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103. A Model for an Undergraduate Research Experience Programin Quantitative Sciences.

Author

Kay See Tan, Elkin, Elena B., and Satagopan, Jaya M.

Subjects
STUDENT attitudes, UNDERGRADUATE programs, RESEARCH skills, UNDERGRADUATES, SCIENCE students
Abstract

We developed a summer research experience program within a freestanding comprehensive cancer center to cultivate undergraduate students with an interest in and an aptitude for quantitative sciences focused on oncology. This unconventional location for an undergraduate program is an ideal setting for interdisciplinary training in the intersection of oncology, statistics, and epidemiology. This article describes the development and implementation of a hands-on research experience program in this unique environment. Core components of the program include faculty-mentored projects, instructional programs to improve research skills and domain knowledge, and professional development activities. We discuss key considerations such as fostering effective partnership between research and administrative units, recruiting students, and identifying facultymentors with quantitative projects. We describe evaluation approaches and discuss post-program outcomes and lessons learned. In its initial two years, the program successfully improved the students' perception of competence gained in research skills and statistical knowledge across several knowledge domains. The majority of students also went on to pursue graduate degrees in a quantitative field or work in oncology-centric academic research roles. Our research-based training model can be adapted by a variety of organizations motivated to develop a summer research experience program in quantitative sciences for undergraduate students. Supplemental files for this article are available online. [ABSTRACT FROM AUTHOR]

Published
2022
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107. IMPROVING FUNCTIONAL RECOVERY FOLLOWING HIP FRACTURE: A RANDOMIZED CONTROLLED TRIAL.

Author

Allegrante, John P, Peterson, Margaret G E, Cornell, Charles N, MacKenzie, C Ronald, Robbins, Laura, Horton, Roberta, Ganz, Sandy B, Augurt, Antonia, Backus, Sherry, Chow, Betty, Dempsey, James, Elkin, Elena B, Murray, Linda, Ruchlin, Hirsch S, Williams-Russo, Pamela, Charlson, Mary E, and Paget, Stephen A

Published
2001

108. Cost-Effectiveness of Smoking Cessation Interventions in the Lung Cancer Screening Setting: A Simulation Study.

Author

Cadham, Christopher J, Cao, Pianpian, Jayasekera, Jinani, Taylor, Kathryn L, Levy, David T, Jeon, Jihyoun, Elkin, Elena B, Foley, Kristie L, Joseph, Anne, Kong, Chung Yin, Minnix, Jennifer A, Rigotti, Nancy A, Toll, Benjamin A, Zeliadt, Steven B, Meza, Rafael, Mandelblatt, Jeanne, Collaboration, the CISNET-SCALE, and CISNET-SCALE Collaboration

Subjects
SMOKING cessation, LUNG cancer, EARLY detection of cancer, HOTLINES (Counseling), COUNSELING, LUNG tumors, COST benefit analysis, MEDICARE, QUALITY-adjusted life years
Abstract

Background: Guidelines recommend offering cessation interventions to smokers eligible for lung cancer screening, but there is little data comparing specific cessation approaches in this setting. We compared the benefits and costs of different smoking cessation interventions to help screening programs select specific cessation approaches.Methods: We conducted a societal-perspective cost-effectiveness analysis using a Cancer Intervention and Surveillance Modeling Network model simulating individuals born in 1960 over their lifetimes. Model inputs were derived from Medicare, national cancer registries, published studies, and micro-costing of cessation interventions. We modeled annual lung cancer screening following 2014 US Preventive Services Task Force guidelines plus cessation interventions offered to current smokers at first screen, including pharmacotherapy only or pharmacotherapy with electronic and/or web-based, telephone, individual, or group counseling. Outcomes included lung cancer cases and deaths, life-years saved, quality-adjusted life-years (QALYs) saved, costs, and incremental cost-effectiveness ratios.Results: Compared with screening alone, all cessation interventions decreased cases of and deaths from lung cancer. Compared incrementally, efficient cessation strategies included pharmacotherapy with either web-based cessation ($555 per QALY), telephone counseling ($7562 per QALY), or individual counseling ($35 531 per QALY). Cessation interventions continued to have costs per QALY well below accepted willingness to pay thresholds even with the lowest intervention effects and was more cost-effective in cohorts with higher smoking prevalence.Conclusion: All smoking cessation interventions delivered with lung cancer screening are likely to provide benefits at reasonable costs. Because the differences between approaches were small, the choice of intervention should be guided by practical concerns such as staff training and availability. [ABSTRACT FROM AUTHOR]

Published
2021
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109. Promoting Breast Cancer Surveillance: The EMPOWER Study, a Randomized Clinical Trial in the Childhood Cancer Survivor Study

Author

Oeffinger, Kevin C., primary, Ford, Jennifer S., additional, Moskowitz, Chaya S., additional, Chou, Joanne F., additional, Henderson, Tara O., additional, Hudson, Melissa M., additional, Diller, Lisa, additional, McDonald, Aaron, additional, Ford, James, additional, Mubdi, Nidha Z., additional, Rinehart, Dayton, additional, Vukadinovich, Christopher, additional, Gibson, Todd M., additional, Anderson, Nassim, additional, Elkin, Elena B., additional, Garrett, Kathleen, additional, Rebull, Margaret, additional, Leisenring, Wendy, additional, Robison, Leslie L., additional, and Armstrong, Gregory T., additional

Published
2019
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111. Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers

Author

Gonen Mithat, Elkin Elena B, Cronin Angel M, and Vickers Andrew J

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Abstract Background Decision curve analysis is a novel method for evaluating diagnostic tests, prediction models and molecular markers. It combines the mathematical simplicity of accuracy measures, such as sensitivity and specificity, with the clinical applicability of decision analytic approaches. Most critically, decision curve analysis can be applied directly to a data set, and does not require the sort of external data on costs, benefits and preferences typically required by traditional decision analytic techniques. Methods In this paper we present several extensions to decision curve analysis including correction for overfit, confidence intervals, application to censored data (including competing risk) and calculation of decision curves directly from predicted probabilities. All of these extensions are based on straightforward methods that have previously been described in the literature for application to analogous statistical techniques. Results Simulation studies showed that repeated 10-fold crossvalidation provided the best method for correcting a decision curve for overfit. The method for applying decision curves to censored data had little bias and coverage was excellent; for competing risk, decision curves were appropriately affected by the incidence of the competing risk and the association between the competing risk and the predictor of interest. Calculation of decision curves directly from predicted probabilities led to a smoothing of the decision curve. Conclusion Decision curve analysis can be easily extended to many of the applications common to performance measures for prediction models. Software to implement decision curve analysis is provided.

Published
2008
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116. Measuring the Value of New Drugs: Validity and Reliability of 4 Value Assessment Frameworks in the Oncology Setting

Author

Bentley, Tanya G.K., primary, Cohen, Joshua T., additional, Elkin, Elena B., additional, Huynh, Julie, additional, Mukherjea, Arnab, additional, Neville, Thanh H., additional, Mei, Matthew, additional, Copher, Ronda, additional, Knoth, Russell, additional, Popescu, Ioana, additional, Lee, Jackie, additional, Zambrano, Jenelle M., additional, and Broder, Michael S., additional

Published
2017
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118. Validity and reliability of four value frameworks for cancer drugs.

Author

Bentley, Tanya GK, primary, Cohen, Joshua T., additional, Elkin, Elena B., additional, Huynh, Julie, additional, Mukherjea, Arnab, additional, Neville, Thanh H., additional, Mei, Matthew Genyeh, additional, Copher, Ronda, additional, Knoth, Russell L., additional, Popescu, Ioana, additional, Lee, Jackie, additional, Zambrano, Jenelle, additional, and Broder, Michael, additional

Published
2017
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120. Treatment-Related Toxicities in Older Adults with Head and Neck Cancer: A Population-Based Analysis

Author

O’Neill, Caitriona B., Baxi, Shrujal S., Atoria, Coral L., O’Neill, James P., Henman, Martin C., Sherman, Eric J., Lee, Nancy Y., Pfister, David G., and Elkin, Elena B.

Subjects
Aged, 80 and over, Male, Drug-Related Side Effects and Adverse Reactions, Radiotherapy, Antineoplastic Agents, Chemoradiotherapy, Article, United States, Cohort Studies, Treatment Outcome, Head and Neck Neoplasms, Humans, Female, Radiation Injuries, Aged, SEER Program
Abstract

Despite advantages in terms of cancer control and organ preservation, the benefits of chemotherapy and radiation therapy (CTRT) may be offset by potentially severe treatment-related toxicities, particularly in older patients. The objectives of this study were to assess the types and frequencies of toxicities in older adults with locally or regionally advanced head and neck squamous cell carcinoma (HNSCC) who were receiving either primary CTRT or radiation therapy (RT) alone.With Surveillance, Epidemiology, and End Results cancer registry data linked with Medicare claims, patients who were 66 years old or older with locally advanced HNSCC, were diagnosed from 2001 to 2009, and received CTRT or RT alone were identified. Differences in the frequency of toxicity-related hospital admissions and emergency room visits as well as feeding tube use were examined, and controlling for demographic and disease characteristics, this study estimated the impact of chemotherapy on the likelihood of toxicity.Among patients who received CTRT (n = 1502), 62% had a treatment-related toxicity, whereas 46% of patients who received RT alone (n = 775) did. When the study controlled for demographic and disease characteristics, CTRT patients were twice as likely to experience an acute toxicity in comparison with their RT-only peers. Fifty-five percent of CTRT patients had a feeding tube placed during or after treatment, whereas 28% of the RT-only group did.In this population-based cohort of older adults with HNSCC, the rates of acute toxicities and feeding tube use in patients receiving CTRT were considerable. It is possible that for certain older patients, the potential benefit of adding chemotherapy to RT does not outweigh the harms of this combined-modality therapy.

Published
2015

121. Screening for thyroid cancer in survivors of childhood and young adult cancer treated with neck radiation

Author

Tonorezos, Emily S., primary, Barnea, Dana, additional, Moskowitz, Chaya S., additional, Chou, Joanne F., additional, Sklar, Charles A., additional, Elkin, Elena B., additional, Wong, Richard J., additional, Li, Duan, additional, Tuttle, R. Michael, additional, Korenstein, Deborah, additional, Wolden, Suzanne L., additional, and Oeffinger, Kevin C., additional

Published
2016
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124. The EMPOWER study: Promoting breast cancer screening—A randomized controlled trial (RCT) in the Childhood Cancer Survivor Study (CCSS).

Author

Oeffinger, Kevin C., primary, Ford, Jennifer, additional, Moskowitz, Chaya S., additional, Chou, Joanne F., additional, Henderson, Tara O., additional, Hudson, Melissa M., additional, Diller, Lisa, additional, McDonald, Aaron, additional, Ford, James, additional, Mubdi, Nidha Z., additional, Rinehart, Dayton, additional, Vukadinovich, Chris, additional, Gibson, Todd M., additional, Anderson, Nassim, additional, Elkin, Elena B., additional, Garrett, Kathleen, additional, Rebull, Margaret, additional, and Armstrong, Gregory T., additional

Published
2016
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128. Sharing a diagnosis of HPV-related head and neck cancer: the emotions, the confusion and what patients want to know

Author

Baxi, Shrujal S., Shuman, Andrew G., Corner, Geoffrey W., Shuk, Elyse, Sherman, Eric J., Elkin, Elena B., Hay, Jennifer L., and Pfister, David G.

Subjects
Adult, Male, Health Knowledge, Attitudes, Practice, Physician-Patient Relations, Emotions, Papillomavirus Infections, Pilot Projects, Middle Aged, Combined Modality Therapy, Risk Assessment, Article, Interviews as Topic, Oropharyngeal Neoplasms, Patient Education as Topic, Adaptation, Psychological, Carcinoma, Squamous Cell, Quality of Life, Humans, Neoplasm Invasiveness, Survivors, Confusion, Needs Assessment, Neoplasm Staging
Abstract

Oropharyngeal cancers are increasingly associated with human papillomavirus (HPV). Little is known about the experience of patients receiving this diagnosis.Semistructured interviews were conducted with ten survivors of HPV-related oropharyngeal cancer. The interviews were transcribed, and recurring themes were identified.Physicians were a trusted source of information regarding HPV. Framing the diagnosis in terms of prognosis resonated with patients. The uncertainty about transmission, latency, and communicability colored the dialogue about HPV. Despite some understanding of prevalence and transmission, patients worried about their partner's risk. Patients sought information about HPV on the Internet, but it was not easily navigable. Emotional reactions to the diagnosis remained mostly cancer-centric rather than HPV-centric. A patient-education handout was developed in response to patient questions.Additional educational resources explaining the facts about HPV in HNSCC in a consistent way including content of highest priority to patients may improve understanding of HPV.

Published
2012

129. Costs and Trends in Pancreatic Cancer Treatment

Author

O’Neill, Caitriona B., Atoria, Coral L., O’Reilly, Eileen M., LaFemina, Jennifer, Henman, Martin C., and Elkin, Elena B.

Subjects
Aged, 80 and over, Male, Health Care Costs, Health Services, Medicare, Article, United States, Hospitalization, Pancreatic Neoplasms, Population Surveillance, Humans, Aged, Retrospective Studies, SEER Program
Abstract

Pancreatic cancer poses a substantial morbidity and mortality burden in the United States, and predominantly affects older adults. The objective of this study was to estimate the direct medical costs of pancreatic cancer treatment in a population-based cohort of Medicare beneficiaries, and the contribution of different treatment modalities and health care services to the total cost of care and trends in costs over time.In the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database, pancreatic cancer patients were identified who were aged 66 years or older and who were diagnosed from 2000 to 2007. Total direct medical costs were estimated from Medicare payments overall and within categories of care. Costs attributable to pancreatic cancer were estimated by subtracting the costs of medical care in a matched cohort of cancer-free beneficiaries.A total of 15,037 patients were identified, of whom 97% were observed from diagnosis until death. Mean total direct medical costs were $65,500. Mean total costs were greater for patients with resectable locoregional disease ($134,700) than for those with unresectable locoregional or distant disease ($65,300 and $49,000, respectively). Hospitalizations and cancer-directed procedures collectively accounted for the largest fraction of health care costs. The total cost of care appeared to increase slightly over the study period (P = .05). The mean costs attributable to pancreatic cancer were $61,700.Despite poor prognosis and short survival, the economic burden of pancreatic cancer in the elderly is substantial. Demographic trends, greater use of targeted therapies, and possible implementation of screening strategies are likely to impact treatment patterns and costs in the future.

Published
2012

140. Advancing Survivors’ Knowledge (ASK) about skin cancer study: study protocol for a randomized controlled trial

Author

Daniel, Casey L, primary, Armstrong, Gregory T, additional, Keske, Robyn R, additional, Davine, Jessica A, additional, McDonald, Aaron J, additional, Sprunck-Harrild, Kim M, additional, Coleman, Catherine, additional, Haneuse, Sebastien J, additional, Mertens, Ann C, additional, Emmons, Karen M, additional, Marghoob, Ashfaq A, additional, Elkin, Elena B, additional, Dusza, Stephen W, additional, Robison, Leslie L, additional, and Geller, Alan C, additional

Published
2015
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