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Perez EA, Jaffee EM, Whyte J, Boyce CA, Carpten JD, Lozano G, Williams RM, Winkfield KM, Bernstein D, Poblete S. Analysis of Population Differences in Digital Conversations About Cancer Clinical Trials: Advanced Data Mining and Extraction Study. JMIR Cancer 2021; 7:e25621. [PMID: 34554099 PMCID: PMC8498899 DOI: 10.2196/25621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 11/27/2022] Open
Abstract
Background Racial and ethnic diversity in clinical trials for cancer treatment is essential for the development of treatments that are effective for all patients and for identifying potential differences in toxicity between different demographics. Mining of social media discussions about clinical trials has been used previously to identify patient barriers to enrollment in clinical trials; however, a comprehensive breakdown of sentiments and barriers by various racial and ethnic groups is lacking. Objective The aim of this study is to use an innovative methodology to analyze web-based conversations about cancer clinical trials and to identify and compare conversation topics, barriers, and sentiments between different racial and ethnic populations. Methods We analyzed 372,283 web-based conversations about cancer clinical trials, of which 179,339 (48.17%) of the discussions had identifiable race information about the individual posting the conversations. Using sophisticated machine learning software and analyses, we were able to identify key sentiments and feelings, topics of interest, and barriers to clinical trials across racial groups. The stage of treatment could also be identified in many of the discussions, allowing for a unique insight into how the sentiments and challenges of patients change throughout the treatment process for each racial group. Results We observed that only 4.01% (372,283/9,284,284) of cancer-related discussions referenced clinical trials. Within these discussions, topics of interest and identified clinical trial barriers discussed by all racial and ethnic groups throughout the treatment process included health care professional interactions, cost of care, fear, anxiety and lack of awareness, risks, treatment experiences, and the clinical trial enrollment process. Health care professional interactions, cost of care, and enrollment processes were notably discussed more frequently in minority populations. Other minor variations in the frequency of discussion topics between ethnic and racial groups throughout the treatment process were identified. Conclusions This study demonstrates the power of digital search technology in health care research. The results are also valuable for identifying the ideal content and timing for the delivery of clinical trial information and resources for different racial and ethnic groups.
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Affiliation(s)
- Edith A Perez
- Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, United States
| | - Elizabeth M Jaffee
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, United States
| | | | - Cheryl A Boyce
- Ohio Commission on Minority Health, Columbus, OH, United States
| | - John D Carpten
- Institute of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Guillermina Lozano
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Karen M Winkfield
- Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Sung Poblete
- Stand Up To Cancer, Los Angeles, CA, United States
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Suglia SF, Campo RA, Brown AGM, Stoney C, Boyce CA, Appleton AA, Bleil ME, Boynton-Jarrett R, Dube SR, Dunn EC, Ellis BJ, Fagundes CP, Heard-Garris NJ, Jaffee SR, Johnson SB, Mujahid MS, Slopen N, Su S, Watamura SE. Social Determinants of Cardiovascular Health: Early Life Adversity as a Contributor to Disparities in Cardiovascular Diseases. J Pediatr 2020; 219:267-273. [PMID: 32111376 PMCID: PMC7883398 DOI: 10.1016/j.jpeds.2019.12.063] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/16/2019] [Accepted: 12/30/2019] [Indexed: 12/22/2022]
Affiliation(s)
| | - Rebecca A Campo
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Alison G M Brown
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Catherine Stoney
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Cheryl A Boyce
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Albany, NY
| | - Maria E Bleil
- Department of Family and Child Nursing, University of Washington, Seattle, WA
| | - Renée Boynton-Jarrett
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Shanta R Dube
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA
| | - Erin C Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Boston, MA
| | - Bruce J Ellis
- Departments of Psychology and Anthropology, University of Utah, Salt Lake City, UT
| | - Christopher P Fagundes
- Department of Psychology, Rice University, Houston, TX; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Psychiatry, Baylor College of Medicine, Waco, TX
| | - Nia J Heard-Garris
- Division of Academic General Pediatrics, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL; Mary Ann and J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Sara R Jaffee
- Department of Psychology, University of Pennsylvania, Philadelphia, PA
| | - Sara B Johnson
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Mahasin S Mujahid
- Division of Epidemiology, Berkeley School of Public Health, University of California, Berkeley CA
| | - Natalie Slopen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
| | - Shaoyong Su
- Department of Population Health Sciences, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
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Abstract
The contribution of iatrogenic blood loss through diagnostic testing to the anaemia of critical illness remains controversial. We measured the effect of an arterial line blood conservation device upon blood loss and anaemia in adult intensive care patients. This randomized controlled trial of 160 patients in a major Intensive Care Unit (ICU) compared a blood conservation device (Venous Arterial Blood Management Protection Plus, VAMP Plus system, Baxter Healthcare) (VAMP group) to a standard arterial pressure line set attached to an arterial catheter (control group). The primary outcome measured was the change in haemoglobin concentration (Hb) during each patient's ICU admission and the volume of blood lost through diagnostic testing in ICU was also recorded. Both groups of 80 patients were matched for age, gender, severity of illness (APACHE II), baseline Hb on entry and ICU length of stay. Both groups had a similar (median [range]) change in Hb during ICU admission (VAMP-7 [- 84 to+21] g/l; Control -4 [-67 to+40] g/l; P=0.33). The VAMP patients lost significantly less blood for diagnostic testing while in ICU (VAMP 63 [0 to 787] ml; Control 133 [7 to 1227] ml; P=0.001). We conclude that the VAMP Plus system significantly reduced iatrogenic blood loss in critically ill patients, but this reduction did not affect the fall in Hb that accompanies critical illness.
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Affiliation(s)
- C M MacIsaac
- Intensive Care Unit, Royal Melbourne Hospital, Melbourne, Victoria
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4
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Farrar D, Robertson MS, Hogan CJ, Roy S, Boyce CA, Howe BD, Presneill JJ, Cade JF. Blood Usage in an Australian Intensive Care Unit: Have We Met Best Practice Goals? Anaesth Intensive Care 2019; 32:775-80. [PMID: 15648987 DOI: 10.1177/0310057x0403200608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The transfusion of blood products, especially red cell concentrates, in critically ill patients is controversial and benefits of red cell concentrate transfusion in these patients have not been clearly demonstrated. We performed a prospective observational study to compare best evidence to actual practice of red cell concentrate and other blood product administration in an intensive care unit (ICU) in a university-associated tertiary hospital. All primary admissions during a 28-day period were included in the study and data collected included transfusion of red cells and blood products, patient demographics and ICU and hospital outcome. One hundred and seventy-five admissions were studied; 44% followed cardiac surgery. Forty-one patients (23%) received red cell concentrates in ICU, with 120 units transfused in 61 separate episodes. Other blood product usage was minimal. One third (20/61) of red cell concentrate transfusion episodes were of a single unit. The mean (±SD) pre-transfusion haemoglobin was 7.9±1.1 g/dl. Despite transfusion, such patients left ICU with a lower haemoglobin concentration compared with untransfused ICU patients (9.5±1.0 versus 10.5±2.1 g/dl; P<0.001). Cardiac surgical patients received similar red cell transfusion to general ICU patients. Univariate analysis showed no significant difference in mortality between patients who did or did not receive red cell concentrate transfusion (P=0.17). However, red cell concentrate transfusion was associated with a reduced adjusted mortality both in ICU (OR 0.13, 95% CI 0.02-0.73) and in hospital at 28 days (OR 0.10, 95% CI 0.02-0.58). The low red cell concentrate and blood product usage in our ICU were consistent with restrictive transfusion practice and selective red cell concentrate transfusion was associated with reduced mortality.
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Affiliation(s)
- D Farrar
- Intensive Care Unit and Haematology Department, The Royal Melbourne Hospital, Melbourne, Victoria
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Sirocco KY, Lynne-Landsman SD, Boyce CA. Developmental Cognitive Neuroscience to Inform Cognitive-Control Interventions for Drug Abuse: Introduction to the Special Section. Child Dev Perspect 2012. [DOI: 10.1111/cdep.12002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bjork JM, Lynne-Landsman SD, Sirocco K, Boyce CA. Brain Maturation and Risky Behavior: The Promise and the Challenges of Neuroimaging-Based Accounts. Child Dev Perspect 2012. [DOI: 10.1111/cdep.12001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- Cheryl A. Boyce
- a National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services
| | - Andrew J. Fuligni
- b Center for Culture and Health, Semel Institute for Neuroscience and Human Behavior, University of California , Los Angeles
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9
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Cooley MR, Boyce CA. An Introduction to Assessing Anxiety in Child and Adolescent Multiethnic Populations: Challenges and Opportunities for Enhancing Knowledge and Practice. Journal of Clinical Child & Adolescent Psychology 2004; 33:210-5. [PMID: 15136184 DOI: 10.1207/s15374424jccp3302_1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Recognizing that researchers and clinicians are increasingly faced with assessing, treating, and studying ethnically, racially, and culturally diverse populations, one question is whether the appropriate tools exist. This special section aspires to advance the available assessment strategies that are appropriate for the treatment, prevention, and research of diverse children and adolescents with anxiety symptoms and disorders. This introduction presents an overview of anxiety and its disorders among multiethnic youth and identifies emerging challenges and opportunities in the assessment and treatment of anxiety symptoms and disorders among Asian American and Pacific Islander, Hispanic/Latino, African American, and European American children and adolescents within a sociocultural context.
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Affiliation(s)
- Michele R Cooley
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Boyce CA. The Art of Translation. Asian Am Pac Isl J Health 2001; 3:109-114. [PMID: 11567304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Boyce CA, Brow MB, Cote KC, DeSisto MC, Evans DA, Gorman D, Heavey J, Jimenez E, Symonds D, Warren CA, Westerberg D, George E. End the debate. Entry level into practice should be the master's degree. J Nurs Adm 2001; 31:166-8. [PMID: 11324326 DOI: 10.1097/00005110-200104000-00002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C A Boyce
- Graduate Program Nursing Administration and Business Management, Regis College, Weston, Massachusetts, USA
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