2024
Trends in use of intensive care during hospitalizations at the end‐of‐life among older adults with advanced cancer
Jain S, Long J, Rao V, Law A, Walkey A, Prsic E, Lindenauer P, Krumholz H, Gross C. Trends in use of intensive care during hospitalizations at the end‐of‐life among older adults with advanced cancer. Journal Of The American Geriatrics Society 2024 PMID: 39090970, DOI: 10.1111/jgs.19119.Peer-Reviewed Original ResearchEnd-of-life hospitalizationsLife-sustaining treatmentEnd-of-lifeIntensity of careIn-hospital deathOlder adultsIntensive care unitAdvanced cancerRisk-adjusted hospitalEvaluate trendsIncreased intensity of careIntensive care unit useSEER-Medicare dataIntensive care unit careMultinomial regression modelsYear of diagnosisIntensive careHospital categoryMedicare beneficiariesSEER-MedicareHospitalization ratesCareCancer characteristicsNoninvasive ventilationHospitalA medical school curriculum to foster the physician-patient relationship through narrative medicine.
Yao J, Hunter C, Jaber Chehayeb R, Sanft T, Prsic E, Dunne D, Kang-Giaimo A. A medical school curriculum to foster the physician-patient relationship through narrative medicine. Journal Of Clinical Oncology 2024, 42: e21015-e21015. DOI: 10.1200/jco.2024.42.16_suppl.e21015.Peer-Reviewed Original ResearchDoctor-patient relationshipPatient storiesNarrative medicineTraining sessionsStrong doctor-patient relationshipOptimal quality careThird-year medical studentsPhysician-patient relationshipMedical school curriculumYear medical studentsImprove well-beingMedical education toolThematic analysis of responsesNarrative medicine curriculumDoctor patient relationshipPre-clerkship studentsMedicine skillsYale School of MedicineQuality careMedical students' senseMedicine curriculumPatient relationshipThematic analysisInterviewed patientsSchool of MedicineAssociation of patient socioeconomic status with outcomes after palliative treatment for disseminated cancer
Maduka R, Canavan M, Walters S, Ermer T, Zhan P, Kaminski M, Li A, Pichert M, Salazar M, Prsic E, Boffa D. Association of patient socioeconomic status with outcomes after palliative treatment for disseminated cancer. Cancer Medicine 2024, 13: e7028. PMID: 38711364, PMCID: PMC11074703, DOI: 10.1002/cam4.7028.Peer-Reviewed Original ResearchConceptsOptimal quality of careQuality of carePatient socioeconomic statusAssociated with improved qualityAssociated with improved quality of lifeEnd-of-lifeUS cancer populationPalliative treatmentQuality of lifeCox proportional hazards modelsMultivariate logistic regressionInformed decision makingProportional hazards modelFacility characteristicsNon-HispanicAssociated with lower ratesInsurance payer statusImproving informed decision makingCancer populationSocioeconomic statusHispanic ethnicityTreatment usePayer statusBlack raceLogistic regressionImmunotherapy Initiation at the End of Life in Patients With Metastatic Cancer in the US
Kerekes D, Frey A, Prsic E, Tran T, Clune J, Sznol M, Kluger H, Forman H, Becher R, Olino K, Khan S. Immunotherapy Initiation at the End of Life in Patients With Metastatic Cancer in the US. JAMA Oncology 2024, 10: 342-351. PMID: 38175659, PMCID: PMC10767643, DOI: 10.1001/jamaoncol.2023.6025.Peer-Reviewed Original ResearchNon-small cell lung cancerEnd of lifeMonth of deathImmunotherapy initiationCohort studyMAIN OUTCOMEStage IV non-small cell lung cancerCharlson-Deyo comorbidity indexHigh metastatic burdenInitiation of immunotherapyNational prescribing patternsRisk-adjusted patientsImmune checkpoint inhibitorsRetrospective cohort studyStage IV melanomaPercentage of patientsHigh-volume centersLocation of metastasesLow-volume centersOdds of deathCell lung cancerNational Clinical DatabaseLow-volume facilitiesDrug Administration approvalCheckpoint inhibitors
2023
Oncology hospitalist impact on hospice utilization
Prsic E, Morris J, Adelson K, Parker N, Gombos E, Kottarathara M, Novosel M, Castillo L, Rothberg BE. Oncology hospitalist impact on hospice utilization. Cancer 2023, 129: 3797-3804. PMID: 37706601, DOI: 10.1002/cncr.35008.Peer-Reviewed Original ResearchConceptsMedical oncology serviceOncology servicesEnd of lifeAdvanced cancerInpatient hospiceHospice utilizationHigher total health care costsTotal health care costsComfort-focused careInpatient oncology serviceSmilow Cancer HospitalAdjusted odds ratioLength of staySolid tumor malignanciesLong-term survivalMultivariable linear regressionHealth care costsElectronic medical recordsHospice transitionUnplanned hospitalizationDischarge dispositionHospice referralInpatient managementLate referralCancer HospitalPrevalence and predictors of long-delayed (> 120 h) chemotherapy-induced nausea and vomiting (CINV)—a systematic review and individual patient data meta-analysis
Chow R, Yin L, Baqri W, Huang R, Boldt G, Younus J, Lock M, Prsic E, Zimmermann C, Herrstedt J. Prevalence and predictors of long-delayed (> 120 h) chemotherapy-induced nausea and vomiting (CINV)—a systematic review and individual patient data meta-analysis. Supportive Care In Cancer 2023, 31: 505. PMID: 37535218, DOI: 10.1007/s00520-023-07978-y.Peer-Reviewed Original ResearchConceptsChemotherapy-induced nauseaIndividual patient dataDay 4Individual patient-level dataPatient dataPatient-level dataStepwise logistic regressionEmetogenic chemotherapyChemotherapy regimenChemotherapy regimensPatient demographicsCochrane CENTRALResultsA totalOverall prevalenceCINVNauseaVomitingPatientsEligible articlesSystematic reviewAntineoplastic agentsStudy authorsLogistic regressionMethodsThis reviewSignificant riskAdvance care planning and hospital outcomes in solid tumour oncology inpatients
Qeska D, Chow R, Balboni T, Kapo J, Zimmermann C, Prsic E. Advance care planning and hospital outcomes in solid tumour oncology inpatients. BMJ Supportive & Palliative Care 2023, 14: e541-e544. PMID: 37500567, DOI: 10.1136/spcare-2023-004396.Peer-Reviewed Original ResearchAdvance care planningHospital mortalityED visitsEmergency departmentCare planningYale-New Haven HospitalObservational cohort analysisIntensive care unitMultivariable logistic regressionSolid tumor malignanciesNew Haven HospitalDecreased readmissionsHospital outcomesOncology inpatientsPatient characteristicsACP documentationHospital readmissionLonger LOSCare unitOncology careRothman IndexCohort analysisPatientsTumor malignancyInpatient teamsThe impact of oncology hospitalist utilization on resident education.
Bhatt S, Yao J, Gould Rothberg BE, Morris J, Parker N, Adelson K, Prsic E. The impact of oncology hospitalist utilization on resident education. Journal Of Clinical Oncology 2023, 41: 11034-11034. DOI: 10.1200/jco.2023.41.16_suppl.11034.Peer-Reviewed Original ResearchHospitalist serviceMedical oncologistsCancer CenterPercent of residentsU.S. cancer centersMann-Whitney U testGOC discussionsMedical oncologyCare discussionsInpatient teaching servicesOutpatient careInpatient careEligible residentsPatient careUniversity IRBFamily meetingsHospitalistsU testOncologistsStatistical significanceStudy intervalTwo-week periodCareP-valueFive-point Likert scaleTrends in Utilization of ICU for Older Adults With Cancer at the End-of-Life
Jain S, Long J, Rao V, Law A, Walkey A, Lindenauer P, Prsic E, Krumholz H, Gross C. Trends in Utilization of ICU for Older Adults With Cancer at the End-of-Life. 2023, a1398-a1398. DOI: 10.1164/ajrccm-conference.2023.207.1_meetingabstracts.a1398.Peer-Reviewed Original ResearchLung Cancer Supportive Care and Symptom Management
Yao J, Novosel M, Bellampalli S, Kapo J, Joseph J, Prsic E. Lung Cancer Supportive Care and Symptom Management. Hematology/Oncology Clinics Of North America 2023, 37: 609-622. PMID: 37024385, DOI: 10.1016/j.hoc.2023.02.011.Peer-Reviewed Original ResearchOutcomes on an inpatient oncology service after the introduction of hospitalist comanagement
Morris J, Rothberg BE, Prsic E, Parker N, Weber U, Gombos E, Kottarathara M, Billingsley K, Adelson K. Outcomes on an inpatient oncology service after the introduction of hospitalist comanagement. Journal Of Hospital Medicine 2023, 18: 391-397. PMID: 36891947, DOI: 10.1002/jhm.13071.Peer-Reviewed Original ResearchConceptsLength of stayInpatient oncology serviceSmilow Cancer HospitalSeverity of illnessOncology servicesOncologists' experiencesReadmission ratesEarly dischargeHospitalist comanagementAverage LOSTime of dischargeMean discharge timeEarly discharge ratesImpact of hospitalistsRace/ethnicityDischarge dispositionMultiple admissionsCancer HospitalMAIN OUTCOMEStudy durationPatient volumeCancer typesStudy periodHospitalistsOutcomesTo Create or Not to Create: How to Establish a System-Wide Proportionate Palliative Sedation Guideline Through Comprehensive Interdisciplinary Collaboration (TH108A)
Bui T, Tenenbaum L, Choi A, Gupta J, Prsic E. To Create or Not to Create: How to Establish a System-Wide Proportionate Palliative Sedation Guideline Through Comprehensive Interdisciplinary Collaboration (TH108A). Journal Of Pain And Symptom Management 2023, 65: e251. DOI: 10.1016/j.jpainsymman.2022.12.028.Peer-Reviewed Original ResearchSedation guidelinesPalliative careComfort-focused careCancer-related painMetastatic lung cancerVulnerable patient populationLack of recommendationsProvider inexperienceHealth system processesRefractory symptomsInterventional painPatient populationRe-evaluation phaseLung cancerPatient prognosisPalliative sedationTerminal illnessExistential distressInterdisciplinary consensusClinical casesPainInstitutional guidelinesSignificant distressHealthcare systemCareOncology Hospitalists: Hospice Utilization on an Inpatient Medical Oncology Service (SA314D)
Prsic E, Morris J, Adelson K, Castillo L, Parker N, Bhatt S, Rothberg B. Oncology Hospitalists: Hospice Utilization on an Inpatient Medical Oncology Service (SA314D). Journal Of Pain And Symptom Management 2023, 65: e305-e306. DOI: 10.1016/j.jpainsymman.2022.12.134.Peer-Reviewed Original ResearchMedical oncology serviceInpatient oncology serviceLength of stayOncology servicesAdvanced cancerMedical oncologistsInpatient hospiceAdjusted odds ratioMultivariable linear regressionElectronic medical recordsRace/ethnicityHospice transitionEnd of lifeUnplanned admissionsBackground PatientsDischarge dispositionOncology inpatientsHospice dischargeHome hospiceMedical recordsOdds ratioInpatient careHospitalist serviceRate of dischargeHospitalist teamAssociation of palliative care and hospital outcomes among solid tumour oncology inpatients
Im J, Chow R, Novosel M, Xiang J, Strait M, Rao V, Kapo J, Zimmermann C, Prsic E. Association of palliative care and hospital outcomes among solid tumour oncology inpatients. BMJ Supportive & Palliative Care 2023, 14: e1349-e1353. PMID: 36849221, DOI: 10.1136/spcare-2023-004207.Peer-Reviewed Original ResearchPalliative care consultationInpatient palliative care consultationCare consultationsHospital deathHospital outcomesICU admissionPalliative careIntensive care unit useRetrospective chart reviewSite of malignancyEmergency department visitsHospital outcome dataMultivariable logistic regressionLength of stayOncology admissionsChart reviewED visitsOncology inpatientsDepartment visitsMultivariable analysisICU levelMedical recordsPatient presentationRothman IndexHigher odds
2022
End-of-life care trajectories among older adults with lung cancer
Davidoff AJ, Canavan ME, Prsic E, Saphire M, Wang SY, Presley CJ. End-of-life care trajectories among older adults with lung cancer. Journal Of Geriatric Oncology 2022, 14: 101381. PMID: 36202695, PMCID: PMC9974538, DOI: 10.1016/j.jgo.2022.09.010.Peer-Reviewed Original ResearchConceptsCancer-directed therapyLung cancerCare trajectoriesOlder adultsSupportive care servicesSEER-Medicare dataSkilled nursing facilitiesNon-Hispanic whitesRace/ethnicityCancer decedentsSymptom managementIntensive careOlder decedentsConcurrent careHospice careReferral regionsHigh riskMultinomial logistic regressionNursing facilitiesMedicare decedentsCare servicesLogistic regressionCancerHospiceDecedentsThe Inpatient Immunotherapy Outcomes study: A multicenter retrospective study of patients treated with immune checkpoint inhibitors in the inpatient setting.
Riaz F, Zhu H, Cheng W, Brongiel S, Baldwin E, Kier M, Zaemes J, Hearn C, Abdelghany O, Parikh R, Reuss J, Prsic E, Doroshow D. The Inpatient Immunotherapy Outcomes study: A multicenter retrospective study of patients treated with immune checkpoint inhibitors in the inpatient setting. Journal Of Clinical Oncology 2022, 40: 300-300. DOI: 10.1200/jco.2022.40.28_suppl.300.Peer-Reviewed Original ResearchImmune checkpoint inhibitorsICI therapyCheckpoint inhibitorsRetrospective studyInpatient settingOutcome studiesPT outcomesStage IV solid malignancyYale-New Haven HospitalImaging-based responseMedian prior linesNon-curative intentOutcome of ptsCTLA-4 inhibitorsMulticenter retrospective studyPD-L1 expressionPoor clinical outcomeCare of patientsTime of administrationMount Sinai HospitalGeorgetown University HospitalHealth care systemICI administrationICI doseICI initiationOncology-hospitalist co-management: A model for efficient, high-quality care and education.
Morris J, Prsic E, Parker N, Weber U, Gombos E, Kottarathara M, Rothberg BE, Adelson K. Oncology-hospitalist co-management: A model for efficient, high-quality care and education. Journal Of Clinical Oncology 2022, 40: 1-1. DOI: 10.1200/jco.2022.40.28_suppl.001.Peer-Reviewed Original ResearchEarly discharge ratesReadmission ratesOncologist satisfactionIntervention teamHospitalist comanagementInpatient oncology serviceSmilow Cancer HospitalOutcome metricsHigher readmission ratesLength of stayMultidisciplinary steering groupHigh-quality careInternal medicine hospitalistsIllness scoresOncology teamCancer HospitalComparator groupOncology servicesPatient populationOutcome comparisonsCase volumeImprovement interventionsPDSA cyclesOncologistsPDSA 2Duloxetine for prevention and treatment of chemotherapy-induced peripheral neuropathy (CIPN): systematic review and meta-analysis
Chow R, Novosel M, So OW, Bellampalli S, Xiang J, Boldt G, Winquist E, Lock M, Lustberg M, Prsic E. Duloxetine for prevention and treatment of chemotherapy-induced peripheral neuropathy (CIPN): systematic review and meta-analysis. BMJ Supportive & Palliative Care 2022, 13: 27-34. PMID: 36194493, DOI: 10.1136/spcare-2022-003815.Peer-Reviewed Original ResearchConceptsChemotherapy-induced peripheral neuropathyTreatment of CIPNDuloxetine usePeripheral neuropathyRisk ratioPrevention of CIPNSystematic reviewUse of duloxetineSummary risk ratiosClinical practice recommendationsHigh-quality trialsDerSimonian-Laird modelComprehensive systematic reviewCochrane CENTRALSafety profileDatabase inceptionHuman trialsDuloxetinePractice recommendationsLimited evidencePreventionTrialsNeuropathyTreatmentReviewAssociation Between Postdischarge Medical Oncology Follow-Up Appointments and Downstream Health Care Use: A Single-Institution Experience
Xiang J, Chow R, Reynoso A, Carafeno T, Deshpande H, Strait M, Prsic E. Association Between Postdischarge Medical Oncology Follow-Up Appointments and Downstream Health Care Use: A Single-Institution Experience. JCO Oncology Practice 2022, 18: e1466-e1474. PMID: 35696632, DOI: 10.1200/op.21.00868.Peer-Reviewed Original ResearchConceptsHealth care useED visitsCare useOncology appointmentsAppointment timingPropensity score-matched analysisMultivariable logistic regression modelYale-New Haven HospitalRetrospective cohort studySingle institution experienceEmergency department visitsTertiary academic centerNew Haven HospitalLower ratesLogistic regression modelsOncology admissionsOncology followCause readmissionMost admissionsCohort studyDepartment visitsMedical oncologySubgroup analysisReadmissionAcademic centers
2021
Medical Outcomes of Oncology Inpatients With and Without Chaplain Spiritual Care Visit: The Yale New Haven Hospital Experience
Chow R, Tenenbaum L, Balboni TA, Prsic EH. Medical Outcomes of Oncology Inpatients With and Without Chaplain Spiritual Care Visit: The Yale New Haven Hospital Experience. JCO Oncology Practice 2021, 18: e334-e338. PMID: 34846912, DOI: 10.1200/op.21.00600.Peer-Reviewed Original ResearchConceptsMedical oncology patientsHealth care utilizationCare utilizationSpiritual careCare visitsOncology patientsIntensive care unit admissionYale-New Haven HospitalHospital health outcomesSpiritual care assessmentCare unit admissionDays of dischargeRetrospective chart reviewEmergency department visitsLength of stayNew Haven HospitalQuality of lifeUnit admissionHospital deathHospital outcomesChart reviewOncology inpatientsReadmission ratesDepartment visitsCare consultations