Literature Review

All posts tagged with “Clinical News | Disease Specific.”



Multidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patients

03/29/25 at 03:30 AM

Multidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patientsCancer Medicine; Nithya Krishnamurthy, Melanie Besculides, Ksenia Gorbenko, Melissa Mazor, Marsha Augustin, Jose Morillo, Marcos Vargas, Cardinale B. Smith; 3/25There are significant disparities in outcomes at the end-of-life (EOL) for minoritized patients with advanced cancer, with most dying without a documented serious illness conversation (SIC). This study aims to assess clinician perceptions of the utility and challenges of implementing a machine learning [ML] model (ALERT) to predict 6-month mortality among patients with advanced solid cancers to prompt timely SIC. Our study found that clinicians expressed widespread acceptability of ALERT and identified clear benefits, particularly in triggering earlier SIC and standardizing prognosis discussions across care teams. [Additionally,] a recent study found that ML prognostic models decreased use of aggressive chemotherapy at EOL and increased SIC frequency fourfold.

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Children as living solid organ donors: Ethical discussion and model hospital policy statement

03/29/25 at 03:15 AM

Children as living solid organ donors: Ethical discussion and model hospital policy statementThe Journal of Clinical Ethics; Gyan C. Moorthy, Aidan P. Crowley, and Sandra Amaral' Spring 2025In recent years, more attention has been paid to living donation as a means to reduce the suffering of individuals with end-stage kidney or liver disease. Implicated ethical issues include medical risk and risk of coercion, counterbalanced by improved medical outcomes and the benefits of saving a life. Living donation becomes particularly ethically complicated with the prospect of child donation, given the child’s developing autonomy and uniquely dependent status. We outline four broad ethical considerations pertinent to living child organ donation: (1) beneficence, (2) respect for the family as a moral unit, (3) respect for the child as a person, and (4) justice. We conclude that it can be ethical for a healthy child to donate a kidney or liver lobe to a close relative who has exhausted other options provided that certain protections are put into place.

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Racial disparities in ALS progression: Time to clinical events observed in a single center

03/29/25 at 03:10 AM

Racial disparities in ALS progression: Time to clinical events observed in a single center Wiley Online Library; by Shanshan Chen, Demetrius Carter, Jillian Prier, JoBeth Bingham, Shital Patel, Manisha Kotay, Paula Burke Brockenbrough, Kelly Gwathmey; 3/10/25 Studies examining racial differences in ALS have previously focused on diagnostic delay and disease severity. Time to critical clinical events has rarely been investigated, despite its importance in revealing differences in ALS patients' disease courses. This study explores racial disparities in time to specific clinical events in Black and non-Hispanic White ALS patients at a single center. ... Our single-center findings demonstrate a large racial difference in time to clinical events for Black versus White ALS patients referred for NIV, AAC, hospice, and wheelchair, suggesting more advanced disease at the time of presentation or more rapid progression.

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Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of Cardiology

03/29/25 at 03:00 AM

Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of CardiologyEuropean Journal of Heart Failure; Maurizio Volterrani, Geza Halasz, Stamatis Adamopoulos, Pier Giuseppe Agostoni, Javed Butler, Andrew J.S. Coats, Alan Cohen-Solal, Wolfram Doehner, Gerasimos Filippatos, Ewa Jankowska, Carolyn S.P. Lam, Ekaterini Lambrinou, Lars H. Lund, Giuseppe Rosano, Marco Metra, Stefania Paolillo, Pasquale Perrone Filardi, Amina Rakisheva, Gianluigi Savarese, Petar Seferovic, Carlo Gabriele Tocchetti, Massimo Piepoli; 3/25 Patients with heart failure (HF) experience much worse QoL [quality of life] and effort intolerance than both the general population and people with other chronic conditions, since they present a range of physical and psychological symptoms, including shortness of breath, chest discomfort, fatigue, fluid congestion, trouble with sleeping, and depression. The importance of QoL for patients with HF is highlighted in a survey showing that 61% attached more weight to QoL over longevity, with 9% and 14% willing to trade 6 and 12 months, respectively, for perfect health and better QoL.It is for these reasons that the Heart Failure Association is developing a new score for QoL in HF, sensitive to mechanism-specific interventions and tailored to be sensitive to changes within individual patients. 

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Hidden battles: Keeping cancer secret

03/27/25 at 03:00 AM

Hidden battles: Keeping cancer secret Harvard Health Publishing - Harvard Medical School; by Maureen Salamon; post is dated 4/1/25, retrieved from the internet 3/25/25 Some people choose to conceal their diagnosis and treatment. Here's why — and reasons that approach can sometimes backfire. ... [In addition to privacy motives, Cristina Pozo-Kaderman, a senior psychologist at Harvard-affiliated Dana-Farber Cancer Institute] says cancer patients may also wish to:

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Palliative care clinic offers supportive care for patients with end-stage heart failure

03/27/25 at 03:00 AM

Palliative care clinic offers supportive care for patients with end-stage heart failure Yale School of Medicine; by Rachel Martin; 3/25/25 ... Michael Beasley, MD, [Yale] assistant professor of medicine (cardiovascular medicine), and Nora Segar, MD, [Yale] assistant clinical professor (general internal medicine) and director of palliative medicine at the Saint Raphael Campus of Yale New Haven Hospital, recently established a new outpatient clinic to provide dedicated palliative care for people with end-stage heart failure. ... “For many patients with advanced heart failure, hospice care does not meet their needs until very late in their course,” said Segar, an early champion of the clinic. “Instead, by providing early palliative care outside of the hospital, when it’s not a time of crisis, we can help patients accept and cope with their prognosis, manage their symptoms, and continue making plans for the future.” New patients receive longer appointments, which allows the team to hear their stories and start building relationships with them. [Continue reading ...]Editor's note: For all palliative and hospice leaders, we highlight this last statement: "New patients receive longer appointments, which allows the team to hear their stories and start building relationships with them."

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Ohio reported its first measles case in 2025. Here’s what you need to know about this highly contagious virus.

03/26/25 at 03:15 AM

Ohio reported its first measles case in 2025. Here’s what you need to know about this highly contagious virus. Signal Cleveland, Cleveland, OH; by Sue Zake and Reegan Davis Saunders; 3/25/25 An unvaccinated adult in Ashtabula contracted the first case of measles in Ohio, according to the Ohio Department of Health. The individual had contact with someone who recently traveled internationally and was confirmed to have contracted the highly contagious respiratory virus. ... As of March 20, the CDC has reported 378 confirmed cases in the U.S.  — 95% of those who became ill were either unvaccinated or had an unknown vaccination status. Twenty-seven percent of children under 5 years of age who contracted measles have been hospitalized since Jan. 1. Here’s more information to help you understand the disease and protect yourself and your family [and prfoessionals]. [Continue reading ...]

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Assisted ventilation withdrawal in motor neuron disease: updated results

03/26/25 at 03:00 AM

Assisted ventilation withdrawal in motor neuron disease: updated results BMJ Supportive & Palliative Care; by Lucy Bleazard, Jonathan Palmer, David Wenzel, Thomas Jeffery, and Christina Faull; 3/24/25 Introduction: Patients with ventilator-dependent motor neuron disease (MND) may request withdrawal of their assisted ventilation. Facilitating this process as a healthcare professional (HCP) can be emotionally and practically challenging. The Association for Palliative Medicine (APM) issued guidance to support HCPs and invited anonymised accounts of the withdrawal process to provide an update on the guidance. ... Results: Younger patients tended to need higher doses to achieve adequate symptom management prior to withdrawal. Practices of weaning the ventilator varied significantly between respondents. The median time to death following withdrawal of ventilation was 30 min, with three-quarters of patients dying within 2 hours. Conclusion: This is the largest data set to date regarding the withdrawal of assisted ventilation in MND. This updated analysis reaffirms that a personalised, titrated approach remains appropriate and effective. The revised APM Guidance 2025 incorporates new sections on recommendations for managing the ventilator. [Continue reading ...]

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[Germany] Web-based educational tools and decision aids for patients with advanced cancer: A systematic review

03/22/25 at 03:55 AM

[Germany] Web-based educational tools and decision aids for patients with advanced cancer: A systematic reviewPatient Education and Counseling; Phoebe Ullrich, Henrike Voß, Laura Unsöld, Michael Thomas, Matthias Villalobos; 2/25In advanced cancer care, patient involvement in decision-making is complex. Web-based solutions are promising because of easy accessibility and dissemination and the ability to adapt information to patients' needs and new treatment developments. Still, only a few evidence-based web-based educational tools and decision aids are available. Filling this gap is essential to empower patients to make informed and goal-concordant treatment decisions.

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Feasibility study of using electronic patient-reported outcomes to screen patients with advanced solid cancers for palliative care needs

03/22/25 at 03:50 AM

Feasibility study of using electronic patient-reported outcomes to screen patients with advanced solid cancers for palliative care needsJournal of Palliative Medicine; Tara L Kaufmann, Matthew Kearney, Dagoberto Cortez, John W Saxton, Katie Goodfellow, Carolyn Smith, Patrick Chang, Katherine Sebastian, Aaron Galaznik, Julie Scott, Elizabeth Ann Kvale, Arif H Kamal, Antonia V Bennett, Angela M Stover, Ashley M Henneghan, Michael Pignone, Gabrielle Betty Rocque; 3/25Standardized, needs-based screening and triage systems are essential to more effectively address patients' palliative care needs. We developed a 13-item ePRO [electronic patient-reported outcomes] palliative care survey to assess multidimensional palliative care needs and conducted a pilot study (n = 25) of a palliative care screening intervention using ePRO monitoring and presentation of ePRO reports to a multidisciplinary care team. Patients found the ePRO palliative survey acceptable and appropriate. Screening patients for unmet palliative needs using ePRO monitoring is feasible, acceptable, and appropriate among patients, but more work is needed to understand the perspectives of diverse patients and how to integrate ePRO palliative care screening into clinical workflows.

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Evaluating performance of the Surprise Question to predict 12-month mortality in patients with end-stage liver disease

03/22/25 at 03:45 AM

Evaluating performance of the Surprise Question to predict 12-month mortality in patients with end-stage liver diseaseAmerican Journal of Hospice and Palliative Care; Sarah Homann, MD; Jamie Pfaff, MD; Elizabeth Stovicek, MD; Rajiv Agarwal, MD, MSC;, Sumathi K. Misra, MD, MPH; Jill M. Pulley, MBA; Justin K. Siemann, PhD; Ashley Spann, MD, MSCAI; Stacey Tillman, MD; Cheryl L. Gatto, PhD; Mohana Karlekar, MD; 2/25ESLD [end-stage liver disease] is associated with significant morbidity and mortality. Early PC engagement has been proposed as a solution to improve the physical and psychological burden associated with ESLD. ... hepatologists were asked the SQ [surprise question]: “Would you be surprised if this patient were to die in the next 12 months?” as a prompt to consider consultation to specialty PC [palliative care]. While the SQ should not be solely used as a prognostic indicator of death, our study proves that the SQ can be utilized by hepatologists as a screening tool with good sensitivity for identifying patients with ESLD who may be at higher risk of death and therefore may benefit from PC co-management.

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Inpatient use of valproic acid in agitated delirium by palliative medicine

03/22/25 at 03:40 AM

Inpatient use of valproic acid in agitated delirium by palliative medicineAmerican Journal of Hospice and Palliative Medicine; Sarah Jacobs, DO; Leah Herbst, DO; Carlos Fernandez, MD; Zankhana Y. Mehta, MD; Amanda Young, MS; Mellar P. Davis, MD; 2/25Valproic acid (VPA), an anti-epileptic medication available in intravenous and parenteral forms, has recently been used to treat agitation associated with delirium. VPA as an adjunct in treating delirium has been reported to be opioid, antipsychotic and benzodiazepine sparing. ... this study did show that 50% of patients did not require benzodiazepines or antipsychotics at all, and that VPA might have a role in sparing the use of medications such as antipsychotics and benzodiazepines which have poor evidence in the management of agitation in delirium.

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VITAS Healthcare is first hospice organization to earn American Heart Association Heart Failure Certification across all 15 states and DC

03/19/25 at 02:30 AM

VITAS Healthcare is first hospice organization to earn American Heart Association Heart Failure Certification across all 15 states and DC Florida News Guide, Miami, FL; Press Release; 3/18/25 ... VITAS has become the first nationwide hospice provider to earn the American Heart Association® Palliative/Hospice Heart Failure certification across all 15 states in which it operates. The certification applies to 56 unique VITAS service areas, including the District of Columbia. ... “Many patients with heart failure do not receive the hospice care that could significantly improve their final months of life,” said Joseph Shega, MD, executive vice president and chief medical officer at VITAS. “This certification affirms our commitment to providing evidence-based hospice care that helps patients and families navigate advanced heart disease with dignity, comfort and the right level of support.”

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Revamped tool can reliably assess pain symptoms in dementia patients: researchers

03/19/25 at 02:00 AM

Revamped tool can reliably assess pain symptoms in dementia patients: researchers McKnights Long-Term Care News; by Zee Johnson; 3/17/25 ... A team of researchers reconstructed the End-of-Life Dementia-Comfort Assessment in Dying, or EOLD-CAD, after a multifacility study showed that caregivers could adequately and reliably address a host of pain symptoms seen in end-of-life dementia patients. ... When clinicians working in the SNFs that were part of the trials used the EOLD-CAD, they were able to detect patterns in more than 600 residents that fell into four categories: physical distress, symptoms of dying, emotional distress, and well-being. Common symptoms observed across these categories were restlessness, shortness of breath, choking, gurgling, difficulty in swallowing, fear and anxiety. ...

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2010 to 2019 saw early palliative care billing up for advanced cancer

03/18/25 at 03:00 AM

2010 to 2019 saw early palliative care billing up for advanced cancer HealthDay News; by Elana Gotkine; 3/17/25 For patients with distant-stage cancers, there was an increase in early palliative care (PC) billing from 2010 to 2019, but the level remained low, according to a study published online March 7 in the Journal of Clinical Oncology. ... The researchers found that in 2010 to 2019, there was an increase in the percentage with early PC billing among 102,032 patients treated by 18,908 unique physicians, from 1.44 to 10.36 percent. The likelihood of early PC billing was increased in association with treating physician's early PC referrals in the previous year and organizations' employment of any HPM specialist (3.01 and 4.54 percentage points, respectively). 

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Terminally ill Stanford professor teaches class about dying from cancer

03/17/25 at 03:00 AM

Terminally ill Stanford professor teaches class about dying from cancerCBS News, Bay Area, CA; by Elizabeth Cook; 3/13/25 A Stanford University professor's new curriculum explores the multiple aspects and phases of a person dying of cancer, and it comes from a person with first-hand knowledge. Dr. Bryant Lin has been a professor for almost two decades. He's used to being the teacher, not the subject of his classes. But that all changed in 2024 when he was diagnosed with stage 4 lung cancer. ... The diagnosis was a dose of cruel irony. Lin co-founded the Center for Asian Health Research and Education. One of the priorities for the foundation is researching non-small cell adenocarcinoma, also known as "never-smoker lung cancer," the same cancer diagnosis that Lin received. ... The class is called "From diagnosis to dialogue: A doctor's real-time battle with cancer." Within minutes of being posted, the class and the waitlist were full. ... The 10-week course covers the entire spectrum of cancer as seen through the eyes of someone who is living it. ... Stanford University recorded every session of the class so that they could live on for future physicians. If you would like to watch them, they can be found on YouTube. 

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Sarcopenia in terminally ill patients with cancer: Clinical implications, diagnostic challenges, and management strategies

03/17/25 at 03:00 AM

Sarcopenia in terminally ill patients with cancer: Clinical implications, diagnostic challenges, and management strategies Journal of Hospice & Palliative Care; by Se-Il Go, Myoung Hee Kang, and Hoon-Gu Kim; 3/1/25 Sarcopenia, characterized by progressive loss of skeletal muscle mass and strength, is a prevalent but often overlooked condition in patients with cancer who are terminally ill. It contributes to functional decline, increased symptom burden, and reduced quality of life, yet remains underrecognized in palliative care. Diagnosing sarcopenia in this population is challenging because conventional imaging techniques are often impractical. Instead, alternative assessments, such as the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls questionnaire (SARC-F), anthropometric measurements, and bioelectrical impedance analysis offer feasible options. Management should focus on symptom relief, functional preservation, and patient comfort, rather than on muscle mass restoration.

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Psychedelics for cancer pain and associated psychological distress: A narrative review of a potential strategy

03/15/25 at 03:20 AM

Psychedelics for cancer pain and associated psychological distress: A narrative review of a potential strategyCancer Medicine; Erika Belitzky, Lis Victoria Ravani Carvalho, Melissa Taylor, Cristina Naranjo Ortiz, Laura Baum, David A Fiellin, Maryam B Lustberg; 3/25Cancer pain can ... be exacerbated by anxiety, depression, quality of life challenges, and fear of death and dying, as well as by fear of recurrence or progression. Psychedelics, such as lysergic acid diethylamide (LSD), psilocybin, mescaline, and N,N-dimethyltryptamine (DMT), are under consideration as new pharmacologic strategies for mitigating pain and the distress associated with cancer pain and associated symptom burden. Although published studies are limited, regulatory hurdles have decreased. Many clinical trials are underway to assess further the use of psychedelics and behavioral counseling for patients with cancer and comorbidities such as anxiety or depression. Early results are promising, and additional research is needed to understand efficacy and tolerability in broader cancer populations. 

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2024 Alzheimer's Disease Facts and Figures

03/14/25 at 03:00 AM

2024 Alzheimer's Disease Facts and Figures: Mapping a better future for dementia care navigation Alzheimer's Association, Chicago, IL; www.alz.org; 2024 2024 Alzheimer’s Disease Facts and Figures is a statistical resource for U.S. data related to Alzheimer’s disease, the most common cause of dementia. Background and context for interpretation of the data are contained in the Overview. Additional sections address prevalence, mortality and morbidity, caregiving, the dementia care workforce, and the use and costs of health care and services. The Special Report provides a comprehensive look into dementia care navigation, revealing significant insights into the experiences and challenges faced by caregivers and health care workers in helping people living with Alzheimer’s or other dementia navigate the health care system. [Click on the title's link to access and download this 149-page PDF]

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Questions to ask when choosing a memory care facility

03/13/25 at 03:00 AM

Questions to ask when choosing a memory care facility The Kansas State Collegian; 3/10/25 ...  Your goal is to find a community where your family member can feel safe, truly cared for, and supported during this next chapter of their life. To help, we’ve put together a list of questions you should ask when touring memory care facilities. These questions will help you cut through the sales pitches and get to the heart of what each community offers. ...

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The staging of 'The Story of My Life' at Asbury Memorial filled with serendipitous moments

03/11/25 at 03:00 AM

The staging of 'The Story of My Life' at Asbury Memorial filled with serendipitous moments Savannah Morning News, Savannah, GA; by Amy Paige Condon; 3/6/25 ... [Ray] Ellis, a retired music and drama teacher who works now as a caregiver, and fellow church member Dottie Kluttz, a retired hospice nurse, were hanging decorations in Asbury Memorial’s Social Hall. Ellis shared how his dream of producing “The Story of My Life” was back on his mind … A former hospice nurse, Kluttz founded Savannah Hospice’s Story Keeping program in 2001 as a way for people near the end of their lives to share the story of their lives. …  [Click on the title’s link to read the serendipitous, synergistic encounters that unfolded, resulting in shows March 28, 29, 30.] [Upon underwriting for production costs,] Ellis proposed that ticket sales for the musical could serve as a fundraiser for Savannah Hospice’s Story Keeping program and the Michael J. Fox Foundation for Parkinson’s Research—a nonprofit near and dear to Ellis, who was diagnosed about three years ago with the progressive brain disease that causes tremors, stiffness and balance problems. … Stage and film actor Mark Rand, who was diagnosed with Parkinson’s around the same time as Ellis, agreed to portray Thomas to Ellis’s Alvin—even after Rand thought he would never perform again. …

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The Medical Minute: Measles cases rising in the US, what you can do

03/10/25 at 03:00 AM

The Medical Minute: Measles cases rising in the US, what you can do PennState, Hershey, PA; 3/6/25 A case of measles in a child was confirmed in Montgomery County on March 2 ─ the first reported case in the state in 2025. Nationwide, the Centers for Disease Control and Prevention (CDC) has reported 164 measles cases in nine states. Texas alone has seen at least 140 cases since late January, including one unvaccinated child who died. Measles is a preventable, highly contagious, airborne virus that can cause serious health complications, including death, especially in children under 5, said Dr. George McSherry, division chief of pediatric infectious diseases at Penn State Health Children’s Hospital. “Measles is a very serious illness. It’s one of the most infectious of the infectious diseases,” McSherry said. “If you put a person with measles in a room with 100 unimmunized people, 90 will get it.” Click on the title's link for more important information. 

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Report finds those with Parkinson’s have unmet hospice needs

03/10/25 at 02:10 AM

Report finds those with Parkinson’s have unmet hospice needsMcKnights Long-Term Care News; by Kristen Fischer; 3/6/25 Hospice use varies depending on whether a person has Parkinson’s disease, Lewy body dementia or Alzheimer’s disease and those with Parkinson’s may have more unmet needs, a new study finds. Researchers evaluated data on 11,327,324 Medicare beneficiaries enrolled in hospice between 2010 and 2020 as part of their study, which was published Tuesday in JAMA Network Open. ... Hospice enrollees who had Parkinson’s disease and dementia with Lewy bodies were less likely to be disenrolled from hospice due to extended prognosis compared to those with Alzheimer’s disease. People who had Parkinson’s disease but not dementia with Lewy bodies were more apt to have longer stays over 180 days and turn hospice away compared to those with Alzheimer’s disease. (Short stays were defined as those less than seven days.)

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Pulmonary embolism–related mortality in patients with cancer

03/08/25 at 03:10 AM

Pulmonary embolism–related mortality in patients with cancerJAMA Network Open; Marco Zuin, MD, MS; Anju Nohria, MD; Stanislav Henkin, MD, MPH; Darsiya Krishnathasan, MS; Alyssa Sato, BA; Gregory Piazza, MD, MS; 2/25This cohort study ... found that despite decreases in cancer-related mortality rates, temporal trends demonstrated an increase in age-adjusted PE [pulmonary embolism]-related mortality from 2011 to 2020 among patients with cancer, with a significantly higher rate of increase observed in younger patients aged 15 to 64 years, Black, Hispanic, and White individuals; and the Southern region of the US. Recognition of such patterns may inform further research into thromboprophylaxis and treatment of PE as a complication of cancer and cancer-directed therapy.

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Algorithm-based palliative care in patients with cancer-A cluster randomized clinical trial

03/08/25 at 03:05 AM

Algorithm-based palliative care in patients with cancer-A cluster randomized clinical trialJAMA Network Open; Ravi B. Parikh, MD, MPP; William J. Ferrell, MPH; Yang Li, MS; Jinbo Chen, PhD; Larry Bilbrey; Nicole Johnson, BSN; Jenna White, MSW; Ramy Sedhom, MD; Natalie R. Dickson, MD; Stephen Schleicher, MD; Justin E. Bekelman, MD; Sandhya Mudumbi, MD; 2/25In this randomized clinical trial conducted in a community oncology network between November 2022 and December 2023 among 562 patients with advanced cancer identified by an automated electronic health record algorithm, default orders increased palliative care consultation (44% vs 8%) and decreased end-of-life systemic therapy (6% vs 16%) compared with usual care but did not improve patient-reported or hospice outcomes. The findings suggest that default algorithm-based palliative care orders are a scalable implementation strategy to increase palliative care referrals and reduce intensive end-of-life care. 

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