma skin cancers) and the second and third leading cause of cancer-related death in male and female individuals, respectively.</p><p><strong>Objective: </strong>The rising incidence of early age-onset colorectal cancer (EAO-CRC; diagnosis at less than 50 years) calls for a better understanding of patients' pathway to diagnosis. Therefore, we evaluated patterns of prescription medication use before EAO-CRC diagnosis.</p><p><strong>Methods: </strong>We used linked administrative health databases in British Columbia (BC), Canada, to identify individuals diagnosed with EAO-CRC between January 1, 2010, and December 31, 2016 (hereinafter referred to as \"cases\"), along with cancer-free controls (1:10), matched by age and sex. We identified all prescriptions dispensed from community pharmacies during the year prior to diagnosis and used the Anatomical Therapeutic Chemical Classification system Level 3 to group prescriptions according to the drug class. A parallel assessment was conducted for individuals diagnosed with average age-onset CRC (diagnosis at age 50 years and older).</p><p><strong>Results: </strong>We included 1001 EAO-CRC cases (n=450, 45% female participants; mean 41.0, SD 6.1 years), and 12,989 prescriptions were filled in the year before diagnosis by 797 (79.7%) individuals. Top-filled drugs were antidepressants (first; n=1698, 13.1%). Drugs for peptic ulcer disease and gastroesophageal reflux disease (third; n=795, 6.1%) were more likely filled by EAO-CRC cases than controls (odds ratio [OR] 1.4, 95% CI 1.2-1.7) and with more frequent fills (OR 1.8, 95% CI 1.7-1.9). We noted similar patterns for topical agents for hemorrhoids and anal fissures, which were more likely filled by EAO-CRC cases than controls (OR 7.4, 95% CI 5.8-9.4) and with more frequent fills (OR 15.6, 95% CI 13.1-18.6).</p><p><strong>Conclusions: </strong>We observed frequent prescription medication use in the year before diagnosis of EAO-CRC, including for drugs to treat commonly reported symptoms of EAO-CRC.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11282380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Usability and Preliminary Efficacy of an Adaptive Supportive Care System for Patients With Cancer: Pilot Randomized Controlled Trial. 癌症患者适应性支持护理系统的可用性和初步疗效:试点随机对照试验。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-07-10 DOI: 10.2196/49703
Sharon H Baik, Karen Clark, Marisol Sanchez, Matthew Loscalzo, Ashley Celis, Marianne Razavi, Dershung Yang, William Dale, Niina Haas

Background: Using an iterative user-centered design process, our team developed a patient-centered adaptive supportive care system, PatientCareAnywhere, that provides comprehensive biopsychosocial screening and supportive cancer care to patients across the continuum of care adaptively. The overarching goal of PatientCareAnywhere is to improve health-related quality of life (HRQOL) and self-efficacy of patients with cancer by empowering them with self-management skills and bringing cancer care support directly to them at home. Such support is adaptive to the patient's needs and health status and coordinated across multiple sources in the forms of referrals, education, engagement of community resources, and secure social communication.

Objective: This study aims to assess the usability of the new web-based PatientCareAnywhere system and examine the preliminary efficacy of PatientCareAnywhere to improve patient-reported outcomes compared with usual care.

Methods: For phase 1, usability testing participants included patients with cancer (n=4) and caregivers (n=7) who evaluated the software prototype and provided qualitative (eg, interviews) and quantitative (eg, System Usability Scale) feedback. For phase 2, participants in the 3-month pilot randomized controlled trial were randomized to receive the PatientCareAnywhere intervention (n=36) or usual care control condition (n=36). HRQOL and cancer-relevant self-efficacy were assessed at baseline (preintervention assessment) and 12 weeks from baseline (postintervention assessment); mean differences between pre- and postintervention scores were compared between the 2 groups.

Results: Participants were highly satisfied with the prototype and reported above-average acceptable usability, with a mean System Usability Scale score of 84.09 (SD 10.02). Qualitative data supported the overall usability and perceived usefulness of the intervention, with a few design features (eg, "help request" function) added based on participant feedback. With regard to the randomized controlled trial, patients in the intervention group reported significant improvements in HRQOL from pre- to postintervention scores (mean difference 6.08, SD 15.26) compared with the control group (mean difference -2.95, SD 10.63; P=.01). In contrast, there was no significant between-group difference in self-efficacy (P=.09).

Conclusions: Overall, PatientCareAnywhere represents a user-friendly, functional, and acceptable supportive care intervention with preliminary efficacy to improve HRQOL among patients diagnosed with cancer. Future studies are needed to further establish the efficacy of PatientCareAnywhere as well as explore strategies to enhance user engagement and investigate the optimal intensity, frequency, and use of the intervention to improve patient outcomes.

Trial registration: ClinicalTrials.gov NCT024

背景:我们的团队采用以用户为中心的迭代设计流程,开发出了以患者为中心的自适应支持性护理系统 PatientCareAnywhere,该系统可为患者提供全面的生物心理社会筛查和自适应的癌症支持性护理。PatientCareAnywhere 的总体目标是提高癌症患者的健康相关生活质量(HRQOL)和自我效能,具体做法是让他们掌握自我管理技能,并直接在家中为他们提供癌症护理支持。这种支持可根据患者的需求和健康状况进行调整,并以转诊、教育、社区资源参与和安全的社会交流等形式从多个来源进行协调:本研究旨在评估新的基于网络的 PatientCareAnywhere 系统的可用性,并检验 PatientCareAnywhere 与常规护理相比在改善患者报告结果方面的初步效果:第一阶段的可用性测试参与者包括癌症患者(4 人)和护理人员(7 人),他们对软件原型进行了评估,并提供了定性(如访谈)和定量(如系统可用性量表)反馈。在第二阶段,为期 3 个月的试点随机对照试验的参与者被随机分配到接受 PatientCareAnywhere 干预(36 人)或常规护理对照条件(36 人)。在基线(干预前评估)和自基线起 12 周(干预后评估)对患者的 HRQOL 和癌症相关自我效能进行评估;比较两组患者干预前和干预后得分的平均差异:结果:参与者对原型非常满意,并表示可用性高于平均水平,系统可用性量表平均得分为 84.09(标准差 10.02)。定性数据支持干预措施的整体可用性和感知有用性,并根据参与者的反馈增加了一些设计功能(如 "帮助请求 "功能)。在随机对照试验方面,与对照组相比,干预组患者的 HRQOL 从干预前到干预后的评分有显著改善(平均差 6.08,标准差 15.26)(平均差 -2.95,标准差 10.63;P=0.01)。相比之下,自我效能感在组间无明显差异(P=.09):总体而言,PatientCareAnywhere 是一种用户友好型、功能性和可接受的支持性护理干预措施,对改善癌症患者的 HRQOL 具有初步疗效。未来的研究需要进一步确定 PatientCareAnywhere 的疗效,探索提高用户参与度的策略,研究干预的最佳强度、频率和使用方法,以改善患者的治疗效果:ClinicalTrials.gov NCT02408406; https://clinicaltrials.gov/study/NCT02408406。
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引用次数: 0
Applying the Unified Theory of Acceptance and Use of Technology to Identify Factors Associated With Intention to Use Teledelivered Supportive Care Among Recently Diagnosed Breast Cancer Survivors During COVID-19 in Hong Kong: Cross-Sectional Survey. 在香港 COVID-19 期间,应用接受和使用技术的统一理论来确定与最近确诊的乳腺癌幸存者使用远程支持性护理的意向相关的因素:横断面调查。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-06-27 DOI: 10.2196/51072
Nelson C Y Yeung, Stephanie T Y Lau, Winnie W S Mak, Cecilia Cheng, Emily Y Y Chan, Judy Y M Siu, Polly S Y Cheung

Background: Many supportive cancer care (SCC) services were teledelivered during COVID-19, but what facilitates patients' intentions to use teledelivered SCC is unknown.

Objective: The study aimed to use the unified theory of acceptance and use of technology to investigate the factors associated with the intentions of breast cancer survivors (BCS) in Hong Kong to use various types of teledelivered SCC (including psychosocial care, medical consultation, complementary care, peer support groups). Favorable telehealth-related perceptions (higher performance expectancy, lower effort expectancy, more facilitating conditions, positive social influences), less technological anxiety, and greater fear of COVID-19 were hypothesized to be associated with higher intentions to use teledelivered SCC. Moreover, the associations between telehealth-related perceptions and intentions to use teledelivered SCC were hypothesized to be moderated by education level, such that associations between telehealth-related perceptions and intentions to use teledelivered SCC would be stronger among those with a higher education level.

Methods: A sample of 209 (209/287, 72.8% completion rate) women diagnosed with breast cancer since the start of the COVID-19 outbreak in Hong Kong (ie, January 2020) were recruited from the Hong Kong Breast Cancer Registry to complete a cross-sectional survey between June 2022 and December 2022. Participants' intentions to use various types of teledelivered SCC (dependent variables), telehealth-related perceptions (independent variables), and sociodemographic variables (eg, education, as a moderator variable) were measured using self-reported, validated measures.

Results: Hierarchical regression analysis results showed that greater confidence using telehealth, performance expectancy (believing telehealth helps with daily tasks), social influence (important others encouraging telehealth use), and facilitating conditions (having resources for telehealth use) were associated with higher intentions to use teledelivered SCC (range: β=0.16, P=.03 to β=0.34, P<.001). Moreover, 2-way interactions emerged between education level and 2 of the telehealth perception variables. Education level moderated the associations between (1) performance expectancy and intention to use teledelivered complementary care (β=0.34, P=.04) and (2) facilitating conditions and intention to use teledelivered peer support groups (β=0.36, P=.03). The positive associations between those telehealth perceptions and intentions were only significant among those with a higher education level.

Conclusions: The findings of this study implied that enhancing BCS' skills at using telehealth, BCS' and their important others' perceived benefits of telehealth, and providing assistance for telehealth use could increase BCS' intentions to use teledelivered SCC. For intentions to use speci

背景:在COVID-19期间,许多癌症支持性护理(SCC)服务都采用了远程递送,但促进患者使用远程递送SCC的因素尚不清楚:本研究旨在利用接受和使用技术的统一理论,调查与香港乳腺癌幸存者(BCS)使用各类远程医疗癌症辅助护理服务(包括社会心理护理、医疗咨询、辅助护理、同伴支持小组)的意向相关的因素。与远程医疗相关的有利认知(更高的性能预期、更低的努力预期、更多的便利条件、积极的社会影响)、较少的技术焦虑以及对 COVID-19 的更大恐惧,被假设与较高的远程传播 SCC 使用意愿相关。此外,我们还假设远程医疗相关认知与使用远程递送的SCC的意向之间的关联会受到教育水平的调节,因此教育水平越高的人对远程医疗相关认知与使用远程递送的SCC的意向之间的关联就越强:我们从香港乳癌登记处招募了209名(209/287,完成率72.8%)自COVID-19在香港爆发以来(即2020年1月)确诊为乳癌的女性样本,在2022年6月至2022年12月期间完成了一项横断面调查。调查采用自我报告的验证方法,测量了参与者使用各种类型远程提供的 SCC 的意向(因变量)、远程医疗相关认知(自变量)和社会人口变量(如教育程度,作为调节变量):分层回归分析结果显示,使用远程医疗的信心、绩效预期(认为远程医疗有助于完成日常任务)、社会影响(重要他人鼓励使用远程医疗)和便利条件(拥有使用远程医疗的资源)与使用远程提供的 SCC 的意向较高相关(范围:β=0.16,P=.03 至 β=0.34,P=.05):本研究的结果表明,提高 BCS 使用远程保健的技能、增强 BCS 及其重要他人对远程保健益处的感知,以及为远程保健的使用提供帮助,可以提高 BCS 使用远程传播 SCC 的意愿。就使用特定类型的 SCC 的意愿而言,解决相关因素(绩效预期、便利条件)可能对那些教育水平较高的人尤其有益。
{"title":"Applying the Unified Theory of Acceptance and Use of Technology to Identify Factors Associated With Intention to Use Teledelivered Supportive Care Among Recently Diagnosed Breast Cancer Survivors During COVID-19 in Hong Kong: Cross-Sectional Survey.","authors":"Nelson C Y Yeung, Stephanie T Y Lau, Winnie W S Mak, Cecilia Cheng, Emily Y Y Chan, Judy Y M Siu, Polly S Y Cheung","doi":"10.2196/51072","DOIUrl":"10.2196/51072","url":null,"abstract":"<p><strong>Background: </strong>Many supportive cancer care (SCC) services were teledelivered during COVID-19, but what facilitates patients' intentions to use teledelivered SCC is unknown.</p><p><strong>Objective: </strong>The study aimed to use the unified theory of acceptance and use of technology to investigate the factors associated with the intentions of breast cancer survivors (BCS) in Hong Kong to use various types of teledelivered SCC (including psychosocial care, medical consultation, complementary care, peer support groups). Favorable telehealth-related perceptions (higher performance expectancy, lower effort expectancy, more facilitating conditions, positive social influences), less technological anxiety, and greater fear of COVID-19 were hypothesized to be associated with higher intentions to use teledelivered SCC. Moreover, the associations between telehealth-related perceptions and intentions to use teledelivered SCC were hypothesized to be moderated by education level, such that associations between telehealth-related perceptions and intentions to use teledelivered SCC would be stronger among those with a higher education level.</p><p><strong>Methods: </strong>A sample of 209 (209/287, 72.8% completion rate) women diagnosed with breast cancer since the start of the COVID-19 outbreak in Hong Kong (ie, January 2020) were recruited from the Hong Kong Breast Cancer Registry to complete a cross-sectional survey between June 2022 and December 2022. Participants' intentions to use various types of teledelivered SCC (dependent variables), telehealth-related perceptions (independent variables), and sociodemographic variables (eg, education, as a moderator variable) were measured using self-reported, validated measures.</p><p><strong>Results: </strong>Hierarchical regression analysis results showed that greater confidence using telehealth, performance expectancy (believing telehealth helps with daily tasks), social influence (important others encouraging telehealth use), and facilitating conditions (having resources for telehealth use) were associated with higher intentions to use teledelivered SCC (range: β=0.16, P=.03 to β=0.34, P<.001). Moreover, 2-way interactions emerged between education level and 2 of the telehealth perception variables. Education level moderated the associations between (1) performance expectancy and intention to use teledelivered complementary care (β=0.34, P=.04) and (2) facilitating conditions and intention to use teledelivered peer support groups (β=0.36, P=.03). The positive associations between those telehealth perceptions and intentions were only significant among those with a higher education level.</p><p><strong>Conclusions: </strong>The findings of this study implied that enhancing BCS' skills at using telehealth, BCS' and their important others' perceived benefits of telehealth, and providing assistance for telehealth use could increase BCS' intentions to use teledelivered SCC. For intentions to use speci","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11240077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heart Rate Monitoring Among Breast Cancer Survivors: Quantitative Study of Device Agreement in a Community-Based Exercise Program. 乳腺癌幸存者的心率监测:社区锻炼计划中设备一致性的定量研究。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-06-20 DOI: 10.2196/51210
Lindsey L Page, Jason Fanning, Connor Phipps, Ann Berger, Elizabeth Reed, Diane Ehlers

Background: Exercise intensity (eg, target heart rate [HR]) is a fundamental component of exercise prescription to elicit health benefits in cancer survivors. Despite the validity of chest-worn monitors, their feasibility in community and unsupervised exercise settings may be challenging. As wearable technology continues to improve, consumer-based wearable sensors may represent an accessible alternative to traditional monitoring, offering additional advantages.

Objective: The purpose of this study was to examine the agreement between the Polar H10 chest monitor and Fitbit Inspire HR for HR measurement in breast cancer survivors enrolled in the intervention arm of a randomized, pilot exercise trial.

Methods: Participants included breast cancer survivors (N=14; aged 38-72 years) randomized to a 12-week aerobic exercise program. This program consisted of three 60-minute, moderate-intensity walking sessions per week, either in small groups or one-on-one, facilitated by a certified exercise physiologist and held at local community fitness centers. As originally designed, the exercise prescription included 36 supervised sessions at a fitness center. However, due to the COVID-19 pandemic, the number of supervised sessions varied depending on whether participants enrolled before or after March 2020. During each exercise session, HR (in beats per minute) was concurrently measured via a Polar H10 chest monitor and a wrist-worn Fitbit Inspire HR at 5 stages: pre-exercise rest; midpoint of warm-up; midpoint of exercise session; midpoint of cool-down; and postexercise recovery. The exercise physiologist recorded the participant's HR from each device at the midpoint of each stage. HR agreement between the Polar H10 and Fitbit Inspire HR was assessed using Lin concordance correlation coefficient (rc) with a 95% CI. Lin rc ranges from 0 to 1.00, with 0 indicating no concordance and 1.00 indicating perfect concordance. Relative error rates were calculated to examine differences across exercise session stages.

Results: Data were available for 200 supervised sessions across the sample (session per participant: mean 13.33, SD 13.7). By exercise session stage, agreement between the Polar H10 monitor and the Fitbit was highest during pre-exercise seated rest (rc=0.76, 95% CI 0.70-0.81) and postexercise seated recovery (rc=0.89, 95% CI 0.86-0.92), followed by the midpoint of exercise (rc=0.63, 95% CI 0.55-0.70) and cool-down (rc=0.68, 95% CI 0.60-0.74). The agreement was lowest during warm-up (rc=0.39, 95% CI 0.27-0.49). Relative error rates ranged from -3.91% to 3.09% and were greatest during warm-up (relative error rate: mean -3.91, SD 11.92%).

Conclusions: The Fitbit overestimated HR during peak exercise intensity, posing risks for overexercising, which may not be safe for breast cancer survivors' fitness levels. While the Fitbit Inspire HR may

背景:运动强度(如目标心率 [HR])是运动处方的基本组成部分,可为癌症幸存者带来健康益处。尽管胸戴式监测器很有效,但其在社区和无监督运动环境中的可行性可能具有挑战性。随着可穿戴技术的不断改进,基于消费者的可穿戴传感器可能会成为传统监测的替代品,提供更多优势:本研究的目的是检验 Polar H10 胸部监测仪和 Fitbit Inspire HR 在为乳腺癌幸存者进行心率测量时的一致性:参与者包括随机参加为期 12 周有氧运动计划的乳腺癌幸存者(14 人;年龄 38-72 岁)。该计划包括每周三次、每次 60 分钟、中等强度的步行训练,以小组或一对一的形式进行,由认证运动生理学家协助,在当地社区健身中心进行。按照最初的设计,运动处方包括在健身中心进行 36 次有监督的训练。然而,由于 COVID-19 大流行,监督课程的次数因参与者是在 2020 年 3 月之前还是之后注册而有所不同。在每次运动过程中,通过 Polar H10 胸部监测器和佩戴在手腕上的 Fitbit Inspire HR 同时测量五个阶段的心率(以每分钟心跳次数为单位):运动前休息、热身中段、运动中段、冷却中段和运动后恢复。运动生理学家在每个阶段的中点用每个设备记录参与者的心率。Polar H10 和 Fitbit Inspire HR 之间的心率一致性使用 Lin 一致性相关系数 (rc) 和 95% CI 进行评估。Lin rc 的范围为 0 至 1.00,0 表示不一致,1.00 表示完全一致。计算相对误差率以检查不同锻炼阶段的差异:结果:样本中共有 200 次指导练习的数据(每位参与者的平均练习次数为 13.33 次,标准差为 13.7 次)。按运动阶段划分,Polar H10 监测器和 Fitbit 在运动前坐姿休息(rc=0.76,95% CI 0.70-0.81)和运动后坐姿恢复(rc=0.89,95% CI 0.86-0.92)期间的一致性最高,其次是运动中点(rc=0.63,95% CI 0.55-0.70)和冷却(rc=0.68,95% CI 0.60-0.74)。热身时的一致性最低(rc=0.39,95% CI 0.27-0.49)。相对误差率从-3.91%到3.09%不等,热身时误差最大(相对误差率:平均-3.91%,标准差11.92%):Fitbit高估了运动强度峰值时的心率,存在运动过度的风险,这对乳腺癌幸存者的体能水平可能并不安全。虽然Fitbit Inspire HR可用于估算运动心率,但在考虑参与者安全和数据解释时需要采取预防措施:Clinicaltrials.gov NCT03980626; https://clinicaltrials.gov/study/NCT03980626?term=NCT03980626&rank=1。
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引用次数: 0
Digital Smoking Cessation Intervention for Cancer Survivors: Analysis of Predictors and Moderators of Engagement and Outcome Alongside a Randomized Controlled Trial. 针对癌症幸存者的数字戒烟干预:与随机对照试验同时进行的参与和结果的预测因素和调节因素分析。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-06-20 DOI: 10.2196/46303
Rosa Andree, Ajla Mujcic, Wouter den Hollander, Margriet van Laar, Brigitte Boon, Rutger Engels, Matthijs Blankers

Background: Recent studies have shown positive, though small, clinical effects of digital smoking cessation (SC) interventions for cancer survivors. However, research on associations among participant characteristics, intervention engagement, and outcomes is limited.

Objective: This study aimed to explore the predictors and moderators of engagement and outcome of MyCourse-Quit Smoking (in Dutch: "MijnKoers-Stoppen met Roken"), a digital minimally guided intervention for cancer survivors.

Methods: A secondary analysis of data from the randomized controlled trial was performed. The number of cigarettes smoked in the past 7 days at 6-month follow-up was the primary outcome measure. We analyzed interactions among participant characteristics (11 variables), intervention engagement (3 variables), and outcome using robust linear (mixed) modeling.

Results: In total, 165 participants were included in this study. Female participants accessed the intervention less often than male participants (B=-11.12; P=.004). A higher Alcohol Use Disorders Identification Test score at baseline was associated with a significantly higher number of logins (B=1.10; P<.001) and diary registrations (B=1.29; P<.001). A higher Fagerström Test for Nicotine Dependence score at baseline in the intervention group was associated with a significantly larger reduction in tobacco use after 6 months (B=-9.86; P=.002). No other associations and no moderating effects were found.

Conclusions: Overall, a limited number of associations was found between participant characteristics, engagement, and outcome, except for gender, problematic alcohol use, and nicotine dependence. Future studies are needed to shed light on how this knowledge can be used to improve the effects of digital SC programs for cancer survivors.

Trial registration: Netherlands Trial register NTR6011/NL5434; https://onderzoekmetmensen.nl/nl/trial/22832.

背景:最近的研究表明,针对癌症幸存者的数字化戒烟(SC)干预措施具有积极的临床效果,尽管这种效果很小。然而,有关参与者特征、干预参与度和结果之间关联的研究却很有限:本研究旨在探索MyCourse-Quit Smoking(荷兰语:"MijnKoers-Stoppen met Roken")参与度和结果的预测因素和调节因素:对随机对照试验的数据进行了二次分析。方法:我们对随机对照试验的数据进行了二次分析,以随访 6 个月时过去 7 天内吸烟的数量为主要结果指标。我们使用稳健线性(混合)模型分析了参与者特征(11 个变量)、干预参与度(3 个变量)和结果之间的交互作用:本研究共纳入 165 名参与者。女性参与者参与干预的频率低于男性参与者(B=-11.12;P=.004)。基线时酒精使用障碍鉴定测试得分越高,登录次数越多(B=1.10;P=.004):总体而言,除了性别、酗酒问题和尼古丁依赖外,在参与者特征、参与度和结果之间发现的关联数量有限。未来的研究需要阐明如何利用这些知识来提高针对癌症幸存者的数字SC项目的效果:荷兰试验登记号:NTR6011/NL5434;https://onderzoekmetmensen.nl/nl/trial/22832。
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引用次数: 0
Real-World Survival Comparisons Between Radiotherapy and Surgery for Metachronous Second Primary Lung Cancer and Predictions of Lung Cancer-Specific Outcomes Using Machine Learning: Population-Based Study. 利用机器学习比较异位第二原发性肺癌放疗和手术的实际生存期并预测肺癌特异性结果:基于人群的研究。
IF 3.3 Q2 ONCOLOGY Pub Date : 2024-06-12 DOI: 10.2196/53354
Yue Zheng, Ailin Zhao, Yuqi Yang, Laduona Wang, Yifei Hu, Ren Luo, Yijun Wu

Background: Metachronous second primary lung cancer (MSPLC) is not that rare but is seldom studied.

Objective: We aim to compare real-world survival outcomes between different surgery strategies and radiotherapy for MSPLC.

Methods: This retrospective study analyzed data collected from patients with MSPLC between 1988 and 2012 in the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) analyses and machine learning were performed to compare variables between patients with MSPLC. Survival curves were plotted using the Kaplan-Meier method and were compared using log-rank tests.

Results: A total of 2451 MSPLC patients were categorized into the following treatment groups: 864 (35.3%) received radiotherapy, 759 (31%) underwent surgery, 89 (3.6%) had surgery plus radiotherapy, and 739 (30.2%) had neither treatment. After PSM, 470 pairs each for radiotherapy and surgery were generated. The surgery group had significantly better survival than the radiotherapy group (P<.001) and the untreated group (563 pairs; P<.001). Further analysis revealed that both wedge resection (85 pairs; P=.004) and lobectomy (71 pairs; P=.002) outperformed radiotherapy in overall survival for MSPLC patients. Machine learning models (extreme gradient boosting, random forest classifier, adaptive boosting) demonstrated high predictive performance based on area under the curve (AUC) values. Least absolute shrinkage and selection operator (LASSO) regression analysis identified 9 significant variables impacting cancer-specific survival, emphasizing surgery's consistent influence across 1 year to 10 years. These variables encompassed age at diagnosis, sex, year of diagnosis, radiotherapy of initial primary lung cancer (IPLC), primary site, histology, surgery, chemotherapy, and radiotherapy of MPSLC. Competing risk analysis highlighted lower mortality for female MPSLC patients (hazard ratio [HR]=0.79, 95% CI 0.71-0.87) and recent IPLC diagnoses (HR=0.79, 95% CI 0.73-0.85), while radiotherapy for IPLC increased mortality (HR=1.31, 95% CI 1.16-1.50). Surgery alone had the lowest cancer-specific mortality (HR=0.83, 95% CI 0.81-0.85), with sublevel resection having the lowest mortality rate among the surgical approaches (HR=0.26, 95% CI 0.21-0.31). The findings provide valuable insights into the factors that influence cumulative cancer-specific mortality.

Conclusions: Surgical resections such as wedge resection and lobectomy confer better survival than radiation therapy for MSPLC, but radiation can be a valid alternative for the treatment of MSPLC.

背景:间变性第二原发性肺癌(MSPLC)并不罕见,但很少被研究:我们旨在比较不同手术策略和放疗对 MSPLC 的实际生存效果:这项回顾性研究分析了监测、流行病学和最终结果(SEER)数据库中1988年至2012年间收集的MSPLC患者数据。通过倾向得分匹配(PSM)分析和机器学习,比较了MSPLC患者之间的变量。使用Kaplan-Meier方法绘制生存曲线,并使用对数秩检验进行比较:共有 2451 名 MSPLC 患者被分为以下治疗组:864 人(35.3%)接受了放疗,759 人(31%)接受了手术,89 人(3.6%)接受了手术加放疗,739 人(30.2%)未接受任何治疗。PSM 后,放疗和手术各产生了 470 对。手术组的生存率明显优于放疗组(PC结论:手术切除(如膀胱切除术)和放疗组的生存率均高于放疗组):手术切除(如楔形切除术和肺叶切除术)比放疗能提高MSPLC的生存率,但放疗也是治疗MSPLC的有效替代方法。
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JMIR Cancer
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