2022
Systemic Anticancer Therapy at the End of Life—Changes in Usage Pattern in the Immunotherapy Era
Canavan ME, Wang X, Ascha MS, Miksad RA, Calip GS, Gross CP, Adelson KB. Systemic Anticancer Therapy at the End of Life—Changes in Usage Pattern in the Immunotherapy Era. JAMA Oncology 2022, 8: 1847-1849. PMID: 36264566, PMCID: PMC9585458, DOI: 10.1001/jamaoncol.2022.4666.Peer-Reviewed Original Research
2021
Impact of a Dedicated Cancer Urgent Care Center on Acute Care Utilization
Rothberg BE, Canavan ME, Mun S, Sedghi T, Carafeno T, Raucci M, Dest V, Sinanis N, Gross CP, Adelson KB. Impact of a Dedicated Cancer Urgent Care Center on Acute Care Utilization. JCO Oncology Practice 2021, 18: e129-e136. PMID: 34383579, DOI: 10.1200/op.21.00183.Peer-Reviewed Original ResearchConceptsUrgent care centersCare centerHospitalization ratesLarge tertiary academic centerAcute care useAcute care utilizationEmergency department presentationsTertiary academic centerEmergency room utilizationCancer care costsPeriod 1 yearProvider visitsActive therapyHospital admissionPrimary outcomeCare utilizationOncology patientsAcute careCare useClinic capacityPatient awarenessPhysician comfortClinical pathwayPatientsAcademic centersCreating and Validating a Predictive Model for Suitability of Hospital at Home for Patients With Solid-Tumor Malignancies.
Chen K, Desai K, Sureshanand S, Adelson K, Schwartz JI, Gross CP, Chaudhry SI. Creating and Validating a Predictive Model for Suitability of Hospital at Home for Patients With Solid-Tumor Malignancies. JCO Oncology Practice 2021, 17: e556-e563. PMID: 33417488, PMCID: PMC8257922, DOI: 10.1200/op.20.00663.Peer-Reviewed Original ResearchConceptsSolid tumor malignanciesAdmission of patientsAdmission sourceMultivariable logistic regression modelActive cancer diagnosisEscalation of careEmergency department visitsModel c-statisticNasogastric tube placementLogistic regression modelsHospital deathUnplanned admissionsIntestinal obstructionNeurologic symptomsPatient demographicsDepartment visitsDerivation cohortHospital admissionPrimary outcomeSecondary malignanciesCancer HospitalTube placementValidation cohortC-statisticGI cancers
2020
Conducting Goals-of-Care Discussions Takes Less Time Than Imagined.
Pintova S, Leibrandt R, Smith CB, Adelson KB, Gonsky J, Egorova N, Franco R, Bickell NA. Conducting Goals-of-Care Discussions Takes Less Time Than Imagined. JCO Oncology Practice 2020, 16: e1499-e1506. PMID: 32749930, DOI: 10.1200/jop.19.00743.Peer-Reviewed Original ResearchConceptsGOC discussionsCare discussionsAdvanced solid tumor cancersDifferent hospital typesLength of encounterSolid tumor cancersTotal encounter timePatient ageAdvanced cancerHospital typeRural hospitalsMedicare coveragePatientsCancer progressionOncologistsMultivariate modelEncounter timeVisitsSignificant differencesCancerProgressionMinutesLess timeCommon misperceptionsPrognosisNCCN Policy Summit: Defining, Measuring, and Applying Quality in an Evolving Health Policy Landscape and the Implications for Cancer Care.
Bandini LAM, Gallo L, Johnson T, Martin K, Schatz AA, Adelson K, Loy BA, Walters RS, Wong T, Carlson RW. NCCN Policy Summit: Defining, Measuring, and Applying Quality in an Evolving Health Policy Landscape and the Implications for Cancer Care. Journal Of The National Comprehensive Cancer Network 2020, 18: 820-824. PMID: 32634773, DOI: 10.6004/jnccn.2020.7599.Peer-Reviewed Original ResearchEffects of a Communication Intervention Randomized Controlled Trial to Enable Goals-of-Care Discussions.
Bickell NA, Back AL, Adelson K, Gonsky JP, Egorova N, Pintova S, Lin JJ, Kozuch P, Bagiella E, Smith CB. Effects of a Communication Intervention Randomized Controlled Trial to Enable Goals-of-Care Discussions. JCO Oncology Practice 2020, 16: e1015-e1028. PMID: 32374710, DOI: 10.1200/op.20.00040.Peer-Reviewed Original ResearchConceptsElicit patient valuesEnd of lifeAdvanced cancerPatient valuesAggressive careGOC discussionsCare discussionsIntensive care unit admissionHigh care utilizationCare unit admissionMean hospitalizationTraining oncologistsUnit admissionUC patientsAggressive treatmentCare utilizationBlock randomizationCommunication skills trainingOncologistsPatientsCancerCommunication interventionsPrevalenceLife expectancyLast month
2019
Treatment-Related Complications of Systemic Therapy and Radiotherapy
Jairam V, Lee V, Park HS, Thomas CR, Melnick ER, Gross CP, Presley CJ, Adelson KB, Yu JB. Treatment-Related Complications of Systemic Therapy and Radiotherapy. JAMA Oncology 2019, 5: 1028-1035. PMID: 30946433, PMCID: PMC6583836, DOI: 10.1001/jamaoncol.2019.0086.Peer-Reviewed Original ResearchConceptsTreatment-related complicationsOverall ED visitsAcute kidney injuryED visitsSystemic therapyInpatient admissionsEmergency departmentKidney injuryCommon complicationMAIN OUTCOMEUtilization Project Nationwide Emergency Department SampleFinancial burdenNationwide Emergency Department SampleHospital-related factorsClinical Modification codesEmergency Department SampleClinical Classification SoftwareTotal financial burdenInternational Statistical ClassificationOverall financial burdenHigh rateRelated Health ProblemsAcute complicationsStudy cohortNinth RevisionThirty-Day Readmissions in Patients With Metastatic Cancer: Room for Improvement?
Solomon R, Egorova N, Adelson K, Smith CB, Franco R, Bickell NA. Thirty-Day Readmissions in Patients With Metastatic Cancer: Room for Improvement? JCO Oncology Practice 2019, 15: e410-e419. PMID: 30925070, DOI: 10.1200/jop.18.00500.Peer-Reviewed Original ResearchConceptsHigher readmission ratesReadmission ratesMetastatic cancerPreventable readmissionsTeaching hospitalNew York State hospital dischargesThirty-day readmissionState hospital dischargeSkilled nursing facilitiesCompeting-risks modelReadmission likelihoodAdvanced diseaseDischarge homeDischarge dispositionHospital dischargeYounger patientsReadmission reduction effortsHospice dischargeFemale sexHospital typeReadmissionNursing facilitiesPatientsHealth needsYounger ageImplementing an Electronic End-of-Life Chemotherapy Utilization Measure
Kraut J, Mooney K, Sweetenham JW, Page RD, Adelson K, Agarwala V, Fessele KL, Hamrick HJ, Kaganman I, Martineau J, Abernethy AP, Meropol NJ. Implementing an Electronic End-of-Life Chemotherapy Utilization Measure. JCO Oncology Practice 2019, 15: jop.18.00408. PMID: 30883256, DOI: 10.1200/jop.18.00408.Peer-Reviewed Original Research
2018
Measuring the Impact of Academic Cancer Network Development on Clinical Integration, Quality of Care, and Patient Satisfaction.
Chiang AC, Lake J, Sinanis N, Brandt D, Kanowitz J, Kidwai W, Kortmansky J, LaSala J, Orell J, Sabbath K, Tara H, Engelking C, Shomsky L, Fradkin M, Adelson K, Uscinski K, Vest K, Lyons C, Lemay A, Lopman A, Fuchs CS, Lilenbaum R. Measuring the Impact of Academic Cancer Network Development on Clinical Integration, Quality of Care, and Patient Satisfaction. JCO Oncology Practice 2018, 14: e823-e833. PMID: 30537462, DOI: 10.1200/jop.18.00419.Peer-Reviewed Original ResearchConceptsQuality of carePatient satisfactionClinical trialsSmilow Cancer HospitalUS academic centersCommunity oncology practicesPress Ganey scoresCenter physiciansAntineoplastic treatmentCancer HospitalOffice visitsCancer practiceTumor stagingCare centerOncology practiceTumor boardClinical careAcademic centersCase presentationPractice sitesCareCore measuresTrialsCommunity practiceClinical integrationRedefining Quality Measurement in Cancer Care.
Nardi EA, McCanney J, Winckworth-Prejsnar K, Schatz AA, Adelson K, Neubauer M, Smith ML, Walters R, Carlson RW. Redefining Quality Measurement in Cancer Care. Journal Of The National Comprehensive Cancer Network 2018, 16: 473-478. PMID: 29752321, DOI: 10.6004/jnccn.2018.7028.Peer-Reviewed Original Research
2017
Development of Imminent Mortality Predictor for Advanced Cancer (IMPAC), a Tool to Predict Short-Term Mortality in Hospitalized Patients With Advanced Cancer
Adelson K, Lee DKK, Velji S, Ma J, Lipka SK, Rimar J, Longley P, Vega T, Perez-Irizarry J, Pinker E, Lilenbaum R. Development of Imminent Mortality Predictor for Advanced Cancer (IMPAC), a Tool to Predict Short-Term Mortality in Hospitalized Patients With Advanced Cancer. JCO Oncology Practice 2017, 14: jop.2017.023200. PMID: 29206553, DOI: 10.1200/jop.2017.023200.Peer-Reviewed Original ResearchConceptsShort-term mortalityAdvanced cancerChance of deathLife carePrognostic toolNovel prognostic toolObjective prognostic toolSmilow Cancer HospitalDay of admissionElectronic health record dataMedian survival timeSubjective clinical assessmentHealth record dataPositive predictive valueMedian survivalHospitalized patientsMortality predictorsCancer HospitalPrognostication toolsClinical assessmentSurvival timePatientsPredictive valueCancerMortalityThe Oncology Care Model: Perspectives From the Centers for Medicare & Medicaid Services and Participating Oncology Practices in Academia and the Community
Kline R, Adelson K, Kirshner JJ, Strawbridge LM, Devita M, Sinanis N, Conway PH, Basch E. The Oncology Care Model: Perspectives From the Centers for Medicare & Medicaid Services and Participating Oncology Practices in Academia and the Community. American Society Of Clinical Oncology Educational Book 2017, 37: 460-466. PMID: 28561660, DOI: 10.1200/edbk_174909.Peer-Reviewed Original ResearchConceptsOncology Care ModelCare modelCancer care deliveryAcademic health systemMedicaid Services (CMS) Innovation CenterCancer careOncology practiceSubstantial burdenCare deliveryHealth systemUnique beneficiariesMedicaid ServicesCommunity practicePayment incentivesCareMedicareFinancial implicationsSubstantial regional differencesRegional differencesPatientsOncologistsSpeaking Up: How Patient and Physician Voices Shaped a Trial to Improve Goals-of-Care Discussions
Solomon R, Smith C, Kallio J, Fenollosa A, Benerofe B, Jones L, Adelson K, Gonsky JP, Messner C, Bickell NA. Speaking Up: How Patient and Physician Voices Shaped a Trial to Improve Goals-of-Care Discussions. The Patient - Patient-Centered Outcomes Research 2017, 10: 489-501. PMID: 28364384, DOI: 10.1007/s40271-017-0226-z.Peer-Reviewed Original ResearchConceptsPalliative care physiciansAdvanced cancerCare physiciansGOC discussionsOutcome measuresPhysician voicesOutcomes Research InstituteCancer benefitIntervention visitsCare discussionsCare conversationsOutcome measurementsPatient inputPatientsNovel interventionsPatient stakeholdersPhysician inputStudy designOncologistsEarly goalDisease managementPhysiciansPhysician stakeholdersIntervention designInterventionStandardized Criteria for Palliative Care Consultation on a Solid Tumor Oncology Service Reduces Downstream Health Care Use
Adelson K, Paris J, Horton JR, Hernandez-Tellez L, Ricks D, Morrison RS, Smith CB. Standardized Criteria for Palliative Care Consultation on a Solid Tumor Oncology Service Reduces Downstream Health Care Use. JCO Oncology Practice 2017, 13: jop.2016.016808. PMID: 28306372, DOI: 10.1200/jop.2016.016808.Peer-Reviewed Original ResearchConceptsHealth care usePC consultationPalliative careHospice referralReadmission ratesAdvanced cancerCancer careOncology servicesCare useStandardized criteriaInpatient oncology serviceReceipt of chemotherapyAdvanced solid tumorsHigh symptom burdenPalliative care consultationProspective cohort studyLength of staySymptom controlCohort studySymptom burdenPrior hospitalizationOncologic careCare consultationsControl subjectsIntervention group
2016
Preparing for Value-Based Payment: A Stepwise Approach for Cancer Centers
Adelson KB, Velji S, Patel K, Chaudhry B, Lyons C, Lilenbaum R. Preparing for Value-Based Payment: A Stepwise Approach for Cancer Centers. JCO Oncology Practice 2016, 12: e924-e932. PMID: 27858564, DOI: 10.1200/jop.2016.014605.Peer-Reviewed Original ResearchConceptsSmilow Cancer HospitalEmergency departmentCancer HospitalCancer CenterValue-based paymentMost cancer centersYale-New HavenMedicare Limited Data SetIntensive care unitPatterns of careSite of careUrgent care servicesDay of deathBetter value careStepwise approachED utilizationHospital admissionCare unitUrgent careCare managementCare servicesPatient careHealth system leadershipValue careFutile treatmentElectronic Intervention to Improve Structured Cancer Stage Data Capture
Cecchini M, Framski K, Lazette P, Vega T, Strait M, Adelson K. Electronic Intervention to Improve Structured Cancer Stage Data Capture. JCO Oncology Practice 2016, 12: e949-e956. PMID: 27650837, DOI: 10.1200/jop.2016.013540.Peer-Reviewed Original ResearchConceptsStaging rateElectronic health recordsCancer stageClinical trial eligibilityElectronic decision supportTrial eligibilityMonths postinterventionCancer stagingPhysician useClinical notesBPA implementationProblem listHealth recordsElectronic interventionMonthsTreatment planningCancerStagingPhysiciansAct methodologyInterventionUnstructured free textHard stopBPAPatientsTesting Violations of the Exponential Assumption in Cancer Clinical Trials with Survival Endpoints
Han G, Schell MJ, Zhang H, Zelterman D, Pusztai L, Adelson K, Hatzis C. Testing Violations of the Exponential Assumption in Cancer Clinical Trials with Survival Endpoints. Biometrics 2016, 73: 687-695. PMID: 27669414, PMCID: PMC6093291, DOI: 10.1111/biom.12590.Peer-Reviewed Original ResearchAssociations Between End-of-Life Cancer Care Patterns and Medicare Expenditures.
Wang SY, Hall J, Pollack CE, Adelson K, Davidoff AJ, Long JB, Gross CP. Associations Between End-of-Life Cancer Care Patterns and Medicare Expenditures. Journal Of The National Comprehensive Cancer Network 2016, 14: 1001-8. PMID: 27496116, PMCID: PMC5577560, DOI: 10.6004/jnccn.2016.0107.Peer-Reviewed Original ResearchConceptsDay of deathLife care expendituresLife careIntensive endCancer decedentsIntensive care unit admissionCare expendituresLife care interventionsCare unit admissionEmergency department visitsSEER-Medicare databaseLast monthProportion of decedentsHospital referral regionsExpenditure differencesHospital deathICU admissionUnit admissionDepartment visitsHospice enrollmentIntensive careHighest quintileLater chemotherapyHospice useLowest quintileTrends in end-of-life cancer care in the Medicare program
Wang SY, Hall J, Pollack CE, Adelson K, Bradley EH, Long JB, Gross CP. Trends in end-of-life cancer care in the Medicare program. Journal Of Geriatric Oncology 2016, 7: 116-125. PMID: 26783015, PMCID: PMC5577563, DOI: 10.1016/j.jgo.2015.11.007.Peer-Reviewed Original ResearchConceptsLife cancer careDay of deathAggressive endLife careCancer careHospital deathHospice enrollmentEmergency departmentIntensive care unit admissionEnd Results-Medicare dataAggressiveness of endLate hospice enrollmentLife chemotherapy useCare unit admissionHospital referral regionsResult of cancerProportion of beneficiariesChemotherapy useICU admissionUnit admissionED visitsPatient demographicsTumor characteristicsReferral regionsMedicare beneficiaries