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.
Christopher E. Jensen, MD, of the University of North Carolina School of Medicine, talks about older adults with acute myeloid leukemia who receive high-intensity chemotherapy. Although they may live longer, much of their survival gains may be spent engaged in oncology care (Abstract 376).
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).
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).
Qinjin Fan, PhD, of the American Cancer Society, explores the question of how mortgage discrimination is linked to lower rates of guideline-concordant care for patients with non–small cell lung cancer. This study highlights the critical need to understand the pathways through which mortgage denials may negatively affect the receipt of equitable care (Abstract 3).