Sandra L. Wong, MD, of the Dartmouth-Hitchcock Medical Center, discusses her study findings showing that when patients with cancer who have had surgery reported severe symptoms via an electronic patient-reported outcomes questionnaire at six cancer centers, it appeared to be beneficial without overtaxing clinicians. There were few strong predictors of severe symptoms, which suggests population surveillance may be preferable to targeted surveillance (Abstract 243).
Dawn L. Hershman, MD, of Columbia University College of Physicians and Surgeons, discusses findings that showed substantial variability in clinicians’ adherence to prescribing primary prophylactic colony stimulating factors in a pragmatic trial. Although the ability to opt out of the intervention is a feature of pragmatic trials, careful prestudy planning to estimate nonadherence is critical to ensure adequate power to detect an effect. Understanding reasons for intervention opt-outs may also inform future pragmatic studies aimed at improving adherence to practice guidelines.
Xuesong Han, PhD, of the American Cancer Society, discusses findings showing that among newly diagnosed patients with stage IV cancers, Medicaid expansion was associated with increases in receipt of palliative care, although overall usage was low. The increase varied by cancer type. Improving Medicaid coverage may facilitate access to guideline-based palliative care (Abstract 73).
Samyukta Mullangi, MD, MBA, of Memorial Sloan Kettering Cancer Center, discusses her findings showing that physicians’ prescribing behavior may be influenced by payer-led pathways. Pathway compliance was associated with higher medical costs during a 6-month baseline period but lower health-care utilization, as measured in hospitalizations and emergency department visits during that baseline period (Abstract 7).
Changchuan Jiang, MD, MPH, of Roswell Park Comprehensive Cancer Center, discusses the lack of transportation as a potentially modifiable barrier to care for patients with cancer. Timely intervention may reduce visits to hospital emergency departments, lower costs, and improve outcomes (Abstract 70).