A Decade of Interactive Educational Exchange: Impacting Interprofessional Palliative Care Education.

The interprofessional clinical practice model is arguably the most impactful and generative aspect of hospice and palliative care (HPC) clinical practice. This article describes the innovative shared interprofessional leadership model, andragogical infrastructure, program development, educational impact, and critical lessons from the Interactive Educational Exchange (IEE). In response to a deficit in interprofessional HPC educational opportunities for rapid scholarship dissemination and mentorship, interprofessional leaders from medicine, social work and nursing proposed and implemented the IEE at the Annual Assembly of Hospice and Palliative Care presented by the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association from 2010-2020.

Effect of Time from Injury to Surgery on Surgical Technique and Complication Rate in Distal Biceps Tendon Repair.

Background: Surgical treatment options for distal biceps tendon ruptures vary based on time from injury to surgery. While direct repair (DR) is preferred for acute injuries, high flexion angle repair (HFA) and allograft reconstruction (AR) are alternatives for chronic cases. This study examines the relationship between time to surgery, surgical technique selection, and complication rates.

Healthcare Resource Use, Healthcare Costs, and Unmet Needs Among Patients Treated for EGFR-Mutated Advanced or Metastatic Non-small Cell Lung Cancer.

Background: Approximately 17% of patients with non-small cell lung cancer (NSCLC) have epidermal growth factor receptor-mutated (EGFRm) NSCLC, 84% of which are exon 19 deletions (Ex19del)/exon 21 substitutions (L858R). Unmet needs for patients treated with tyrosine kinase inhibitors (TKIs) for EGFRm (Ex19del/L858R) advanced NSCLC, including osimertinib, are relevant to US population health decision makers.

Objectives: To describe healthcare resource utilization (HRU) and costs by line of therapy (LOT) among patients with EGFRm (Ex19del/L858R) advanced NSCLC initiating first-line (1L) treatment.

Clinical performance of the fully automated Lumipulse plasma p-tau217 assay in mild cognitive impairment and mild dementia.

Introduction: Plasma phosphorylated tau (p-tau)217 is a leading blood-biomarker for the detection of amyloid beta (Aβ) pathology. We assessed the performance of a fully automated plasma p-tau217 immunoassay to detect Aβ pathology in mild cognitive impairment (MCI)/mild dementia.

Methods: Paired plasma and cerebrospinal fluid (CSF) samples were obtained at time of diagnostic lumbar puncture (LP) in a specialist memory service.

Comparison of a Virtual and in-Person OSCE on Advanced Communication Skills: Qualitative Insights from Medical Student Debrief Transcripts.

Objectives: This study investigates the differences between in-person versus virtual format of an advanced communication skills OSCE through thematic analyses of post-OSCE debrief transcripts.

Methods: Two cohorts of senior medical students participated in either a 2019 in-person or 2021 virtual advanced communication skills OSCE. Students were grouped in triads and rotated through three of five possible cases.

Experiences of Simulated Phone Death Notification.

Background: Physicians perform many difficult skills, but notifying loved ones about the death of a family member is a particularly challenging skill that requires specific training. Descriptions of such training are lacking in the literature. We developed a formative standardised patient encounter on death notification over the telephone for fourth-year medical students and evaluated their qualitative perspectives, including emotional safety.

AAHPM Assessment Workgroup: Hospice and Palliative Medicine Fellowship Assessment Needs and Directions.

Context: Medical education is moving towards competency based medical education (CBME). This provides opportunities and challenges for the field of Hospice and Palliative Medicine (HPM). The American Academy of Hospice and Palliative Medicine (AAHPM) created the Assessment Workgroup to spearhead a shared vision and process to implement high-quality assessment of fellow performance.

Exploring multidisciplinary team members' experiences of supporting eating and drinking with acknowledged risk in healthcare and aged care settings.

Purpose: Dysphagia is a swallowing condition which has significant health and quality of life implications. Speech-language pathologists provide assessment and support shared decision making to optimise swallowing safety. Many people elect to eat and drink with acknowledged risk.

Adherence to First-Line Intravesical Bacillus Calmette-Guérin Therapy in the Context of Guideline Recommendations for US Patients With High-Risk Non-muscle Invasive Bladder Cancer.

Bacillus Calmette-Guérin (BCG) can reduce recurrence and delay progression among patients with high-risk non-muscle invasive bladder cancer (NMIBC), but is associated with a substantial emotional, physical, and social burden. This study evaluated the adequacy of first-line intravesical BCG treatment among high-risk NMIBC patients in the United States, including the subgroup with carcinoma in situ (CIS) of the bladder. Adults with high-risk NMIBC treated with BCG were selected from de-identified MarketScan® Commercial, Medicare, and Medicaid Databases (1/1/2010-2/28/2021).

Impact of next-generation sequencing vs polymerase chain reaction testing on payer costs and clinical outcomes throughout the treatment journeys of patients with metastatic non-small cell lung cancer.

Background: For patients with metastatic non-small cell lung cancer (mNSCLC), next-generation sequencing (NGS) biomarker testing has been associated with a faster time to appropriate targeted therapy and more comprehensive testing relative to polymerase chain reaction (PCR) testing. However, the impact on payer costs and clinical outcomes during patients' treatment journeys has not been fully characterized.

Objective: To assess the costs and clinical outcomes of NGS vs PCR biomarker testing among patients with newly diagnosed de novo mNSCLC from a US payers' perspective.

Homologous Recombination Repair Testing Patterns and Outcomes in mCRPC by Alteration Status and Race.

Background: Alterations in DNA damage repair genes in advanced prostate cancer (PC) may impact responses to therapy and clinical outcomes. This study described homologous recombination repair (HRR) testing patterns and clinical outcomes among patients with metastatic castration-resistant prostate cancer (mCRPC) by HRR alteration status and race in the United States (US).

Methods: Clinical data in the nationwide (US-based) Flatiron Health-Foundation Medicine, Inc.

Treatment patterns for patients with BRCA1/2-positive metastatic castration-resistant prostate cancer.

Background: Patients with BRCA-positive metastatic castration-resistant prostate cancer (mCRPC) have an aggressive disease course. This study aimed to describe real-world treatment patterns among patients with BRCA-positive mCRPC.

Materials And Methods: De-identified electronic health record data from the Flatiron Health-Foundation Medicine Inc.

Real-world economic burden associated with disease progression from metastatic castration-sensitive to castration-resistant prostate cancer on treatment in the United States.

Background: The advent of next-generation imaging will likely reduce nonmetastatic prostate cancer (PC) prevalence and increase identification of metastatic prostate cancer cases, resulting in two predominant advanced stages in the metastatic setting. There is a need to characterize changes in health care resource utilization (HRU) and costs when metastatic castration-sensitive PC (mCSPC) progresses to metastatic castration-resistant PC (mCRPC) to identify value drivers from current and new treatments.

Objective: To describe treatment patterns, HRU, and total health care costs among patients with mCSPC, before and after progression to mCRPC.

Discrete Relationships between Spatiotemporal Gait Characteristics and Domain-Specific Neuropsychological Performance in Midlife.

Midlife risk factors such as type 2 diabetes mellitus (T2DM) confer a significantly increased risk of cognitive impairment in later life with executive function, memory, and attention domains often affected first. Spatiotemporal gait characteristics are emerging as important integrative biomarkers of neurocognitive function and of later dementia risk. We examined 24 spatiotemporal gait parameters across five domains of gait previously linked to cognitive function on usual-pace, maximal-pace, and cognitive dual-task gait conditions in 102 middle-aged adults with (57.

Frailty in an Adult Acute Hospital Population: Predictors, Prevalence, and Outcomes.

Frailty is common among older hospital inpatients. While studies describe frailty prevalence in acute hospitals, it is usually based upon retrospective hospital-coded data or brief screening on admission rather than comprehensive geriatric assessment (CGA). Further, little is known about differences between pre-admission and current frailty status.

Impact of Frailty on Healthcare Outcomes after Cardioembolic Ischaemic Stroke Due to Atrial Fibrillation.

Stroke due to atrial fibrillation (AF) is more common in older adults. Frailty is associated with AF. As little is known about the impact of frailty on cardioembolic stroke, we examined its association with important healthcare outcomes including mortality and functional outcome in stroke with AF.

A Comparison Between In-Person and Virtual Communication Skills OSCE for Medical Students.

Objectives: This study investigates the effectiveness of a virtual format of an advanced communication skills observed structured clinical examination (OSCE) for senior medical students in comparison to an in-person format. The study also examines the emotional support students experience in the virtual setting. Our analysis was based on quantitative data collected through objective checklists and post-OSCE survey results.

The quality of pharmacist-led community warfarin management across 2 provinces in Canada: A cross-sectional observational study.

Background: Guidelines for anticoagulation management services recommend personnel be specially trained in warfarin management and suggest using tools such as decision-support software. To date, there have been no Canadian studies documenting the quality of warfarin management using a similar guideline recommended approach.

Methods: A cross-sectional, retrospective observational study was conducted to measure the quality of pharmacist-led warfarin management using point-of-care international normalized ratio (INR) testing and decision-support software in various ambulatory settings in Canada.

Characterizing the real-world economic burden of metastatic castration-sensitive prostate cancer in the United States.

Aims: To describe healthcare resource utilization (HRU) and costs of patients with metastatic castration-sensitive prostate cancer (mCSPC).

Methods: Linked data from Flatiron Metastatic PC Core Registry and Komodo's Healthcare Map were evaluated (01/2016-12/2021). Patients with chart-confirmed diagnoses for metastatic PC without confirmed castration resistance in Flatiron who initiated androgen deprivation therapy (ADT) monotherapy or advanced therapy for mCSPC in 2017 or later (index date) with a corresponding pharmacy or medical claim in Komodo Health were included.

Cost of genetic testing, delayed care, and suboptimal treatment associated with polymerase chain reaction versus next-generation sequencing biomarker testing for genomic alterations in metastatic non-small cell lung cancer.

Aims: To assess US payers' per-patient cost of testing associated with next-generation sequencing (NGS) versus polymerase chain reaction (PCR) biomarker testing strategies among patients with metastatic non-small cell lung cancer (mNSCLC), including costs of testing, delayed care, and suboptimal treatment initiation.

Methods: A decision tree model considered biomarker testing for genomic alterations using either NGS, sequential PCR testing, or hotspot panel PCR testing. Literature-based model inputs included time-to-test results, costs for testing/medical care, costs of delaying care, costs of immunotherapy [IO]/chemotherapy [CTX] initiation prior to receiving test results, and costs of suboptimal treatment initiation after test results (i.