Journal ArticleJ Pain Symptom Manage · August 2024
BACKGROUND: Opioids are a first-line treatment for severe cancer pain. However, clinicians may be reluctant to prescribe opioids for patients with concurrent substance use disorders (SUD) or clinical concerns about non-prescribed substance use. MEASURES: P ...
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Journal ArticleJ Gen Intern Med · July 19, 2024
BACKGROUND: Substance misuse is common among cancer survivors and can negatively impact cancer outcomes. METHODS: We conducted a cross-sectional study using National Survey on Drug Use and Health data for 2015 to 2020. We included adult respondents with a ...
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Journal ArticleLearn Health Syst · July 2024
While considerable scholarship has explored responsibilities owed to research participants at the conclusion of explanatory clinical trials, no guidance exists regarding responsibilities owed at the conclusion of a pragmatic clinical trial (PCT). Yet post- ...
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Journal ArticleJ Gen Intern Med · July 2024
Pragmatism in clinical trials is focused on increasing the generalizability of research findings for routine clinical care settings. Hybridism in clinical trials (i.e., assessing both clinical effectiveness and implementation success) is focused on speedin ...
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Journal ArticleJ Natl Cancer Inst · June 7, 2024
BACKGROUND: Racial and ethnic disparities in genomic testing could exacerbate disparities in access to precision cancer therapies and survival-particularly in the context of lung cancer where genomic testing has been recommended for the past decade. Howeve ...
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Journal ArticleJ Gen Intern Med · May 2024
In contrast to traditional randomized controlled trials, embedded pragmatic clinical trials (ePCTs) are conducted within healthcare settings with real-world patient populations. ePCTs are intentionally designed to align with health system priorities levera ...
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Journal ArticleJAMA Oncol · March 1, 2024
IMPORTANCE: Some individuals are predisposed to cancer based on their substance use history, and others may use substances to manage cancer-related symptoms. Yet the intersection of substance use disorder (SUD) and cancer is understudied. Because SUD may a ...
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Journal ArticleTransl Behav Med · February 7, 2024
Clinical and health services researchers seek to discover effective programs, practices, and interventions to improve people's health. The current paradigm for evidence generation is incremental and misaligned to translate evidence-based discoveries into r ...
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Journal ArticleAm J Hosp Palliat Care · January 2024
OBJECTIVES: Many cancer survivors experience chronic pain after completing curative-intent treatment. Based on available data, chronic pain may be undertreated in this context; however, little is known about cancer survivors' experiences with clinical mana ...
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Journal ArticleBreast Cancer Res Treat · January 2024
PURPOSE: Treatment for HER2-low [defined as ImmunoHistoChemistry (IHC) 1 + or 2 + and negative/normal in Situ Hybridization (ISH)] breast cancer patients is rapidly evolving, yet we lack critical information about the HER2-low population. METHODS: We condu ...
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Journal ArticleContemp Clin Trials · December 2023
BACKGROUND: Many patients with advanced cancer describe pain as a debilitating symptom that greatly interferes with daily activities and enjoyment of life. Psychosocial interventions can improve cancer-related pain but rarely address spiritual concerns (e. ...
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Journal ArticleJ Palliat Med · August 2023
Background: For many cancer survivors post-cure, chronic pain is a devastating complication of cancer treatment. The prevalence of chronic pain among cancer survivors is double that of the general population. However, little is known about the pain experie ...
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Journal ArticleJ Pain Symptom Manage · August 2023
CONTEXT: While professional societies and expert panels have recommended quality indicators related to advance care planning (ACP) documentation, including using structured documentation templates, it is unclear how clinicians document these conversations. ...
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Journal ArticlePsychooncology · July 2023
OBJECTIVE: For patients with advanced cancer, pain is a common and debilitating symptom that can negatively impact physical, emotional, and spiritual well-being. This trial examined the feasibility and initial effects of Meaning-Centered Pain Coping Skills ...
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Journal ArticleClin Lung Cancer · June 2023
BACKGROUND: Despite recommendations for molecular testing irrespective of patient characteristics, differences exist in receipt of molecular testing for oncogenic drivers amongst metastatic non-small cell lung cancer (mNSCLC) patients. Exploration into the ...
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Journal ArticleJCO Oncol Pract · April 2023
PURPOSE: Among cancer survivors who have completed curative-intent treatment, the high prevalence and adverse consequences of chronic pain are well documented. Yet, research on clinicians' experiences with and perspectives on managing chronic pain among ca ...
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Journal ArticleContemp Clin Trials · March 2023
BACKGROUND: Conducting an embedded pragmatic clinical trial in the workflow of a healthcare system is a complex endeavor. The complexity of the intervention delivery can have implications for study planning, ability to maintain fidelity to the intervention ...
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Journal ArticleSupport Care Cancer · December 2022
PURPOSE: Cancer is a major reason for concurrent prescription of opioids with other sedating medications-particularly benzodiazepines and gabapentinoids-yet population-based assessments of the extent and predictors of concurrent prescribing among clinicall ...
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Journal ArticleTrials · August 26, 2022
BACKGROUND: For patients and their intimate partners, advanced cancer poses significant challenges that can negatively impact both individuals and their relationship. Prior studies have found evidence that couple-based communication skills interventions ca ...
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Journal ArticleJ Pain Symptom Manage · April 2022
CONTEXT: Recent years show a sharp increase in research on opioid use among cancer survivors, but evidence syntheses are lacking, leaving knowledge gaps. Corresponding research needs are unclear. OBJECTIVES: To provide an evidence synthesis. METHODS: We se ...
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Journal ArticleJ Pain Symptom Manage · August 2024
BACKGROUND: Opioids are a first-line treatment for severe cancer pain. However, clinicians may be reluctant to prescribe opioids for patients with concurrent substance use disorders (SUD) or clinical concerns about non-prescribed substance use. MEASURES: P ...
Full textLink to itemCite
Journal ArticleJ Gen Intern Med · July 19, 2024
BACKGROUND: Substance misuse is common among cancer survivors and can negatively impact cancer outcomes. METHODS: We conducted a cross-sectional study using National Survey on Drug Use and Health data for 2015 to 2020. We included adult respondents with a ...
Full textLink to itemCite
Journal ArticleLearn Health Syst · July 2024
While considerable scholarship has explored responsibilities owed to research participants at the conclusion of explanatory clinical trials, no guidance exists regarding responsibilities owed at the conclusion of a pragmatic clinical trial (PCT). Yet post- ...
Full textOpen AccessLink to itemCite
Journal ArticleJ Gen Intern Med · July 2024
Pragmatism in clinical trials is focused on increasing the generalizability of research findings for routine clinical care settings. Hybridism in clinical trials (i.e., assessing both clinical effectiveness and implementation success) is focused on speedin ...
Full textLink to itemCite
Journal ArticleJ Natl Cancer Inst · June 7, 2024
BACKGROUND: Racial and ethnic disparities in genomic testing could exacerbate disparities in access to precision cancer therapies and survival-particularly in the context of lung cancer where genomic testing has been recommended for the past decade. Howeve ...
Full textOpen AccessLink to itemCite
Journal ArticleJ Gen Intern Med · May 2024
In contrast to traditional randomized controlled trials, embedded pragmatic clinical trials (ePCTs) are conducted within healthcare settings with real-world patient populations. ePCTs are intentionally designed to align with health system priorities levera ...
Full textOpen AccessLink to itemCite
Journal ArticleJAMA Oncol · March 1, 2024
IMPORTANCE: Some individuals are predisposed to cancer based on their substance use history, and others may use substances to manage cancer-related symptoms. Yet the intersection of substance use disorder (SUD) and cancer is understudied. Because SUD may a ...
Full textLink to itemCite
Journal ArticleTransl Behav Med · February 7, 2024
Clinical and health services researchers seek to discover effective programs, practices, and interventions to improve people's health. The current paradigm for evidence generation is incremental and misaligned to translate evidence-based discoveries into r ...
Full textLink to itemCite
Journal ArticleAm J Hosp Palliat Care · January 2024
OBJECTIVES: Many cancer survivors experience chronic pain after completing curative-intent treatment. Based on available data, chronic pain may be undertreated in this context; however, little is known about cancer survivors' experiences with clinical mana ...
Full textLink to itemCite
Journal ArticleBreast Cancer Res Treat · January 2024
PURPOSE: Treatment for HER2-low [defined as ImmunoHistoChemistry (IHC) 1 + or 2 + and negative/normal in Situ Hybridization (ISH)] breast cancer patients is rapidly evolving, yet we lack critical information about the HER2-low population. METHODS: We condu ...
Full textLink to itemCite
Journal ArticleContemp Clin Trials · December 2023
BACKGROUND: Many patients with advanced cancer describe pain as a debilitating symptom that greatly interferes with daily activities and enjoyment of life. Psychosocial interventions can improve cancer-related pain but rarely address spiritual concerns (e. ...
Full textLink to itemCite
Journal ArticleJ Palliat Med · August 2023
Background: For many cancer survivors post-cure, chronic pain is a devastating complication of cancer treatment. The prevalence of chronic pain among cancer survivors is double that of the general population. However, little is known about the pain experie ...
Full textLink to itemCite
Journal ArticleJ Pain Symptom Manage · August 2023
CONTEXT: While professional societies and expert panels have recommended quality indicators related to advance care planning (ACP) documentation, including using structured documentation templates, it is unclear how clinicians document these conversations. ...
Full textLink to itemCite
Journal ArticlePsychooncology · July 2023
OBJECTIVE: For patients with advanced cancer, pain is a common and debilitating symptom that can negatively impact physical, emotional, and spiritual well-being. This trial examined the feasibility and initial effects of Meaning-Centered Pain Coping Skills ...
Full textLink to itemCite
Journal ArticleClin Lung Cancer · June 2023
BACKGROUND: Despite recommendations for molecular testing irrespective of patient characteristics, differences exist in receipt of molecular testing for oncogenic drivers amongst metastatic non-small cell lung cancer (mNSCLC) patients. Exploration into the ...
Full textLink to itemCite
Journal ArticleJCO Oncol Pract · April 2023
PURPOSE: Among cancer survivors who have completed curative-intent treatment, the high prevalence and adverse consequences of chronic pain are well documented. Yet, research on clinicians' experiences with and perspectives on managing chronic pain among ca ...
Full textLink to itemCite
Journal ArticleContemp Clin Trials · March 2023
BACKGROUND: Conducting an embedded pragmatic clinical trial in the workflow of a healthcare system is a complex endeavor. The complexity of the intervention delivery can have implications for study planning, ability to maintain fidelity to the intervention ...
Full textLink to itemCite
Journal ArticleSupport Care Cancer · December 2022
PURPOSE: Cancer is a major reason for concurrent prescription of opioids with other sedating medications-particularly benzodiazepines and gabapentinoids-yet population-based assessments of the extent and predictors of concurrent prescribing among clinicall ...
Full textLink to itemCite
Journal ArticleTrials · August 26, 2022
BACKGROUND: For patients and their intimate partners, advanced cancer poses significant challenges that can negatively impact both individuals and their relationship. Prior studies have found evidence that couple-based communication skills interventions ca ...
Full textLink to itemCite
Journal ArticleJ Pain Symptom Manage · April 2022
CONTEXT: Recent years show a sharp increase in research on opioid use among cancer survivors, but evidence syntheses are lacking, leaving knowledge gaps. Corresponding research needs are unclear. OBJECTIVES: To provide an evidence synthesis. METHODS: We se ...
Full textLink to itemCite
Journal ArticleJ Palliat Med · April 2022
How do we build on the proven successes of hospice and palliative care and build clinical programs to serve those who need it in the context of real-world health care? Experiences with glide pathways have clearly shown that changes in financial incentives ...
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Journal ArticleJ Pain Symptom Manage · March 2022
CONTEXT: Palliative care (PC) research has grown over the last 20 years. Yet, the causal components and pathways of PC interventions remain unclear. OBJECTIVES: To document the prevalence and application of theoretical frameworks in developing and testing ...
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Journal ArticleJCO Oncol Pract · February 2022
PURPOSE: The financial toxicity of anticancer drugs is well-documented, but little is known about the costs of drugs used to manage cancer-associated symptoms. METHODS: We reviewed relevant guidelines and compiled drugs used to manage seven cancer-associat ...
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Journal ArticleJ Natl Cancer Inst · November 2, 2021
BACKGROUND: No population-based studies have examined chronic opioid use among cancer survivors who are diverse with respect to diagnosis, age group, and insurance status. METHODS: We conducted a retrospective cohort study using North Carolina cancer regis ...
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Journal ArticleJ Pain Symptom Manage · August 2021
CONTEXT: Interventions that teach patients cognitive and behavioral strategies for managing cancer pain have demonstrated effectiveness. Systematic reviews of such interventions call for research to inform their implementation in practice, including invest ...
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Journal ArticleNeurooncol Pract · August 2021
INTRODUCTION: Given the high symptom burden and complex clinical decision making associated with a diagnosis of brain metastases (BM), specialty palliative care (PC) can meaningfully improve patient quality of life. However, no prior study has formally eva ...
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Journal ArticleJ Gen Intern Med · June 2021
BACKGROUND: Implementation science (IS) and quality improvement (QI) inhabit distinct areas of scholarly literature, but are often blended in practice. Because practice-based research networks (PBRNs) draw from both traditions, their experience could infor ...
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Journal ArticleJ Natl Cancer Inst · April 6, 2021
BACKGROUND: Despite high rates of opioid therapy, evidence about the risk of preventable opioid harms among cancer survivors is underdeveloped. Our objective was to estimate the odds of opioid use disorder (OUD) and overdose following breast, colorectal, o ...
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ConferenceJ Gen Intern Med · January 2021
BACKGROUND: Implementation methods of risk-stratified cancer screening guidance throughout a health care system remains understudied. OBJECTIVE: Conduct a preliminary analysis of the implementation of a risk-stratified prostate cancer screening algorithm i ...
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Journal ArticleJ Palliat Med · January 2021
Background: Information routinely collected during a palliative care consultation request may help predict the level of complexity of that patient encounter. Objectives: We examined whether patient and consultation characteristics, as captured in consultat ...
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Journal ArticleJ Gen Intern Med · January 2021
Efforts to improve cancer care primarily come from two fields: improvement science and implementation science. The two fields have developed independently, yet they have potential for synergy. Leveraging that synergy to enhance alignment could both reduce ...
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Chapter · January 1, 2021
Persistent breast pain (PBP) following a cancer diagnosis and treatment is common and can be highly distressing, interfering with daily activities, and leading to decreases in overall quality of life. PBP can result from breast surgeries, radiation, chemot ...
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Journal ArticleJAMA Netw Open · September 1, 2020
IMPORTANCE: National efforts to improve safe opioid prescribing focus on preventing misuse, overdose, and opioid use disorder. This approach overlooks opportunities to better prevent other serious opioid-related harms in complex populations, such as older ...
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Journal ArticleJ Natl Cancer Inst · July 1, 2020
Guidelines recommend using caution in co-prescribing opioids with benzodiazepines, yet, in practice, the extent of concurrent prescribing is poorly understood. Notably, no population-based studies, to our knowledge, have investigated concurrent prescribing ...
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Journal ArticleJ Palliat Med · April 2020
The field of palliative care (PC) has spent the past decade demonstrating that it improves outcomes for patients, clinicians, and health systems. Forward-thinking organizations preparing for a reimbursement system rooted in value have built robust inpatien ...
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Journal ArticleJ Palliat Med · March 2020
Background: Investigators have tested interventions delivered by specialty palliative care (SPC) clinicians, or by clinicians without palliative care specialization (primary palliative care, PPC). Objective: To compare the characteristics and outcomes of r ...
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Journal ArticleBreast Cancer Res Treat · February 2020
PURPOSE: Reports suggest that up to 50% of women with hormone receptor-positive (HR+) breast cancer (BC) do not complete the recommended 5 years of adjuvant endocrine therapy (AET). We examined the impact of an outreach program at Kaiser Permanente Norther ...
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Journal ArticleJ Urol · January 2020
PURPOSE: Patients who undergo cystectomy due to bladder cancer can elect an ileal conduit or a neobladder for urinary diversion. Decision regret related to this choice is an important and undesirable patient reported outcome. Our objective was to compare t ...
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Journal ArticleHead Neck · November 2019
BACKGROUND: Oropharyngeal cancer survivors experience difficulty returning to work after treatment. To better understand specific barriers to returning to work, we investigated factors associated with discontinuing employment among older and working-age su ...
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Journal ArticleSupport Care Cancer · May 2019
BACKGROUND: Compared to non-Hispanic Whites, Hispanic women are more likely to report pain, depression, and other mental health concerns. However, little is known about Hispanic women's use of supportive medications, and whether use differs depending on na ...
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Journal ArticleJ Pain Symptom Manage · March 2019
CONTEXT: Patients with cancer commonly experience depression. If not addressed, depression can lead to reduced quality of life and survival. OBJECTIVE: Given the introduction of national initiatives to improve management of psychiatric symptoms among patie ...
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Journal ArticleUrology · February 2019
OBJECTIVE: To examine intravesical chemotherapy (IVC) use according to non-muscle-invasive bladder cancer patient disease risk, and the contributions of multilevel factors to variation in proficient use among patients with low-intermediate disease. METHODS ...
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Journal ArticleLung Cancer · November 2018
OBJECTIVES: To examine the role of uniform access to care in reducing racial/ethnic disparities in receipt of resection for early stage non-small cell lung cancer (NSCLC) by comparing integrated health system member patients to demographically similar non- ...
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Journal ArticleBreast Cancer Res Treat · August 2018
PURPOSE: Racial/ethnic differences in cancer symptom burden are well documented, but limited research has evaluated modifiable factors underlying these differences. Our objective was to examine the role of patient-provider interactions to help explain the ...
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Journal ArticlePsychooncology · October 2017
BACKGROUND: Decision-making about advanced cancer treatment is complex and may be influenced by patients' family context, including the presence of children. We explored how parental values and concerns motivate patients' preferences about aggressiveness o ...
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Journal ArticlePalliat Med · March 2017
BACKGROUND: Patients with advanced cancer who have dependent children are an important population with a life-limiting illness and high levels of psychological distress. Few studies have addressed the experience of being a parent with advanced cancer and t ...
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Journal ArticleSupport Care Cancer · December 2016
PURPOSE: Racial minority cancer patients may experience underuse of antiemetic medications to prevent chemotherapy-induced nausea and vomiting (CINV). In addition to its adverse implications for quality of life, antiemetic underuse may contribute to observ ...
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Journal ArticleSupport Care Cancer · August 2016
PURPOSE: A randomized controlled trial of cancer patients has linked early supportive care with improved hospice use and less-aggressive end-of-life care. In practice, the early use of supportive interventions and potential impact on end-of-life care are p ...
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Journal ArticlePsychooncology · August 2016
OBJECTIVE: Parents with life-limiting illness anticipate the loss of their parental role and the long-term consequences of their illness on their children. The purpose of this study was to examine relationships between parenting concerns, quality of life ( ...
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Journal ArticleJ Clin Oncol · July 1, 2016
PURPOSE: Early supportive care may improve quality of life and end-of-life care among patients with cancer. We assessed racial disparities in early use of medications for common cancer symptoms (depression, anxiety, insomnia) and whether these potential di ...
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Journal ArticleBreast Cancer Res Treat · April 2016
Chemotherapy-induced nausea and vomiting (CINV) is a major concern for cancer patients and, if uncontrolled, can seriously compromise quality of life (QOL) and other treatment outcomes. Because of the expense of antiemetic medications used to prevent CINV ...
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Journal ArticlePsychooncology · November 2015
OBJECTIVE: Effective physician communication about prognosis is a critical aspect of quality care for families affected by terminal illness. This is particularly important for spousal caregivers of terminally ill parents of dependent children, who may have ...
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Journal ArticleSupport Care Cancer · August 2015
PURPOSE: The Institute of Medicine (2006) has recommended that cancer survivors completing treatment receive a survivorship care plan (SCP). The survivorship needs in advanced cancer have been overlooked and understudied. The potential role of SCPs for sur ...
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Journal ArticleImplement Sci · May 3, 2015
BACKGROUND: Survivorship care plans (SCPs) are written treatment summaries and follow-up care plans that are intended to facilitate communication and coordination of care among survivors, cancer care providers, and primary care providers. A growing number ...
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Journal ArticleCancer · April 1, 2015
In 2006, the Institute of Medicine recommended that cancer survivors who are completing primary treatment receive a survivorship care plan (SCP) based on face validity. The state of scientific knowledge regarding the SCP is unclear. The authors conducted a ...
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Journal ArticleAJOB Prim Res · January 1, 2014
BACKGROUND: Certificates of Confidentiality are intended to facilitate participation in critical public health research by protecting against forced disclosure of identifying data in legal proceedings, but little is known about the effect of Certificate de ...
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Journal ArticleClin Trials · August 2013
BACKGROUND: To improve the efficiency of conducting multicenter clinical trials, the Food and Drug Administration, the Office of Human Research Protections, and the Department of Health and Human Services have expressed support for using a centralized inst ...
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Journal ArticleAm Heart J · June 2013
BACKGROUND: Aldosterone antagonist therapy is recommended for selected patients with heart failure and reduced ejection fraction. Adherence to therapy in the transition from hospital to home is not well understood. METHODS: We identified patients with hear ...
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Journal ArticlePLoS One · 2013
Research institutions differ in their willingness to defer to a single, central institutional review board (IRB) for multicenter clinical trials, despite statements from the FDA, OHRP, and NIH in support of using central IRBs to improve the efficiency of c ...
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Journal ArticlePLoS One · 2012
Certificates of Confidentiality, issued by agencies of the U.S. government, are regarded as an important tool for meeting ethical and legal obligations to safeguard research participants' privacy and confidentiality. By shielding against forced disclosure ...
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