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Understanding Cancer Care

Temporal trends in opioid utilization among elderly metastatic cancer survivors

This study aims to understand temporal trends in opioid utilization and to clarify the clinical appropriateness of opioid prescribing changes by examining trends in emergency department visits for cancer-related pain. In addition, we aim to describe time trends in rates of opioid use disorder and opioid overdose among cancer survivors.

Funding source: American Cancer Society
Principal Investigator: Vikram Jairam

The Pediatric Advanced Cancer Experience (PACE): Measuring Quality of End-of-Life Care for Children with Cancer

Although cure rates for childhood cancer have increased over several decades, cancer remains the leading cause of non-accidental death in children. Yet, there are no existing quality measures to define optimal end-of- life care (EOLC) for children with cancer. A lack of standards for EOLC contributes to high healthcare utilization for children with advanced, incurable cancer, as well as widely variable palliative care provision. The overall objectives of this proposal are to prioritize family-centered quality measures for EOLC and to pioneer complementary approaches to assess care quality for children with advanced cancer.

Funding source: National Cancer Institute
Principal Investigator: Prasanna Ananth

Trends in Opioid Use Among Patients with Cancer

Given the rapid pace of opioid-reduction efforts, there is an unmet need to understand the impact of these efforts on cancer patients for whom these medications may be intended or required. To address this knowledge gap, we propose the following project goals: (1) a population level analysis using SEER-Medicare to assess trends in receipt of new opioid use across strata of clinical appropriateness (patients with metastatic disease, patients undergoing surgery for early stage disease, and patients without cancer) and (2) an analysis of institutional data to assess trends in new opioid use across 3 distinct clinical scenarios (patients with metastatic disease, patients undergoing palliative radiotherapy, and patients undergoing surgery for early stage disease.

Funding source: U.S. Food and Drug Administration
Principal Investigator: Henry Park

Myeloproliferative Neoplasms: Etiology, Patterns of Care, and Outcomes

This project is designed to evaluate the risk factors for myeloproliferative neoplasms in a large, prospective cohort with over 600,000 participants and to assess the patterns of care and clinical outcomes of patients in a separate population-based cohort of Medicare beneficiaries diagnosed with myeloproliferative neoplasms.

Funding source: Frederick A. DeLuca Foundation
Principal Investigator: Xiaomei Ma & Nikolai Podoltsev

Establishing Benchmarks for High Quality End-of-Life Care in Children with Cancer

Although thousands of children succumb to incurable cancer each year, no standards exist to define optimal, high quality end-of-life care for children with cancer. Arriving at a consensus for what defines high quality end-of-life care in pediatric oncology is imperative to providing care that meets patient and family goals and reduces suffering. The overall objective of this proposal is to refine and pilot stakeholder-centered EOLC quality measures for children with cancer. By deriving patient-centered quality measures through rigorous methods, this research seeks to transform the existing paradigm for pediatric cancer care delivery near the end of life.

Funding source: National Comprehensive Cancer Network, Yale Center for Clinical Investigation
Principal Investigator: Prasanna Ananth