Publications by authors named "John D Peipert"

Aim: Patient-perceived treatment tolerability can affect patient ability and willingness to remain on therapy. We sought to examine completion rates for a single item of overall side effect bother at baseline and at the first on-treatment assessment, the association between this item with other patient-reported outcomes (PROs) and the odds of early discontinuation due to clinician-assessed adverse events or reasons other than disease progression.

Methods: Data were from three commercial cancer trials in solid tumours, focusing on the safety population.

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Introduction: Social participation is a valued aspect of quality of life among kidney transplant recipients; however, few validated measures exist to assess it. This study aimed to explore the reliability and validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities (PROMIS-SP), administered as a computer adaptive test (CAT), among kidney transplant recipients.

Methods: This was a cross-sectional study involving a convenience sample of adult recipients from Toronto, Canada.

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The American Society of Transplantation commissioned a survey assessing transplant recipients' perceptions of unmet immunosuppressant needs. Topics included medication side effects, treatment burden, health-related quality of life, adherence, self-efficacy, costs, trust, and discrimination; 10 091 responses were included (9543 adults, 548 pediatric respondents) representing 232 transplant centers. Respondents were a mean of 6.

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Objectives: This study explored the potential of a co-produced clinical dashboard on shared decision-making (SDM) and patient-reported outcomes (PROs), and its usability in rheumatology care.

Methods: We conducted a prospective, single-group, pretest-posttest study involving patients with rheumatologic diseases (RD). Patients completed PROs via their patient portal which was integrated with the electronic health record (EHR), and data were displayed on a dashboard accessible to clinicians.

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Background: Aromatic L-amino acid decarboxylase deficiency (AADCd) is a rare genetic disorder characterized by movement disorders, motor and autonomic dysfunction, and developmental delays. The gene therapy eladocagene exuparvovec has become available in some regions; pooled clinical trial results demonstrate continuous long-term improvement in motor development and cognitive function. We sought to characterize clinically meaningful change in motor function, as measured by Total Peabody Developmental Motor Scales-Second Edition (PDMS-2) score, and assess correlations with cognition and language domains of the Bayley-III and motor milestone (MM) achievement.

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Rationale & Objective: Valid measures of side effects are important to inform clinical use of calcineurin inhibitors (CNIs). This study developed and established the content validity of a patient-reported outcome (PRO) measure to capture side effects among kidney transplant recipients taking CNIs.

Study Design: Qualitative interviews for concept elicitation and cognitive debriefing.

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Article Synopsis
  • This study focuses on evaluating two patient-reported outcome measures for people with non-small cell lung cancer (NSCLC), specifically the PROMIS Physical Function short form and the NSCLC Symptom Assessment Questionnaire.
  • Data were derived from two clinical trials involving a total of 915 participants, assessing the reliability, validity, and thresholds for meaningful changes in these measures.
  • The findings showed that both measures are reliable and valid for clinical use, with specific thresholds identified for meaningful changes: a decrease of 6-7 points for PROMIS PF-SF indicating worsening physical function and an increase of 2-3 points for NSCLC-SAQ indicating worsening symptoms.
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Introduction: Fluid overload is a source of substantial morbidity for adults and children with nephrotic syndrome (NS). Preparation and Rationale for a Fluid Overload in Nephrotic Syndrome Clinical Outcomes Assessment Set for Drug Development (Prepare-NS, 5UG3FD007308) was funded by the US Food and Drug Administration to develop a core set of patient-reported and observer-reported (for young children) outcome measures of fluid overload for use in pharmaceutical trials across the lifespan.

Methods: The Prepare-NS study team developed the proposed context of use with input from stakeholders.

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Article Synopsis
  • Early phase clinical trials focus on evaluating the safety and tolerability of new therapies, primarily using investigator and lab results rather than patient feedback.
  • A recent expert roundtable brought together 22 stakeholders to discuss the need for a universal patient-reported outcomes (PRO) model in early phase trials and how to effectively incorporate PROs to assess tolerability and guide treatment decisions.
  • The discussions yielded key recommendations and identified priority areas for further research on integrating patient feedback into early trials to improve safety and symptom management.
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Interpretation of patient-reported outcome (PRO) scores has been supported by identifying score thresholds or ranges that indicate clinical importance. There has been a recent focus on the estimation of meaningful within patient change (MWPC). While much attention has been focused on anchor-based methods, some researchers prefer that a lower bound to these estimates should exceed a change score that could be observed due to measurement error alone as a safeguard against misclassifying individual patients as changed when they have not.

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Background: The authors examined baseline physical functional (PF) impairment among cancer outpatients in the National Cancer Institute Cancer Moonshot study Northwestern University Improving the Management of Symptoms During and Following Cancer Treatment (NU IMPACT). They hypothesized that PF impairment, measured with the Patient Reported Outcome Measurement Information System-Physical Function (PROMIS-PF) survey, would (1) be common and more prevalent for patients receiving treatment compared with no treatment and (2) differ across tumor types, independent of cancer continuum phase.

Methods: Adults who were diagnosed with cancer in NU IMPACT (n = 2273) were sampled, and their PROMIS-PF scores were compared across tumor types and cancer continuum (curative, noncurative, or no treatment), with scores ≤40 indicating moderate-severe impairment.

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Article Synopsis
  • * In a study of 2,184 LDCs at five transplant centers, 18.6% ended up donating, while 38.2% had modifiable reasons for stopping and 43.2% were found medically ineligible.
  • * Factors that increased likelihood of donation included discussing donation with the recipient beforehand, completing high school, and having a close relationship with the recipient; meanwhile, high anxiety levels, the importance of religion, and being Non-White were associated with lower donation rates
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Purpose: Financial hardship (FH) is a complex issue in cancer care, affecting material conditions, well-being, and coping behaviors. This study aimed to longitudinally examine FH, anxiety, depressive symptoms, and their associations while incorporating social determinants of health and health care cost covariates in a sample of patients diagnosed with cancer.

Methods: This prospective, longitudinal cohort study analyzed data from 2,305 participants from the Northwestern University Improving the Management of Symptoms during and following Cancer Treatment trial.

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Purpose: Patients with head/neck squamous cell carcinomas (HNSCC) experience significant tumor- and treatment-related side effects. No efficient summary measure capturing the totality of side effect burden currently exists. We examined associations between a single patient-reported outcome (PRO) item evaluating side effect bother (FACT GP5, "I am bothered by side effects of treatment") with overall side effects in HNSCC.

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Objectives: To assess the use of a co-designed patient-reported outcome (PRO) clinical dashboard and estimate its impact on shared decision-making (SDM) and symptomatology in adults with advanced cancer or chronic kidney disease (CKD).

Materials And Methods: We developed a clinical PRO dashboard within the Northwestern Medicine Patient-Reported Outcomes system, enhanced through co-design involving 20 diverse constituents. Using a single-group, pretest-posttest design, we evaluated the dashboard's use among patients with advanced cancer or CKD between June 2020 and January 2022.

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Purpose: Regulatory guidance suggests capturing patient-reported overall side effect impact in cancer trials. We examined whether the Functional Assessment of Cancer Therapy (FACT) GP5 item ("I am bothered by side effects of treatment") post-neoadjuvant chemotherapy/radiotherapy differed between oxaliplatin vs. non- oxaliplatin arms in the National Surgical Adjuvant Breast and Bowel Project (NSABP) R-04 trial of stage II-III rectal cancer patients.

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Article Synopsis
  • Shared decision making (SDM) involves patients and clinicians collaborating to make informed healthcare choices, with clinical dashboards providing valuable information like patient-reported outcomes to enhance this process.
  • A co-design initiative was executed over 14 sessions with multidisciplinary teams, including patients, care partners, and clinicians, aiming to develop a PRO-informed clinical dashboard tailored for patients with advanced cancer or chronic kidney disease (CKD).
  • The co-design strategy showed strong success in its implementation, with high observer-rated fidelity and adoption scores, along with robust stakeholder representation, confirming its effectiveness in promoting SDM in these patient populations.
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Importance: Biosimilar drugs provide cost-effective yet clinically indistinguishable replications of target drugs. During initial development, this class of biologic medicines was expected to revolutionize pharmaceutical markets; however, following US Food and Drug Administration approval of the first biosimilar drug in 2015, the commercialization of biosimilars has been limited. The lack of biosimilar use may be especially salient in oncology, given that biosimilar distribution in this particularly high-cost area of medicine would bring savings on the order of many billions of dollars.

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Article Synopsis
  • - The study investigates the link between a specific patient-reported outcome (the GP5 assessment from a cancer therapy scale) and early treatment discontinuation due to side effects in patients with newly diagnosed multiple myeloma.
  • - Conducted between February and April 2023, the research analyzed responses from participants in the ECOG-ACRIN E1A11 trial, focusing on treatment regimens involving bortezomib and carfilzomib, with assessments taken at various intervals during treatment.
  • - Results from logistic regression will highlight whether higher reported bother from adverse events correlates with a higher likelihood of discontinuing treatment early, adjusting for factors like treatment type, patient demographics, and disease stage.
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Background: As patient-reported outcome measures (PROMs) become available to clinicians for routine clinical decision-making, many wonder how to define a meaningful change in a patient's PROM score. Some PROMs have a specific threshold that indicates meaningful change, but since those numbers are based on population averages, they do not necessarily apply to the varying experiences of each individual patient. Rather than viewing this as a weakness of PROMs, it is worth considering how clinicians use other existing measures in clinical decision-making-and whether PROMs can be used similarly.

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Patient-reported outcomes (PROs) are increasingly used in healthcare research to provide evidence of the benefits and risks of interventions from the patient perspective and to inform regulatory decisions and health policy. The use of PROs in clinical practice can facilitate symptom monitoring, tailor care to individual needs, aid clinical decision-making and inform value-based healthcare initiatives. Despite their benefits, there are concerns that the potential burden on respondents may reduce their willingness to complete PROs, with potential impact on the completeness and quality of the data for decision-making.

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Article Synopsis
  • Regulatory agencies are promoting systematic collection of patient experience data, particularly patient-reported outcomes (PROs), in cancer trials to enhance regulatory decision-making.
  • There’s an increasing acknowledgment that understanding cancer treatment tolerability should involve the patients' perspectives, especially regarding side effects that may not be fully reported by clinicians.
  • Methodologies for evaluating patient-reported tolerability are being developed, but current methods remain largely descriptive, and inconsistencies in analyses and objectives of PROs present challenges for interpreting the results effectively.
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Introduction: Overactive bladder (OAB) can adversely affect health-related quality-of-life (HRQoL) and adherence to treatments; however, the extent of their association is unknown. This study sought to characterize Sleep Disturbance, Depression, Fatigue, and patient-reported medication adherence among adults with OAB in the United States. MATERIALS AND METHODS: In this descriptive, observational study, patients completed patient-reported outcome (PRO) measures of urinary symptoms, anxiety, depression, fatigue, sleep quality, and medication adherence.

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