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Cancer patients prefer computer-free interactions
SAN DIEGO—A new study suggests patients with advanced cancer may prefer doctors who do not use a computer while communicating with them.
Most of the 120 patients studied said they preferred face-to-face consultations in which a doctor used a notepad rather than a computer.
Doctors who did not use a computer were perceived as more compassionate, communicative, and professional.
These findings were presented at the 2017 Palliative and Supportive Care in Oncology Symposium (abstract 26*).
“To our knowledge, this is the only study that compares exam room interactions between people with advanced cancer and their physicians, with or without a computer present,” said study investigator Ali Haider, MD, of the University of Texas MD Anderson Cancer Center in Houston.
For this study, Dr Haider and his colleagues enrolled 120 patients with localized, recurrent, or metastatic disease. The patients’ median ECOG performance status was 2.
All patients were English speakers, they had a median age of 58 (range, 44-66), and 55% were female. Sixty-seven percent of patients were white, 18% were Hispanic, 13% were African American, and 2% were “other.” Forty-one percent of patients had completed college.
According to the Edmonton Symptom Assessment System, patients’ median pain score was 5 (range, 2-7), and their median fatigue score was 4 (range, 3-7). According to the Hospital Anxiety and Depression Scale, patients’ median anxiety score was 6 (range, 4-8), and their median depression score was 6 (range, 4-9).
The intervention
The investigators randomly assigned patients to watch different videos showing doctor-patient interactions with and without computer use. The team had filmed 4 short videos that featured actors playing the parts of doctor and patient.
All study participants were blinded to the hypothesis of the study. The actors were carefully scripted and used the same gestures, expressions, and other nonverbal communication in each video to minimize bias.
Video 1 involved Doctor A in a face-to-face consultation with just a notepad in hand, and Video 2 involved Doctor A in a consultation using a computer.
Video 3 involved Doctor B in a face-to-face consultation with just a notepad in hand, and Video 4 involved Doctor B in a consultation using a computer.
Doctors A and B looked similar, which was intended to minimize bias.
After viewing their first video, patients completed a validated questionnaire rating the doctor’s communication skills, professionalism, and compassion.
Subsequently, each group was assigned to a video topic (face-to-face or computer) they had not viewed previously featuring the doctor they had not viewed in the first video.
A follow-up questionnaire was given after this round of viewing, and the patients were also asked to rate their overall physician preference.
Results
After the first round of viewing, the patients gave better ratings to doctors (A or B) in the face-to-face videos than in the computer videos. Face-to-face doctors were rated significantly higher for compassion (P=0.0003), communication skills (P=0.0012), and professionalism (P=0.0001).
After patients had watched both videos, doctors in the face-to-face videos still had better scores for compassion, communication, and professionalism (P<0.001 for all).
Most patients (72%) said they preferred the face-to-face consultation, while 8% said they preferred the computer consultation, and 20% said they had no preference.
Dr Haider said a possible explanation for these findings is that patients with serious chronic illnesses might value undivided attention from their physicians, and patients might perceive providers using computers as more distracted or multitasking during visits.
“We know that having a good rapport with patients can be extremely beneficial for their health,” Dr Haider said. “Patients with advanced disease need the cues that come with direct interaction to help them along with their care.”
However, Dr Haider also noted that additional research is needed to confirm these results. And he said perceptions might be different in a younger population with higher computer literacy. 
*Data in the abstract differ from the presentation.
SAN DIEGO—A new study suggests patients with advanced cancer may prefer doctors who do not use a computer while communicating with them.
Most of the 120 patients studied said they preferred face-to-face consultations in which a doctor used a notepad rather than a computer.
Doctors who did not use a computer were perceived as more compassionate, communicative, and professional.
These findings were presented at the 2017 Palliative and Supportive Care in Oncology Symposium (abstract 26*).
“To our knowledge, this is the only study that compares exam room interactions between people with advanced cancer and their physicians, with or without a computer present,” said study investigator Ali Haider, MD, of the University of Texas MD Anderson Cancer Center in Houston.
For this study, Dr Haider and his colleagues enrolled 120 patients with localized, recurrent, or metastatic disease. The patients’ median ECOG performance status was 2.
All patients were English speakers, they had a median age of 58 (range, 44-66), and 55% were female. Sixty-seven percent of patients were white, 18% were Hispanic, 13% were African American, and 2% were “other.” Forty-one percent of patients had completed college.
According to the Edmonton Symptom Assessment System, patients’ median pain score was 5 (range, 2-7), and their median fatigue score was 4 (range, 3-7). According to the Hospital Anxiety and Depression Scale, patients’ median anxiety score was 6 (range, 4-8), and their median depression score was 6 (range, 4-9).
The intervention
The investigators randomly assigned patients to watch different videos showing doctor-patient interactions with and without computer use. The team had filmed 4 short videos that featured actors playing the parts of doctor and patient.
All study participants were blinded to the hypothesis of the study. The actors were carefully scripted and used the same gestures, expressions, and other nonverbal communication in each video to minimize bias.
Video 1 involved Doctor A in a face-to-face consultation with just a notepad in hand, and Video 2 involved Doctor A in a consultation using a computer.
Video 3 involved Doctor B in a face-to-face consultation with just a notepad in hand, and Video 4 involved Doctor B in a consultation using a computer.
Doctors A and B looked similar, which was intended to minimize bias.
After viewing their first video, patients completed a validated questionnaire rating the doctor’s communication skills, professionalism, and compassion.
Subsequently, each group was assigned to a video topic (face-to-face or computer) they had not viewed previously featuring the doctor they had not viewed in the first video.
A follow-up questionnaire was given after this round of viewing, and the patients were also asked to rate their overall physician preference.
Results
After the first round of viewing, the patients gave better ratings to doctors (A or B) in the face-to-face videos than in the computer videos. Face-to-face doctors were rated significantly higher for compassion (P=0.0003), communication skills (P=0.0012), and professionalism (P=0.0001).
After patients had watched both videos, doctors in the face-to-face videos still had better scores for compassion, communication, and professionalism (P<0.001 for all).
Most patients (72%) said they preferred the face-to-face consultation, while 8% said they preferred the computer consultation, and 20% said they had no preference.
Dr Haider said a possible explanation for these findings is that patients with serious chronic illnesses might value undivided attention from their physicians, and patients might perceive providers using computers as more distracted or multitasking during visits.
“We know that having a good rapport with patients can be extremely beneficial for their health,” Dr Haider said. “Patients with advanced disease need the cues that come with direct interaction to help them along with their care.”
However, Dr Haider also noted that additional research is needed to confirm these results. And he said perceptions might be different in a younger population with higher computer literacy.
*Data in the abstract differ from the presentation.
SAN DIEGO—A new study suggests patients with advanced cancer may prefer doctors who do not use a computer while communicating with them.
Most of the 120 patients studied said they preferred face-to-face consultations in which a doctor used a notepad rather than a computer.
Doctors who did not use a computer were perceived as more compassionate, communicative, and professional.
These findings were presented at the 2017 Palliative and Supportive Care in Oncology Symposium (abstract 26*).
“To our knowledge, this is the only study that compares exam room interactions between people with advanced cancer and their physicians, with or without a computer present,” said study investigator Ali Haider, MD, of the University of Texas MD Anderson Cancer Center in Houston.
For this study, Dr Haider and his colleagues enrolled 120 patients with localized, recurrent, or metastatic disease. The patients’ median ECOG performance status was 2.
All patients were English speakers, they had a median age of 58 (range, 44-66), and 55% were female. Sixty-seven percent of patients were white, 18% were Hispanic, 13% were African American, and 2% were “other.” Forty-one percent of patients had completed college.
According to the Edmonton Symptom Assessment System, patients’ median pain score was 5 (range, 2-7), and their median fatigue score was 4 (range, 3-7). According to the Hospital Anxiety and Depression Scale, patients’ median anxiety score was 6 (range, 4-8), and their median depression score was 6 (range, 4-9).
The intervention
The investigators randomly assigned patients to watch different videos showing doctor-patient interactions with and without computer use. The team had filmed 4 short videos that featured actors playing the parts of doctor and patient.
All study participants were blinded to the hypothesis of the study. The actors were carefully scripted and used the same gestures, expressions, and other nonverbal communication in each video to minimize bias.
Video 1 involved Doctor A in a face-to-face consultation with just a notepad in hand, and Video 2 involved Doctor A in a consultation using a computer.
Video 3 involved Doctor B in a face-to-face consultation with just a notepad in hand, and Video 4 involved Doctor B in a consultation using a computer.
Doctors A and B looked similar, which was intended to minimize bias.
After viewing their first video, patients completed a validated questionnaire rating the doctor’s communication skills, professionalism, and compassion.
Subsequently, each group was assigned to a video topic (face-to-face or computer) they had not viewed previously featuring the doctor they had not viewed in the first video.
A follow-up questionnaire was given after this round of viewing, and the patients were also asked to rate their overall physician preference.
Results
After the first round of viewing, the patients gave better ratings to doctors (A or B) in the face-to-face videos than in the computer videos. Face-to-face doctors were rated significantly higher for compassion (P=0.0003), communication skills (P=0.0012), and professionalism (P=0.0001).
After patients had watched both videos, doctors in the face-to-face videos still had better scores for compassion, communication, and professionalism (P<0.001 for all).
Most patients (72%) said they preferred the face-to-face consultation, while 8% said they preferred the computer consultation, and 20% said they had no preference.
Dr Haider said a possible explanation for these findings is that patients with serious chronic illnesses might value undivided attention from their physicians, and patients might perceive providers using computers as more distracted or multitasking during visits.
“We know that having a good rapport with patients can be extremely beneficial for their health,” Dr Haider said. “Patients with advanced disease need the cues that come with direct interaction to help them along with their care.”
However, Dr Haider also noted that additional research is needed to confirm these results. And he said perceptions might be different in a younger population with higher computer literacy.
*Data in the abstract differ from the presentation.
FDA to rely on foreign authorities’ inspections
The US Food and Drug Administration (FDA) will now recognize 8 European drug regulatory authorities as capable of conducting inspections of manufacturing facilities that meet FDA requirements.
This move is a step toward successful implementation of the amended Pharmaceutical Annex to the 1998 US-European Union (EU) Mutual Recognition Agreement.
This agreement enables US and EU regulators to utilize each other’s good manufacturing practice (GMP) inspections of pharmaceutical manufacturing facilities.
In June, the European Commission determined that the FDA “has the capability, capacity, and procedures in place to carry out GMP inspections at a level equivalent to the EU.”
Now, the FDA has followed suit. The agency said it will rely on inspections of manufacturing facilities conducted by regulatory authorities located in Austria, Croatia, France, Italy, Malta, Spain, Sweden, and the United Kingdom.
“Beginning November 1, we will take the unprecedented and significant step forward in realizing the key benefits of the Mutual Recognition Agreement with our European counterparts in that we will now rely on the inspectional data obtained by these 8 regulatory agencies,” said Dara Corrigan, the FDA’s acting deputy commissioner for global regulatory operations and policy.
“The progress made so far puts us on track to meet our goal of completing all 28 capability assessments in the EU by July 2019.”
The completion of these capability assessments is intended to reduce duplication of drug inspections and allow regulators to devote more resources to other manufacturing facilities in countries where there may be greater risk.
The FDA believes that, ultimately, the prioritization of such inspections will help identify potential drug quality problems more quickly and prevent poor quality drugs from entering the US market.
“At a time in which medical product manufacturing is truly a global enterprise, there is much to be gained by partnering with regulatory counterparts to reduce duplicative efforts and maximize global resources while realizing the greatest bang for our collective inspectional buck,” said FDA Commissioner Scott Gottlieb, MD.
“By partnering with these countries, we can create greater efficiencies and better fulfill our public health goals, relying on the expertise of our colleagues and refocusing our resources on inspections in higher-risk countries.”
The US Food and Drug Administration (FDA) will now recognize 8 European drug regulatory authorities as capable of conducting inspections of manufacturing facilities that meet FDA requirements.
This move is a step toward successful implementation of the amended Pharmaceutical Annex to the 1998 US-European Union (EU) Mutual Recognition Agreement.
This agreement enables US and EU regulators to utilize each other’s good manufacturing practice (GMP) inspections of pharmaceutical manufacturing facilities.
In June, the European Commission determined that the FDA “has the capability, capacity, and procedures in place to carry out GMP inspections at a level equivalent to the EU.”
Now, the FDA has followed suit. The agency said it will rely on inspections of manufacturing facilities conducted by regulatory authorities located in Austria, Croatia, France, Italy, Malta, Spain, Sweden, and the United Kingdom.
“Beginning November 1, we will take the unprecedented and significant step forward in realizing the key benefits of the Mutual Recognition Agreement with our European counterparts in that we will now rely on the inspectional data obtained by these 8 regulatory agencies,” said Dara Corrigan, the FDA’s acting deputy commissioner for global regulatory operations and policy.
“The progress made so far puts us on track to meet our goal of completing all 28 capability assessments in the EU by July 2019.”
The completion of these capability assessments is intended to reduce duplication of drug inspections and allow regulators to devote more resources to other manufacturing facilities in countries where there may be greater risk.
The FDA believes that, ultimately, the prioritization of such inspections will help identify potential drug quality problems more quickly and prevent poor quality drugs from entering the US market.
“At a time in which medical product manufacturing is truly a global enterprise, there is much to be gained by partnering with regulatory counterparts to reduce duplicative efforts and maximize global resources while realizing the greatest bang for our collective inspectional buck,” said FDA Commissioner Scott Gottlieb, MD.
“By partnering with these countries, we can create greater efficiencies and better fulfill our public health goals, relying on the expertise of our colleagues and refocusing our resources on inspections in higher-risk countries.”
The US Food and Drug Administration (FDA) will now recognize 8 European drug regulatory authorities as capable of conducting inspections of manufacturing facilities that meet FDA requirements.
This move is a step toward successful implementation of the amended Pharmaceutical Annex to the 1998 US-European Union (EU) Mutual Recognition Agreement.
This agreement enables US and EU regulators to utilize each other’s good manufacturing practice (GMP) inspections of pharmaceutical manufacturing facilities.
In June, the European Commission determined that the FDA “has the capability, capacity, and procedures in place to carry out GMP inspections at a level equivalent to the EU.”
Now, the FDA has followed suit. The agency said it will rely on inspections of manufacturing facilities conducted by regulatory authorities located in Austria, Croatia, France, Italy, Malta, Spain, Sweden, and the United Kingdom.
“Beginning November 1, we will take the unprecedented and significant step forward in realizing the key benefits of the Mutual Recognition Agreement with our European counterparts in that we will now rely on the inspectional data obtained by these 8 regulatory agencies,” said Dara Corrigan, the FDA’s acting deputy commissioner for global regulatory operations and policy.
“The progress made so far puts us on track to meet our goal of completing all 28 capability assessments in the EU by July 2019.”
The completion of these capability assessments is intended to reduce duplication of drug inspections and allow regulators to devote more resources to other manufacturing facilities in countries where there may be greater risk.
The FDA believes that, ultimately, the prioritization of such inspections will help identify potential drug quality problems more quickly and prevent poor quality drugs from entering the US market.
“At a time in which medical product manufacturing is truly a global enterprise, there is much to be gained by partnering with regulatory counterparts to reduce duplicative efforts and maximize global resources while realizing the greatest bang for our collective inspectional buck,” said FDA Commissioner Scott Gottlieb, MD.
“By partnering with these countries, we can create greater efficiencies and better fulfill our public health goals, relying on the expertise of our colleagues and refocusing our resources on inspections in higher-risk countries.”
FDA approves IV formulation of drug for CINV
The US Food and Drug Administration (FDA) has approved an intravenous (IV) formulation of rolapitant (VARUBI®) for the same indication as the oral formulation.
This means IV rolapitant is now FDA-approved for use in combination with other antiemetic agents to prevent delayed nausea and vomiting associated with initial and repeat courses of emetogenic chemotherapy in adults with cancer.
TESARO Inc., makers of rolapitant, said the US commercial launch of IV rolapitant is planned for November.
Rolapitant is a selective and competitive antagonist of human substance P/neurokinin 1 receptors, which play an important role in the delayed phase of chemotherapy-induced nausea and vomiting (CINV).
IV rolapitant features a ready-to-use, single-dose vial for administration. It does not require refrigerated storage or mixing.
The recommended dose of IV rolapitant is 166.5 mg, administered over 30 minutes. The drug is to be administered up to 2 hours before chemotherapy administration in combination with a 5-HT3 receptor antagonist and dexamethasone.
The full prescribing information for IV rolapitant is available at www.varubirx.com.
Bioequivalence trial
Results from a bioequivalence trial suggest the IV and oral formulations of rolapitant are comparable.
The study was conducted in healthy volunteers. Subjects were randomized to receive a single dose of IV rolapitant at 166.5 mg administered over 30 minutes (n=61) or oral rolapitant at 180 mg (n=62).
The primary endpoint was bioequivalence, and the 166.5 mg IV infusion of rolapitant met bioequivalence criteria.
Researchers said the safety profile of IV rolapitant was largely consistent with that of oral rolapitant, although infusion-site reactions were observed with the IV formulation. These included the sensation of warmth, abdominal pain, dizziness, and paresthesia.
These results were recently published in The Journal of Clinical Pharmacology.
Oral rolapitant trials
Two phase 3 trials showed that oral rolapitant, in combination with a 5-HT3 receptor antagonist and dexamethasone, was well tolerated and more effective than active control in preventing CINV after highly emetogenic chemotherapy.
Results from these trials (NCT01499849 and NCT01500213) were published in a single article in The Lancet Oncology.
A third phase 3 trial showed that oral rolapitant, in combination with a 5-HT3 receptor antagonist and dexamethasone, was well tolerated and more effective than active control in preventing CINV after moderately emetogenic chemotherapy.
Results from this trial (NCT01500226) were also published in The Lancet Oncology.
The US Food and Drug Administration (FDA) has approved an intravenous (IV) formulation of rolapitant (VARUBI®) for the same indication as the oral formulation.
This means IV rolapitant is now FDA-approved for use in combination with other antiemetic agents to prevent delayed nausea and vomiting associated with initial and repeat courses of emetogenic chemotherapy in adults with cancer.
TESARO Inc., makers of rolapitant, said the US commercial launch of IV rolapitant is planned for November.
Rolapitant is a selective and competitive antagonist of human substance P/neurokinin 1 receptors, which play an important role in the delayed phase of chemotherapy-induced nausea and vomiting (CINV).
IV rolapitant features a ready-to-use, single-dose vial for administration. It does not require refrigerated storage or mixing.
The recommended dose of IV rolapitant is 166.5 mg, administered over 30 minutes. The drug is to be administered up to 2 hours before chemotherapy administration in combination with a 5-HT3 receptor antagonist and dexamethasone.
The full prescribing information for IV rolapitant is available at www.varubirx.com.
Bioequivalence trial
Results from a bioequivalence trial suggest the IV and oral formulations of rolapitant are comparable.
The study was conducted in healthy volunteers. Subjects were randomized to receive a single dose of IV rolapitant at 166.5 mg administered over 30 minutes (n=61) or oral rolapitant at 180 mg (n=62).
The primary endpoint was bioequivalence, and the 166.5 mg IV infusion of rolapitant met bioequivalence criteria.
Researchers said the safety profile of IV rolapitant was largely consistent with that of oral rolapitant, although infusion-site reactions were observed with the IV formulation. These included the sensation of warmth, abdominal pain, dizziness, and paresthesia.
These results were recently published in The Journal of Clinical Pharmacology.
Oral rolapitant trials
Two phase 3 trials showed that oral rolapitant, in combination with a 5-HT3 receptor antagonist and dexamethasone, was well tolerated and more effective than active control in preventing CINV after highly emetogenic chemotherapy.
Results from these trials (NCT01499849 and NCT01500213) were published in a single article in The Lancet Oncology.
A third phase 3 trial showed that oral rolapitant, in combination with a 5-HT3 receptor antagonist and dexamethasone, was well tolerated and more effective than active control in preventing CINV after moderately emetogenic chemotherapy.
Results from this trial (NCT01500226) were also published in The Lancet Oncology.
The US Food and Drug Administration (FDA) has approved an intravenous (IV) formulation of rolapitant (VARUBI®) for the same indication as the oral formulation.
This means IV rolapitant is now FDA-approved for use in combination with other antiemetic agents to prevent delayed nausea and vomiting associated with initial and repeat courses of emetogenic chemotherapy in adults with cancer.
TESARO Inc., makers of rolapitant, said the US commercial launch of IV rolapitant is planned for November.
Rolapitant is a selective and competitive antagonist of human substance P/neurokinin 1 receptors, which play an important role in the delayed phase of chemotherapy-induced nausea and vomiting (CINV).
IV rolapitant features a ready-to-use, single-dose vial for administration. It does not require refrigerated storage or mixing.
The recommended dose of IV rolapitant is 166.5 mg, administered over 30 minutes. The drug is to be administered up to 2 hours before chemotherapy administration in combination with a 5-HT3 receptor antagonist and dexamethasone.
The full prescribing information for IV rolapitant is available at www.varubirx.com.
Bioequivalence trial
Results from a bioequivalence trial suggest the IV and oral formulations of rolapitant are comparable.
The study was conducted in healthy volunteers. Subjects were randomized to receive a single dose of IV rolapitant at 166.5 mg administered over 30 minutes (n=61) or oral rolapitant at 180 mg (n=62).
The primary endpoint was bioequivalence, and the 166.5 mg IV infusion of rolapitant met bioequivalence criteria.
Researchers said the safety profile of IV rolapitant was largely consistent with that of oral rolapitant, although infusion-site reactions were observed with the IV formulation. These included the sensation of warmth, abdominal pain, dizziness, and paresthesia.
These results were recently published in The Journal of Clinical Pharmacology.
Oral rolapitant trials
Two phase 3 trials showed that oral rolapitant, in combination with a 5-HT3 receptor antagonist and dexamethasone, was well tolerated and more effective than active control in preventing CINV after highly emetogenic chemotherapy.
Results from these trials (NCT01499849 and NCT01500213) were published in a single article in The Lancet Oncology.
A third phase 3 trial showed that oral rolapitant, in combination with a 5-HT3 receptor antagonist and dexamethasone, was well tolerated and more effective than active control in preventing CINV after moderately emetogenic chemotherapy.
Results from this trial (NCT01500226) were also published in The Lancet Oncology.
High symptom burden in advanced cancer patients
New research indicates that hospitalized patients with advanced cancer have a high burden of physical and psychological symptoms, and this burden is linked to longer hospital stays and a greater risk for unplanned hospital readmissions and death.
Researchers said these findings highlight the need to develop and test interventions to lessen patients’ symptoms.
Ryan Nipp, MD, of Massachusetts General Hospital in Boston, and his colleagues reported the findings in Cancer.
The researchers noted that patients with advanced cancer often experience frequent and prolonged hospitalizations for reasons that have not been fully explored.
To investigate, the team collected information from 1036 patients with advanced cancer as they were being admitted for an unplanned hospitalization.
The Edmonton Symptom Assessment System (ESAS) was used to assess patients’ physical symptoms, and the Patient Health Questionnaire 4 (PHQ-4) was used to assess their psychological symptoms.
The researchers examined the relationship between patients’ symptom burden and the duration of their hospital stay, risk of readmission, and death.
Many patients reported moderate or severe fatigue (86.7%), poor well-being (74.2%), drowsiness (71.7%), pain (67.7%), and lack of appetite (67.3%). Nearly 30% of patients had clinically significant symptoms of depression (28.8%) and anxiety (28.0%).
The patients’ mean hospital stay was 6.3 days, the readmission rate within 90 days of discharge was 43.1%, and the 90-day mortality rate was 41.6%.
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P=0.040), and depression symptoms (P=0.017) were significantly associated with longer hospital stays, but anxiety symptoms were not (P=0.190).
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P=0.072), and anxiety symptoms (P=0.045) were significantly associated with a higher likelihood of readmission within 90 days, but depression symptoms were not (P=0.219).
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P<0.001), depression symptoms (P<0.001), and anxiety symptoms (P=0.012) were all significantly associated with a higher likelihood of death or readmission within 90 days.
“We demonstrated that many hospitalized patients with advanced cancer experience an immense physical and psychological symptom burden,” Dr Nipp said.
“Interventions to identify and treat symptomatic patients hold great potential for improving patients’ experience with their illness, enhancing their quality of life, and reducing their healthcare utilization.”
New research indicates that hospitalized patients with advanced cancer have a high burden of physical and psychological symptoms, and this burden is linked to longer hospital stays and a greater risk for unplanned hospital readmissions and death.
Researchers said these findings highlight the need to develop and test interventions to lessen patients’ symptoms.
Ryan Nipp, MD, of Massachusetts General Hospital in Boston, and his colleagues reported the findings in Cancer.
The researchers noted that patients with advanced cancer often experience frequent and prolonged hospitalizations for reasons that have not been fully explored.
To investigate, the team collected information from 1036 patients with advanced cancer as they were being admitted for an unplanned hospitalization.
The Edmonton Symptom Assessment System (ESAS) was used to assess patients’ physical symptoms, and the Patient Health Questionnaire 4 (PHQ-4) was used to assess their psychological symptoms.
The researchers examined the relationship between patients’ symptom burden and the duration of their hospital stay, risk of readmission, and death.
Many patients reported moderate or severe fatigue (86.7%), poor well-being (74.2%), drowsiness (71.7%), pain (67.7%), and lack of appetite (67.3%). Nearly 30% of patients had clinically significant symptoms of depression (28.8%) and anxiety (28.0%).
The patients’ mean hospital stay was 6.3 days, the readmission rate within 90 days of discharge was 43.1%, and the 90-day mortality rate was 41.6%.
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P=0.040), and depression symptoms (P=0.017) were significantly associated with longer hospital stays, but anxiety symptoms were not (P=0.190).
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P=0.072), and anxiety symptoms (P=0.045) were significantly associated with a higher likelihood of readmission within 90 days, but depression symptoms were not (P=0.219).
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P<0.001), depression symptoms (P<0.001), and anxiety symptoms (P=0.012) were all significantly associated with a higher likelihood of death or readmission within 90 days.
“We demonstrated that many hospitalized patients with advanced cancer experience an immense physical and psychological symptom burden,” Dr Nipp said.
“Interventions to identify and treat symptomatic patients hold great potential for improving patients’ experience with their illness, enhancing their quality of life, and reducing their healthcare utilization.”
New research indicates that hospitalized patients with advanced cancer have a high burden of physical and psychological symptoms, and this burden is linked to longer hospital stays and a greater risk for unplanned hospital readmissions and death.
Researchers said these findings highlight the need to develop and test interventions to lessen patients’ symptoms.
Ryan Nipp, MD, of Massachusetts General Hospital in Boston, and his colleagues reported the findings in Cancer.
The researchers noted that patients with advanced cancer often experience frequent and prolonged hospitalizations for reasons that have not been fully explored.
To investigate, the team collected information from 1036 patients with advanced cancer as they were being admitted for an unplanned hospitalization.
The Edmonton Symptom Assessment System (ESAS) was used to assess patients’ physical symptoms, and the Patient Health Questionnaire 4 (PHQ-4) was used to assess their psychological symptoms.
The researchers examined the relationship between patients’ symptom burden and the duration of their hospital stay, risk of readmission, and death.
Many patients reported moderate or severe fatigue (86.7%), poor well-being (74.2%), drowsiness (71.7%), pain (67.7%), and lack of appetite (67.3%). Nearly 30% of patients had clinically significant symptoms of depression (28.8%) and anxiety (28.0%).
The patients’ mean hospital stay was 6.3 days, the readmission rate within 90 days of discharge was 43.1%, and the 90-day mortality rate was 41.6%.
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P=0.040), and depression symptoms (P=0.017) were significantly associated with longer hospital stays, but anxiety symptoms were not (P=0.190).
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P=0.072), and anxiety symptoms (P=0.045) were significantly associated with a higher likelihood of readmission within 90 days, but depression symptoms were not (P=0.219).
Physical symptoms (P<0.001), total ESAS score (P<0.001), total PHQ-4 score (P<0.001), depression symptoms (P<0.001), and anxiety symptoms (P=0.012) were all significantly associated with a higher likelihood of death or readmission within 90 days.
“We demonstrated that many hospitalized patients with advanced cancer experience an immense physical and psychological symptom burden,” Dr Nipp said.
“Interventions to identify and treat symptomatic patients hold great potential for improving patients’ experience with their illness, enhancing their quality of life, and reducing their healthcare utilization.”
Women may ask fewer questions at scientific conferences
Women may ask fewer questions than men at scientific conferences, according to research published in PLOS ONE.
Researchers studied question-asking behavior at a large international conference and found that men asked 80% more questions than women.
“Previous research has shown that men are more likely to be invited to speak at conferences, which is likely to lead to them having a higher social reputation than their female peers,” said study author Amy Hinsley, PhD, of the University of Oxford in the UK.
“If women feel that they are low-status and have suffered discrimination and bias throughout their career, then they may be less likely to participate in public discussions, which will, in turn, affect their scientific reputation. This negative feedback loop can affect women and men, but the evidence in this study suggests that women are affected more.”
For this study, Dr Hinsley and her colleagues looked at question-asking behavior at the 2015 International Congress for Conservation Biology. The conference had a clear code of conduct for its 2000 attendees, which promoted equality and prohibited discrimination.
The authors observed 31 sessions across the 4-day conference, counting how many questions were asked and whether men or women were asking them.
Accounting for the number of men and women in the audience, men asked 1.8 questions for each question asked by a woman.
The same pattern was observed in younger researchers (1.8 to 1), suggesting it is not simply due to senior researchers, a large proportion of whom are men, asking all the questions.
Dr Hinsley and her colleagues feel this study should be used as an opportunity to raise awareness of the disparity in question-asking behavior between men and women and inspire discussion about why it is happening.
“We want our research to inspire conference organizers to encourage participation among all attendees,” said Alison Johnston, PhD, of Cambridge University in the UK.
“For example, questions over Twitter or other creative solutions could be tested. Session chairs could also be encouraged to pick participants that represent the gender in the audience. However, these patterns of behavior we observed are only a symptom of the bigger issue. Addressing this alone will not solve the problem [of gender inequality].”
“We should continue to research and investigate the underlying causes so we can implement actions that change the bigger picture for women in science. If we are to level the playing field for women in STEM, the complex issue of gender inequality has to stay on the agenda.”
Women may ask fewer questions than men at scientific conferences, according to research published in PLOS ONE.
Researchers studied question-asking behavior at a large international conference and found that men asked 80% more questions than women.
“Previous research has shown that men are more likely to be invited to speak at conferences, which is likely to lead to them having a higher social reputation than their female peers,” said study author Amy Hinsley, PhD, of the University of Oxford in the UK.
“If women feel that they are low-status and have suffered discrimination and bias throughout their career, then they may be less likely to participate in public discussions, which will, in turn, affect their scientific reputation. This negative feedback loop can affect women and men, but the evidence in this study suggests that women are affected more.”
For this study, Dr Hinsley and her colleagues looked at question-asking behavior at the 2015 International Congress for Conservation Biology. The conference had a clear code of conduct for its 2000 attendees, which promoted equality and prohibited discrimination.
The authors observed 31 sessions across the 4-day conference, counting how many questions were asked and whether men or women were asking them.
Accounting for the number of men and women in the audience, men asked 1.8 questions for each question asked by a woman.
The same pattern was observed in younger researchers (1.8 to 1), suggesting it is not simply due to senior researchers, a large proportion of whom are men, asking all the questions.
Dr Hinsley and her colleagues feel this study should be used as an opportunity to raise awareness of the disparity in question-asking behavior between men and women and inspire discussion about why it is happening.
“We want our research to inspire conference organizers to encourage participation among all attendees,” said Alison Johnston, PhD, of Cambridge University in the UK.
“For example, questions over Twitter or other creative solutions could be tested. Session chairs could also be encouraged to pick participants that represent the gender in the audience. However, these patterns of behavior we observed are only a symptom of the bigger issue. Addressing this alone will not solve the problem [of gender inequality].”
“We should continue to research and investigate the underlying causes so we can implement actions that change the bigger picture for women in science. If we are to level the playing field for women in STEM, the complex issue of gender inequality has to stay on the agenda.”
Women may ask fewer questions than men at scientific conferences, according to research published in PLOS ONE.
Researchers studied question-asking behavior at a large international conference and found that men asked 80% more questions than women.
“Previous research has shown that men are more likely to be invited to speak at conferences, which is likely to lead to them having a higher social reputation than their female peers,” said study author Amy Hinsley, PhD, of the University of Oxford in the UK.
“If women feel that they are low-status and have suffered discrimination and bias throughout their career, then they may be less likely to participate in public discussions, which will, in turn, affect their scientific reputation. This negative feedback loop can affect women and men, but the evidence in this study suggests that women are affected more.”
For this study, Dr Hinsley and her colleagues looked at question-asking behavior at the 2015 International Congress for Conservation Biology. The conference had a clear code of conduct for its 2000 attendees, which promoted equality and prohibited discrimination.
The authors observed 31 sessions across the 4-day conference, counting how many questions were asked and whether men or women were asking them.
Accounting for the number of men and women in the audience, men asked 1.8 questions for each question asked by a woman.
The same pattern was observed in younger researchers (1.8 to 1), suggesting it is not simply due to senior researchers, a large proportion of whom are men, asking all the questions.
Dr Hinsley and her colleagues feel this study should be used as an opportunity to raise awareness of the disparity in question-asking behavior between men and women and inspire discussion about why it is happening.
“We want our research to inspire conference organizers to encourage participation among all attendees,” said Alison Johnston, PhD, of Cambridge University in the UK.
“For example, questions over Twitter or other creative solutions could be tested. Session chairs could also be encouraged to pick participants that represent the gender in the audience. However, these patterns of behavior we observed are only a symptom of the bigger issue. Addressing this alone will not solve the problem [of gender inequality].”
“We should continue to research and investigate the underlying causes so we can implement actions that change the bigger picture for women in science. If we are to level the playing field for women in STEM, the complex issue of gender inequality has to stay on the agenda.”
Cryotherapy can reduce signs of CIPN
A new study suggests cryotherapy can reduce symptoms of chemotherapy-induced peripheral neuropathy (CIPN).
Researchers found that having chemotherapy patients wear frozen gloves and socks for 90-minute periods significantly reduced the incidence of CIPN symptoms.
Hiroshi Ishiguro, MD, PhD, of International University of Health and Welfare Hospital in Tochigi, Japan, and colleagues reported these findings in the Journal of the National Cancer Institute.
The researchers prospectively evaluated the efficacy of cryotherapy for preventing CIPN. Breast cancer patients treated weekly with paclitaxel (80 mg/m2 for 1 hour) wore frozen gloves and socks on one side of their bodies for 90 minutes, including the entire duration of drug infusion.
The researchers then compared symptoms on the treated sides with those on the untreated sides.
The primary endpoint was CIPN incidence assessed by changes in tactile sensitivity from a pretreatment baseline. The researchers also assessed subjective symptoms, as reported in the Patient Neuropathy Questionnaire, and patients' manual dexterity.
Among the 40 patients studied, 4 did not reach the cumulative dose due to the occurrence of pneumonia, severe fatigue, liver dysfunction, and macular edema. Of the 36 remaining patients, none dropped out due to cold intolerance.
The incidence of objective and subjective signs of CIPN was clinically and statistically significantly lower on the intervention side than on the control side for most measurements, which includes (among other measures):
- Hand tactile sensitivity—27.8% and 80.6%, respectively (odds ratio[OR]= 20.00, P<0.001)
- Foot tactile sensitivity—25.0% and 63.9%, respectively (OR=infinite, P<0.001)
- Hand warm sense—8.8% and 32.4%, respectively (OR=9.00, P=0.02)
- Foot warm sense—33.4% and 57.6%, respectively (OR=5.00, P=0.04)
- Hand cold sense—2.8% and 13.9%, respectively (OR=infinite, P=0.13)
- Foot cold sense—12.6% and 18.8%, respectively (OR=2.00, P=0.69)
- Severe CIPN in the hand according to the Patient Neuropathy Questionnaire—2.8% and 41.7%, respectively (OR=infinite, P<0.001)
- Severe CIPN in the foot according to the Patient Neuropathy Questionnaire—2.8% and 36.1%, respectively (OR=infinite, P<0.001).
A new study suggests cryotherapy can reduce symptoms of chemotherapy-induced peripheral neuropathy (CIPN).
Researchers found that having chemotherapy patients wear frozen gloves and socks for 90-minute periods significantly reduced the incidence of CIPN symptoms.
Hiroshi Ishiguro, MD, PhD, of International University of Health and Welfare Hospital in Tochigi, Japan, and colleagues reported these findings in the Journal of the National Cancer Institute.
The researchers prospectively evaluated the efficacy of cryotherapy for preventing CIPN. Breast cancer patients treated weekly with paclitaxel (80 mg/m2 for 1 hour) wore frozen gloves and socks on one side of their bodies for 90 minutes, including the entire duration of drug infusion.
The researchers then compared symptoms on the treated sides with those on the untreated sides.
The primary endpoint was CIPN incidence assessed by changes in tactile sensitivity from a pretreatment baseline. The researchers also assessed subjective symptoms, as reported in the Patient Neuropathy Questionnaire, and patients' manual dexterity.
Among the 40 patients studied, 4 did not reach the cumulative dose due to the occurrence of pneumonia, severe fatigue, liver dysfunction, and macular edema. Of the 36 remaining patients, none dropped out due to cold intolerance.
The incidence of objective and subjective signs of CIPN was clinically and statistically significantly lower on the intervention side than on the control side for most measurements, which includes (among other measures):
- Hand tactile sensitivity—27.8% and 80.6%, respectively (odds ratio[OR]= 20.00, P<0.001)
- Foot tactile sensitivity—25.0% and 63.9%, respectively (OR=infinite, P<0.001)
- Hand warm sense—8.8% and 32.4%, respectively (OR=9.00, P=0.02)
- Foot warm sense—33.4% and 57.6%, respectively (OR=5.00, P=0.04)
- Hand cold sense—2.8% and 13.9%, respectively (OR=infinite, P=0.13)
- Foot cold sense—12.6% and 18.8%, respectively (OR=2.00, P=0.69)
- Severe CIPN in the hand according to the Patient Neuropathy Questionnaire—2.8% and 41.7%, respectively (OR=infinite, P<0.001)
- Severe CIPN in the foot according to the Patient Neuropathy Questionnaire—2.8% and 36.1%, respectively (OR=infinite, P<0.001).
A new study suggests cryotherapy can reduce symptoms of chemotherapy-induced peripheral neuropathy (CIPN).
Researchers found that having chemotherapy patients wear frozen gloves and socks for 90-minute periods significantly reduced the incidence of CIPN symptoms.
Hiroshi Ishiguro, MD, PhD, of International University of Health and Welfare Hospital in Tochigi, Japan, and colleagues reported these findings in the Journal of the National Cancer Institute.
The researchers prospectively evaluated the efficacy of cryotherapy for preventing CIPN. Breast cancer patients treated weekly with paclitaxel (80 mg/m2 for 1 hour) wore frozen gloves and socks on one side of their bodies for 90 minutes, including the entire duration of drug infusion.
The researchers then compared symptoms on the treated sides with those on the untreated sides.
The primary endpoint was CIPN incidence assessed by changes in tactile sensitivity from a pretreatment baseline. The researchers also assessed subjective symptoms, as reported in the Patient Neuropathy Questionnaire, and patients' manual dexterity.
Among the 40 patients studied, 4 did not reach the cumulative dose due to the occurrence of pneumonia, severe fatigue, liver dysfunction, and macular edema. Of the 36 remaining patients, none dropped out due to cold intolerance.
The incidence of objective and subjective signs of CIPN was clinically and statistically significantly lower on the intervention side than on the control side for most measurements, which includes (among other measures):
- Hand tactile sensitivity—27.8% and 80.6%, respectively (odds ratio[OR]= 20.00, P<0.001)
- Foot tactile sensitivity—25.0% and 63.9%, respectively (OR=infinite, P<0.001)
- Hand warm sense—8.8% and 32.4%, respectively (OR=9.00, P=0.02)
- Foot warm sense—33.4% and 57.6%, respectively (OR=5.00, P=0.04)
- Hand cold sense—2.8% and 13.9%, respectively (OR=infinite, P=0.13)
- Foot cold sense—12.6% and 18.8%, respectively (OR=2.00, P=0.69)
- Severe CIPN in the hand according to the Patient Neuropathy Questionnaire—2.8% and 41.7%, respectively (OR=infinite, P<0.001)
- Severe CIPN in the foot according to the Patient Neuropathy Questionnaire—2.8% and 36.1%, respectively (OR=infinite, P<0.001).
Primary care may be inadequate for cancer survivors
Primary care may not meet the healthcare needs of cancer survivors in the US, according to research published in JAMA Internal Medicine.
Researchers examined 12 advanced primary care practices selected from a national registry of “workforce innovators” and found that none of these practices had a comprehensive survivorship care program in place.
In addition, there were 3 main barriers to survivorship care—not treating cancer survivors as a distinct population, limitations of electronic health records, and a lack of information and guidance for clinicians.
“This is troubling because these are highly innovative practices that have a national reputation,” said study author Benjamin Crabtree, PhD, of Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey.
Dr Crabtree and his colleagues evaluated survivorship care* at the 12 practices, which were based in Colorado, Illinois, Maine, New York, Pennsylvania, and Washington.
Over nearly 2 years, the team spent 10 to 12 days observing each of the practices and interviewing clinicians and administrators.
In this way, the researchers identified 3 main barriers to integrating survivorship care into primary medicine.
Barrier 1
The first barrier was that clinicians did not treat cancer survivors as a distinct population or clinical category.
“There is no diagnosis code for ‘cancer survivor’ that can be entered into the medical record, which is important if you want physicians to pay attention,” Dr Crabtree said.
Some of the clinicians interviewed said their care was comprehensive enough to address the needs of all patients. Other clinicians did not understand what survivorship care entails.
Barrier 2
The second barrier was that electronic health record systems didn’t support survivorship care.
Clinicians reported an inability to identify patients with a history of cancer. Even if a patient’s cancer history was included in his or her record, it might take searching through multiple screens to find the information.
In addition, medical records were sometimes lost as patients changed clinicians over the years, which left it up to patients to report their cancer histories.
Barrier 3
The third barrier was that clinicians did not receive adequate information or guidance for follow-up care of cancer survivors.
Although some of the practices received cancer-related information about their patients, it was considered “inadequate” or “not actionable.”
Clinicians expressed concerns about their knowledge gaps in cancer care and the need to monitor changing information in oncology.
“There is nothing in the residency curriculum about cancer survivorship,” Dr Crabtree said. “There is also nothing in Continuing Medical Education courses. It’s just not there.”
Dr Crabtree and his colleagues believe these barriers must be addressed so that comprehensive cancer survivorship services can move to the forefront of primary care.
* Survivorship care includes checking for cancer recurrence, monitoring long-term effects of radiation and chemotherapy, and assessing a patient’s psychological well-being.
Primary care may not meet the healthcare needs of cancer survivors in the US, according to research published in JAMA Internal Medicine.
Researchers examined 12 advanced primary care practices selected from a national registry of “workforce innovators” and found that none of these practices had a comprehensive survivorship care program in place.
In addition, there were 3 main barriers to survivorship care—not treating cancer survivors as a distinct population, limitations of electronic health records, and a lack of information and guidance for clinicians.
“This is troubling because these are highly innovative practices that have a national reputation,” said study author Benjamin Crabtree, PhD, of Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey.
Dr Crabtree and his colleagues evaluated survivorship care* at the 12 practices, which were based in Colorado, Illinois, Maine, New York, Pennsylvania, and Washington.
Over nearly 2 years, the team spent 10 to 12 days observing each of the practices and interviewing clinicians and administrators.
In this way, the researchers identified 3 main barriers to integrating survivorship care into primary medicine.
Barrier 1
The first barrier was that clinicians did not treat cancer survivors as a distinct population or clinical category.
“There is no diagnosis code for ‘cancer survivor’ that can be entered into the medical record, which is important if you want physicians to pay attention,” Dr Crabtree said.
Some of the clinicians interviewed said their care was comprehensive enough to address the needs of all patients. Other clinicians did not understand what survivorship care entails.
Barrier 2
The second barrier was that electronic health record systems didn’t support survivorship care.
Clinicians reported an inability to identify patients with a history of cancer. Even if a patient’s cancer history was included in his or her record, it might take searching through multiple screens to find the information.
In addition, medical records were sometimes lost as patients changed clinicians over the years, which left it up to patients to report their cancer histories.
Barrier 3
The third barrier was that clinicians did not receive adequate information or guidance for follow-up care of cancer survivors.
Although some of the practices received cancer-related information about their patients, it was considered “inadequate” or “not actionable.”
Clinicians expressed concerns about their knowledge gaps in cancer care and the need to monitor changing information in oncology.
“There is nothing in the residency curriculum about cancer survivorship,” Dr Crabtree said. “There is also nothing in Continuing Medical Education courses. It’s just not there.”
Dr Crabtree and his colleagues believe these barriers must be addressed so that comprehensive cancer survivorship services can move to the forefront of primary care.
* Survivorship care includes checking for cancer recurrence, monitoring long-term effects of radiation and chemotherapy, and assessing a patient’s psychological well-being.
Primary care may not meet the healthcare needs of cancer survivors in the US, according to research published in JAMA Internal Medicine.
Researchers examined 12 advanced primary care practices selected from a national registry of “workforce innovators” and found that none of these practices had a comprehensive survivorship care program in place.
In addition, there were 3 main barriers to survivorship care—not treating cancer survivors as a distinct population, limitations of electronic health records, and a lack of information and guidance for clinicians.
“This is troubling because these are highly innovative practices that have a national reputation,” said study author Benjamin Crabtree, PhD, of Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey.
Dr Crabtree and his colleagues evaluated survivorship care* at the 12 practices, which were based in Colorado, Illinois, Maine, New York, Pennsylvania, and Washington.
Over nearly 2 years, the team spent 10 to 12 days observing each of the practices and interviewing clinicians and administrators.
In this way, the researchers identified 3 main barriers to integrating survivorship care into primary medicine.
Barrier 1
The first barrier was that clinicians did not treat cancer survivors as a distinct population or clinical category.
“There is no diagnosis code for ‘cancer survivor’ that can be entered into the medical record, which is important if you want physicians to pay attention,” Dr Crabtree said.
Some of the clinicians interviewed said their care was comprehensive enough to address the needs of all patients. Other clinicians did not understand what survivorship care entails.
Barrier 2
The second barrier was that electronic health record systems didn’t support survivorship care.
Clinicians reported an inability to identify patients with a history of cancer. Even if a patient’s cancer history was included in his or her record, it might take searching through multiple screens to find the information.
In addition, medical records were sometimes lost as patients changed clinicians over the years, which left it up to patients to report their cancer histories.
Barrier 3
The third barrier was that clinicians did not receive adequate information or guidance for follow-up care of cancer survivors.
Although some of the practices received cancer-related information about their patients, it was considered “inadequate” or “not actionable.”
Clinicians expressed concerns about their knowledge gaps in cancer care and the need to monitor changing information in oncology.
“There is nothing in the residency curriculum about cancer survivorship,” Dr Crabtree said. “There is also nothing in Continuing Medical Education courses. It’s just not there.”
Dr Crabtree and his colleagues believe these barriers must be addressed so that comprehensive cancer survivorship services can move to the forefront of primary care.
* Survivorship care includes checking for cancer recurrence, monitoring long-term effects of radiation and chemotherapy, and assessing a patient’s psychological well-being.
Some cancers linked to weight are on the rise in the US
Cancers associated with being overweight or obese accounted for about 40% of all cancers diagnosed in the US in 2014, according to the latest Vital Signs report by the US Centers for Disease Control and Prevention.
The International Agency for Research on Cancer has identified 13 cancers associated with overweight and obesity—multiple myeloma (MM), meningioma, adenocarcinoma of the esophagus, and thyroid, postmenopausal breast, gallbladder, stomach, liver, pancreatic, kidney, ovarian, uterine, and colorectal cancers.
For the Vital Signs report, researchers reviewed US data from 2005 to 2014 to determine trends for cancers associated with being overweight (having a body mass index [BMI] of 25 to 29.9 kg/m2) or obese (having a BMI of 30 kg/m2 and higher).
In 2014, roughly 631,000 people were diagnosed with cancers associated with overweight and obesity, which represents 40% of all cancers diagnosed.
Fifty-five percent of all cancers diagnosed in women and 24% of those diagnosed in men were associated with overweight and obesity.
Incidence rates of the 13 cancers combined were highest in non-Hispanic blacks, followed by non-Hispanic whites, American Indians/Alaska Natives, Hispanics, and Asians/Pacific Islanders.
Incidence over time
Overall, the incidence of cancers associated with overweight and obesity decreased 2% from 2005 to 2014.
However, when colorectal cancer was excluded, the incidence of the other 12 cancers combined increased 7% from 2005 to 2014. The incidence of colorectal cancer decreased 23% during that time. Researchers said this was due, in large part, to screening.
The incidence of cancers not associated with overweight and obesity decreased 13% from 2005 to 2014.
The incidence of MM increased over the period studied, but it was not a significant increase. The incidence rate of MM was 5.6 per 100,000 persons (age-adjusted to the 2000 US standard population) in 2005 and 6.0 per 100,000 persons in 2014.
So overall, there was an 8% increase in MM incidence rate from 2005 to 2014, or a 1.1% average annual increase. There was a 2% increase in the risk of MM per 1 kg/m2 increase in BMI.
Like MM, 3 other cancers had fairly stable incidence rates over the study period—adenocarcinoma of the esophagus, gallbladder cancer, and postmenopausal breast cancer.
However, incidence rates increased significantly each year for thyroid cancer (4.0% per year), liver cancer (2.9%), gastric cardia cancer (1.2%), endometrial cancer (1.1%), pancreatic cancer (0.8%), and kidney cancer (0.7%).
And incidence rates decreased significantly each year for meningioma (-3.8%), colorectal cancer (-2.9%), and ovarian cancer (-2.0%).
Cancers associated with being overweight or obese accounted for about 40% of all cancers diagnosed in the US in 2014, according to the latest Vital Signs report by the US Centers for Disease Control and Prevention.
The International Agency for Research on Cancer has identified 13 cancers associated with overweight and obesity—multiple myeloma (MM), meningioma, adenocarcinoma of the esophagus, and thyroid, postmenopausal breast, gallbladder, stomach, liver, pancreatic, kidney, ovarian, uterine, and colorectal cancers.
For the Vital Signs report, researchers reviewed US data from 2005 to 2014 to determine trends for cancers associated with being overweight (having a body mass index [BMI] of 25 to 29.9 kg/m2) or obese (having a BMI of 30 kg/m2 and higher).
In 2014, roughly 631,000 people were diagnosed with cancers associated with overweight and obesity, which represents 40% of all cancers diagnosed.
Fifty-five percent of all cancers diagnosed in women and 24% of those diagnosed in men were associated with overweight and obesity.
Incidence rates of the 13 cancers combined were highest in non-Hispanic blacks, followed by non-Hispanic whites, American Indians/Alaska Natives, Hispanics, and Asians/Pacific Islanders.
Incidence over time
Overall, the incidence of cancers associated with overweight and obesity decreased 2% from 2005 to 2014.
However, when colorectal cancer was excluded, the incidence of the other 12 cancers combined increased 7% from 2005 to 2014. The incidence of colorectal cancer decreased 23% during that time. Researchers said this was due, in large part, to screening.
The incidence of cancers not associated with overweight and obesity decreased 13% from 2005 to 2014.
The incidence of MM increased over the period studied, but it was not a significant increase. The incidence rate of MM was 5.6 per 100,000 persons (age-adjusted to the 2000 US standard population) in 2005 and 6.0 per 100,000 persons in 2014.
So overall, there was an 8% increase in MM incidence rate from 2005 to 2014, or a 1.1% average annual increase. There was a 2% increase in the risk of MM per 1 kg/m2 increase in BMI.
Like MM, 3 other cancers had fairly stable incidence rates over the study period—adenocarcinoma of the esophagus, gallbladder cancer, and postmenopausal breast cancer.
However, incidence rates increased significantly each year for thyroid cancer (4.0% per year), liver cancer (2.9%), gastric cardia cancer (1.2%), endometrial cancer (1.1%), pancreatic cancer (0.8%), and kidney cancer (0.7%).
And incidence rates decreased significantly each year for meningioma (-3.8%), colorectal cancer (-2.9%), and ovarian cancer (-2.0%).
Cancers associated with being overweight or obese accounted for about 40% of all cancers diagnosed in the US in 2014, according to the latest Vital Signs report by the US Centers for Disease Control and Prevention.
The International Agency for Research on Cancer has identified 13 cancers associated with overweight and obesity—multiple myeloma (MM), meningioma, adenocarcinoma of the esophagus, and thyroid, postmenopausal breast, gallbladder, stomach, liver, pancreatic, kidney, ovarian, uterine, and colorectal cancers.
For the Vital Signs report, researchers reviewed US data from 2005 to 2014 to determine trends for cancers associated with being overweight (having a body mass index [BMI] of 25 to 29.9 kg/m2) or obese (having a BMI of 30 kg/m2 and higher).
In 2014, roughly 631,000 people were diagnosed with cancers associated with overweight and obesity, which represents 40% of all cancers diagnosed.
Fifty-five percent of all cancers diagnosed in women and 24% of those diagnosed in men were associated with overweight and obesity.
Incidence rates of the 13 cancers combined were highest in non-Hispanic blacks, followed by non-Hispanic whites, American Indians/Alaska Natives, Hispanics, and Asians/Pacific Islanders.
Incidence over time
Overall, the incidence of cancers associated with overweight and obesity decreased 2% from 2005 to 2014.
However, when colorectal cancer was excluded, the incidence of the other 12 cancers combined increased 7% from 2005 to 2014. The incidence of colorectal cancer decreased 23% during that time. Researchers said this was due, in large part, to screening.
The incidence of cancers not associated with overweight and obesity decreased 13% from 2005 to 2014.
The incidence of MM increased over the period studied, but it was not a significant increase. The incidence rate of MM was 5.6 per 100,000 persons (age-adjusted to the 2000 US standard population) in 2005 and 6.0 per 100,000 persons in 2014.
So overall, there was an 8% increase in MM incidence rate from 2005 to 2014, or a 1.1% average annual increase. There was a 2% increase in the risk of MM per 1 kg/m2 increase in BMI.
Like MM, 3 other cancers had fairly stable incidence rates over the study period—adenocarcinoma of the esophagus, gallbladder cancer, and postmenopausal breast cancer.
However, incidence rates increased significantly each year for thyroid cancer (4.0% per year), liver cancer (2.9%), gastric cardia cancer (1.2%), endometrial cancer (1.1%), pancreatic cancer (0.8%), and kidney cancer (0.7%).
And incidence rates decreased significantly each year for meningioma (-3.8%), colorectal cancer (-2.9%), and ovarian cancer (-2.0%).
Researchers win Nobel Prize for developing cryo-EM
Three researchers have received the Nobel Prize in Chemistry 2017 for the development of cryo-electron microscopy (EM), which has simplified and improved the imaging of biomolecules.
Cryo-EM is a method used to image frozen biological molecules without the use of structure-altering dyes or fixatives or the need to coax the molecules into crystalline form.
This provides a simpler way to generate images of molecules in their normal states and greater understanding of biological function. It also aids the development of pharmaceuticals.
For developing cryo-EM, this year’s Nobel Prize in Chemistry* was awarded to:
- Jacques Dubochet, PhD, of University of Lausanne in Switzerland
- Joachim Frank, PhD, of Columbia University in New York, New York
- Richard Henderson, PhD, of MRC Laboratory of Molecular Biology in Cambridge, UK.
About the work
Electron microscopes were long believed to be suitable only for imaging dead matter because the electron beam destroys biological material.
However, in 1990, Dr Henderson succeeded in using an electron microscope to generate a 3-dimensional image of a protein at atomic resolution. This breakthrough proved the technology’s potential.
Dr Frank made the technology generally applicable. Between 1975 and 1986, he developed an image processing method in which the electron microscope’s fuzzy, 2-dimensional images are analyzed and merged to reveal a sharp, 3-dimensional structure.
Dr Dubochet added water to the mix. Liquid water evaporates in the electron microscope’s vacuum, which makes the biomolecules collapse.
In the early 1980s, Dr Dubochet succeeded in vitrifying water. He cooled water so rapidly that it solidified in its liquid form around a biological sample, allowing the biomolecules to retain their natural shape even in a vacuum.
Following these discoveries, the electron microscope’s every nut and bolt have been optimized. The desired atomic resolution was reached in 2013, and researchers can now routinely produce 3-dimensional structures of biomolecules.
In the past few years, the scientific literature has been filled with images of everything from proteins that cause antibiotic resistance to the surface of the Zika virus.
*The prize amount is 9 million Swedish krona to be shared equally among the Laureates.
Three researchers have received the Nobel Prize in Chemistry 2017 for the development of cryo-electron microscopy (EM), which has simplified and improved the imaging of biomolecules.
Cryo-EM is a method used to image frozen biological molecules without the use of structure-altering dyes or fixatives or the need to coax the molecules into crystalline form.
This provides a simpler way to generate images of molecules in their normal states and greater understanding of biological function. It also aids the development of pharmaceuticals.
For developing cryo-EM, this year’s Nobel Prize in Chemistry* was awarded to:
- Jacques Dubochet, PhD, of University of Lausanne in Switzerland
- Joachim Frank, PhD, of Columbia University in New York, New York
- Richard Henderson, PhD, of MRC Laboratory of Molecular Biology in Cambridge, UK.
About the work
Electron microscopes were long believed to be suitable only for imaging dead matter because the electron beam destroys biological material.
However, in 1990, Dr Henderson succeeded in using an electron microscope to generate a 3-dimensional image of a protein at atomic resolution. This breakthrough proved the technology’s potential.
Dr Frank made the technology generally applicable. Between 1975 and 1986, he developed an image processing method in which the electron microscope’s fuzzy, 2-dimensional images are analyzed and merged to reveal a sharp, 3-dimensional structure.
Dr Dubochet added water to the mix. Liquid water evaporates in the electron microscope’s vacuum, which makes the biomolecules collapse.
In the early 1980s, Dr Dubochet succeeded in vitrifying water. He cooled water so rapidly that it solidified in its liquid form around a biological sample, allowing the biomolecules to retain their natural shape even in a vacuum.
Following these discoveries, the electron microscope’s every nut and bolt have been optimized. The desired atomic resolution was reached in 2013, and researchers can now routinely produce 3-dimensional structures of biomolecules.
In the past few years, the scientific literature has been filled with images of everything from proteins that cause antibiotic resistance to the surface of the Zika virus.
*The prize amount is 9 million Swedish krona to be shared equally among the Laureates.
Three researchers have received the Nobel Prize in Chemistry 2017 for the development of cryo-electron microscopy (EM), which has simplified and improved the imaging of biomolecules.
Cryo-EM is a method used to image frozen biological molecules without the use of structure-altering dyes or fixatives or the need to coax the molecules into crystalline form.
This provides a simpler way to generate images of molecules in their normal states and greater understanding of biological function. It also aids the development of pharmaceuticals.
For developing cryo-EM, this year’s Nobel Prize in Chemistry* was awarded to:
- Jacques Dubochet, PhD, of University of Lausanne in Switzerland
- Joachim Frank, PhD, of Columbia University in New York, New York
- Richard Henderson, PhD, of MRC Laboratory of Molecular Biology in Cambridge, UK.
About the work
Electron microscopes were long believed to be suitable only for imaging dead matter because the electron beam destroys biological material.
However, in 1990, Dr Henderson succeeded in using an electron microscope to generate a 3-dimensional image of a protein at atomic resolution. This breakthrough proved the technology’s potential.
Dr Frank made the technology generally applicable. Between 1975 and 1986, he developed an image processing method in which the electron microscope’s fuzzy, 2-dimensional images are analyzed and merged to reveal a sharp, 3-dimensional structure.
Dr Dubochet added water to the mix. Liquid water evaporates in the electron microscope’s vacuum, which makes the biomolecules collapse.
In the early 1980s, Dr Dubochet succeeded in vitrifying water. He cooled water so rapidly that it solidified in its liquid form around a biological sample, allowing the biomolecules to retain their natural shape even in a vacuum.
Following these discoveries, the electron microscope’s every nut and bolt have been optimized. The desired atomic resolution was reached in 2013, and researchers can now routinely produce 3-dimensional structures of biomolecules.
In the past few years, the scientific literature has been filled with images of everything from proteins that cause antibiotic resistance to the surface of the Zika virus.
*The prize amount is 9 million Swedish krona to be shared equally among the Laureates.
FDA grants EUA to Zika testing system
The US Food and Drug Administration (FDA) has granted emergency use authorization (EUA) for Chembio Diagnostics, Inc.’s DPP® Zika System.
The system includes the DPP Zika IgM Assay, which enables in vitro qualitative detection of human IgM antibodies to Zika virus, and the DPP Micro Reader, which is a portable, hand-held device intended to reduce the risk of human error during test interpretation.
The DPP Zika System provides results in 15 to 20 minutes from 10 µL of blood.
The system is designed to detect Zika virus IgM antibodies in finger-stick whole blood, EDTA venous whole blood, EDTA plasma (each collected alongside a patient-matched serum specimen), or serum (plain or separation gel) specimens.
The EUA for the DPP Zika System does not mean it is FDA cleared or approved.
An EUA allows for the use of unapproved medical products (or unapproved uses of approved medical products) in an emergency. The products must be used to diagnose, treat, or prevent serious or life-threatening conditions caused by chemical, biological, radiological, or nuclear threat agents, when there are no adequate alternatives.
The EUA for the DPP Zika System means the test is only authorized as long as circumstances exist to justify the emergency use of in vitro diagnostics for the detection of Zika virus, unless the authorization is terminated or revoked sooner.
Testing using the DPP Zika System is authorized to be conducted by laboratories in the US that are certified under the Clinical Laboratory Improvement Amendments of 1988, 42 U.S.C. § 263a, to perform high complexity tests, or by similarly qualified non-US laboratories.
The DPP Zika System can be used to test individuals who meet the Centers for Disease Control and Prevention (CDC) Zika virus clinical criteria (eg, a history of clinical signs and symptoms associated with Zika virus infection) and/or CDC Zika virus epidemiological criteria (eg, a history of residence in or travel to a geographic region with active Zika transmission at the time of travel or other epidemiological criteria for which Zika virus testing may be indicated).
The DPP Zika System can be used starting 8 days after symptom onset or risk of exposure and for up to 12 weeks after that point.
Where there are reactive results from the DPP Zika IgM Assay, confirmation of the presence of anti-Zika IgM antibodies requires additional testing and/or consideration alongside test results for other patient-matched specimens using the latest CDC testing algorithms for the diagnosis of Zika virus infection.
Development of the DPP Zika System has been funded, in part, with federal funds from the Biomedical Advanced Research and Development Authority (BARDA) within the Office of the Assistant Secretary for Preparedness and Response in the US Department of Health and Human Services.
Chembio Diagnostics, Inc. has been awarded a contract for $5.9 million to develop the product and obtain EUA and 510(k) clearance from the FDA, with the potential of $13.2 million in total funding from BARDA if all options are exercised, to advance clinical development of the DPP Zika System and DPP® Zika/Dengue/Chikungunya System.
More information on the DPP Zika System and other Zika tests granted EUAs can be found on the FDA’s EUA page.
The US Food and Drug Administration (FDA) has granted emergency use authorization (EUA) for Chembio Diagnostics, Inc.’s DPP® Zika System.
The system includes the DPP Zika IgM Assay, which enables in vitro qualitative detection of human IgM antibodies to Zika virus, and the DPP Micro Reader, which is a portable, hand-held device intended to reduce the risk of human error during test interpretation.
The DPP Zika System provides results in 15 to 20 minutes from 10 µL of blood.
The system is designed to detect Zika virus IgM antibodies in finger-stick whole blood, EDTA venous whole blood, EDTA plasma (each collected alongside a patient-matched serum specimen), or serum (plain or separation gel) specimens.
The EUA for the DPP Zika System does not mean it is FDA cleared or approved.
An EUA allows for the use of unapproved medical products (or unapproved uses of approved medical products) in an emergency. The products must be used to diagnose, treat, or prevent serious or life-threatening conditions caused by chemical, biological, radiological, or nuclear threat agents, when there are no adequate alternatives.
The EUA for the DPP Zika System means the test is only authorized as long as circumstances exist to justify the emergency use of in vitro diagnostics for the detection of Zika virus, unless the authorization is terminated or revoked sooner.
Testing using the DPP Zika System is authorized to be conducted by laboratories in the US that are certified under the Clinical Laboratory Improvement Amendments of 1988, 42 U.S.C. § 263a, to perform high complexity tests, or by similarly qualified non-US laboratories.
The DPP Zika System can be used to test individuals who meet the Centers for Disease Control and Prevention (CDC) Zika virus clinical criteria (eg, a history of clinical signs and symptoms associated with Zika virus infection) and/or CDC Zika virus epidemiological criteria (eg, a history of residence in or travel to a geographic region with active Zika transmission at the time of travel or other epidemiological criteria for which Zika virus testing may be indicated).
The DPP Zika System can be used starting 8 days after symptom onset or risk of exposure and for up to 12 weeks after that point.
Where there are reactive results from the DPP Zika IgM Assay, confirmation of the presence of anti-Zika IgM antibodies requires additional testing and/or consideration alongside test results for other patient-matched specimens using the latest CDC testing algorithms for the diagnosis of Zika virus infection.
Development of the DPP Zika System has been funded, in part, with federal funds from the Biomedical Advanced Research and Development Authority (BARDA) within the Office of the Assistant Secretary for Preparedness and Response in the US Department of Health and Human Services.
Chembio Diagnostics, Inc. has been awarded a contract for $5.9 million to develop the product and obtain EUA and 510(k) clearance from the FDA, with the potential of $13.2 million in total funding from BARDA if all options are exercised, to advance clinical development of the DPP Zika System and DPP® Zika/Dengue/Chikungunya System.
More information on the DPP Zika System and other Zika tests granted EUAs can be found on the FDA’s EUA page.
The US Food and Drug Administration (FDA) has granted emergency use authorization (EUA) for Chembio Diagnostics, Inc.’s DPP® Zika System.
The system includes the DPP Zika IgM Assay, which enables in vitro qualitative detection of human IgM antibodies to Zika virus, and the DPP Micro Reader, which is a portable, hand-held device intended to reduce the risk of human error during test interpretation.
The DPP Zika System provides results in 15 to 20 minutes from 10 µL of blood.
The system is designed to detect Zika virus IgM antibodies in finger-stick whole blood, EDTA venous whole blood, EDTA plasma (each collected alongside a patient-matched serum specimen), or serum (plain or separation gel) specimens.
The EUA for the DPP Zika System does not mean it is FDA cleared or approved.
An EUA allows for the use of unapproved medical products (or unapproved uses of approved medical products) in an emergency. The products must be used to diagnose, treat, or prevent serious or life-threatening conditions caused by chemical, biological, radiological, or nuclear threat agents, when there are no adequate alternatives.
The EUA for the DPP Zika System means the test is only authorized as long as circumstances exist to justify the emergency use of in vitro diagnostics for the detection of Zika virus, unless the authorization is terminated or revoked sooner.
Testing using the DPP Zika System is authorized to be conducted by laboratories in the US that are certified under the Clinical Laboratory Improvement Amendments of 1988, 42 U.S.C. § 263a, to perform high complexity tests, or by similarly qualified non-US laboratories.
The DPP Zika System can be used to test individuals who meet the Centers for Disease Control and Prevention (CDC) Zika virus clinical criteria (eg, a history of clinical signs and symptoms associated with Zika virus infection) and/or CDC Zika virus epidemiological criteria (eg, a history of residence in or travel to a geographic region with active Zika transmission at the time of travel or other epidemiological criteria for which Zika virus testing may be indicated).
The DPP Zika System can be used starting 8 days after symptom onset or risk of exposure and for up to 12 weeks after that point.
Where there are reactive results from the DPP Zika IgM Assay, confirmation of the presence of anti-Zika IgM antibodies requires additional testing and/or consideration alongside test results for other patient-matched specimens using the latest CDC testing algorithms for the diagnosis of Zika virus infection.
Development of the DPP Zika System has been funded, in part, with federal funds from the Biomedical Advanced Research and Development Authority (BARDA) within the Office of the Assistant Secretary for Preparedness and Response in the US Department of Health and Human Services.
Chembio Diagnostics, Inc. has been awarded a contract for $5.9 million to develop the product and obtain EUA and 510(k) clearance from the FDA, with the potential of $13.2 million in total funding from BARDA if all options are exercised, to advance clinical development of the DPP Zika System and DPP® Zika/Dengue/Chikungunya System.
More information on the DPP Zika System and other Zika tests granted EUAs can be found on the FDA’s EUA page.