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 misperceptionsPrognosisEffects 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 monthImpact of High-Quality Goals-of-Care Discussions on Oncologist Productivity.
Pintova S, Leibrandt R, Smith CB, Adelson KB, Gonsky JP, Egorova N, Franco R, Bickell NA. Impact of High-Quality Goals-of-Care Discussions on Oncologist Productivity. JCO Oncology Practice 2020, 16: e290-e297. PMID: 32048945, DOI: 10.1200/jop.19.00381.Peer-Reviewed Original ResearchConceptsGOC discussionsAdvanced cancerPatient populationCare discussionsPractice settingsDifferent practice settingsOncologist characteristicsStudy patientsCommunity hospitalRural hospitalsPatientsOncologistsHigh-quality goalsRural settingsSignificant differencesHospitalCancerValue unitsHoursSettingPrognosisPopulationCommunication skillsVisits
2018
Disparities in length of goals of care conversations between oncologists and patients with advanced cancer.
Smith C, Pintova S, Adelson K, Gonsky J, Egorova N, Bickell N. Disparities in length of goals of care conversations between oncologists and patients with advanced cancer. Journal Of Clinical Oncology 2018, 36: 19-19. DOI: 10.1200/jco.2018.36.34_suppl.19.Peer-Reviewed Original ResearchNon-minority patientsProgression of diseaseMinority patientsAdvanced cancerCancer patientsHigh-quality cancer careAdvanced cancer patientsGoals of careMinority cancer patientsNon-Hispanic blacksNon-Hispanic whitesPaucity of dataGOC conversationsGOC discussionsCancer carePoor survivalCare conversationsPatientsRural hospitalsSubstandard treatmentCommunication skills trainingOncologistsCancer treatmentRisk adjustmentMixed-effects modelsDoes training oncologists to have goals of care discussions affect healthcare utilization among patients with advanced cancer?
Bickell N, Adelson K, Gonsky J, Lin J, Franco R, Egorova N, Smith C. Does training oncologists to have goals of care discussions affect healthcare utilization among patients with advanced cancer? Journal Of Clinical Oncology 2018, 36: 6595-6595. DOI: 10.1200/jco.2018.36.15_suppl.6595.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 valueCancerMortalitySpeaking 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
2014
Emergency department (ED) utilization and hospital admission rates among oncology patients at a large academic center and the need for improved urgent care access.
Adelson K, Dest V, Velji S, Lisitano R, Lilenbaum R. Emergency department (ED) utilization and hospital admission rates among oncology patients at a large academic center and the need for improved urgent care access. Journal Of Clinical Oncology 2014, 32: 19-19. DOI: 10.1200/jco.2014.32.30_suppl.19.Peer-Reviewed Original ResearchOncology patientsHospital admissionSmilow Cancer HospitalYale-New HavenPalliative care consultationHospital admission ratesEmergency department utilizationLarge academic centerEpic electronic medical recordAmbulatory oncology practicesElectronic medical recordsAverage daily costEducation of physiciansCancer expendituresMean hospitalizationAbdominal painED referralsAdvanced cancerCancer HospitalHospital EDUrgent presentationCare consultationsMost hospitalizationsDisease groupAdmission ratesCharacterization of aggressive interventions within 30 days of death in lung cancer patients at Smilow Cancer Hospital (SCH).
Zhang B, Adelson K, Velji S, Rimar J, Longley P, Keane B, Chiang A, Lilenbaum R. Characterization of aggressive interventions within 30 days of death in lung cancer patients at Smilow Cancer Hospital (SCH). Journal Of Clinical Oncology 2014, 32: 20-20. DOI: 10.1200/jco.2014.32.30_suppl.20.Peer-Reviewed Original ResearchSmilow Cancer HospitalLung cancer patientsAggressive interventionRothman IndexDay of deathCancer patientsAdvanced cancerClinical conditionsAdvanced lung cancer patientsAdvanced lung cancerPalliative care consultationRetrospective chart reviewPatient's clinical conditionICU stayIOM guidelinesAggressive careChart reviewCancer HospitalCare consultationsCancer populationLung cancerFiscal year 2012Study populationEMR toolStage III
2013
Standardized criteria for required palliative care consultation on the solid tumor oncology service.
Adelson K, Paris J, Smith C, Horton J, Morrison R. Standardized criteria for required palliative care consultation on the solid tumor oncology service. Journal Of Clinical Oncology 2013, 31: 37-37. DOI: 10.1200/jco.2013.31.31_suppl.37.Peer-Reviewed Original ResearchPalliative care consultationPalliative careReadmission ratesHospice utilizationASCO guidelinesPC consultationCare consultationsMortality indexStandardized criteriaComparing group 1Improved symptom controlPalliative care consultStage IV diseaseHigh symptom burdenHealth care resourcesCare consultUncontrolled symptomsHospital deathST patientsSymptom controlSymptom burdenDays hospitalizationPrimary outcomeAdvanced cancerStay index