A5061952019- Palliative Care and End-of-Life Issues
- Patient-Provider Communication in Healthcare
- Childhood Cancer Survivors' Quality of Life
- Cancer survivorship and care
- Family and Patient Care in Intensive Care Units
- Patient Dignity and Privacy
- Lung Cancer Treatments and Mutations
- Cancer Immunotherapy and Biomarkers
- Lung Cancer Diagnosis and Treatment
- Management of metastatic bone disease
- Lung Cancer Research Studies
- Economic and Financial Impacts of Cancer
- Cancer Treatment and Pharmacology
- Hematopoietic Stem Cell Transplantation
- Grief, Bereavement, and Mental Health
- Ethics in medical practice
- CAR-T cell therapy research
- Medical Malpractice and Liability Issues
- Family Support in Illness
- Interprofessional Education and Collaboration
- Nutrition and Health in Aging
- Health Systems, Economic Evaluations, Quality of Life
- Cancer Genomics and Diagnostics
- Body Composition Measurement Techniques
- Brain Metastases and Treatment
University of Wisconsin Carbone Cancer Center
2014-2025
University of Wisconsin–Madison
2016-2025
Wisconsin Division of Public Health
2024
UW Health University Hospital
2016-2023
Highland Community College - Illinois
2009-2020
University of Calgary
2019
Oregon Health & Science University
2019
The University of Texas Southwestern Medical Center
2019
University of Colorado Denver
2017
American Society of Clinical Oncology
2016
To provide evidence-based guidance on the optimum management of chronic pain in adult cancer survivors.An ASCO-convened expert panel conducted a systematic literature search studies investigating survivors. Outcomes interest included symptom relief, intensity, quality life, functional outcomes, adverse events, misuse or diversion, and risk assessment mitigation.A total 63 met eligibility criteria compose evidentiary basis for recommendations. Studies tended to be heterogeneous terms quality,...
IMPORTANCE Although many older adults prefer to avoid burdensome interventions with limited ability preserve their functional status, aggressive treatments, including surgery, are common near the end of life.Shared decision making is critical achieve value-concordant treatment decisions and minimize unwanted care.However, communication in acute inpatient setting challenging.OBJECTIVE To evaluate proof concept an intervention teach surgeons use Best Case/Worst Case framework as a strategy...
PURPOSE To provide guidance on the clinical management of dyspnea in adult patients with advanced cancer. METHODS ASCO convened an Expert Panel to review evidence and formulate recommendations. An Agency for Healthcare Research Quality (AHRQ) systematic provided base nonpharmacologic pharmacologic interventions alleviate dyspnea. The included randomized controlled trials (RCTs) observational studies a concurrent comparison group published through early May 2020. also wished address...
Importance Numerous studies show that early palliative care improves quality of life and other key outcomes in patients with advanced cancer their caregivers, although most lack access to this evidence-based model care. Objective To evaluate whether delivering via secure video vs in-person visits has an equivalent effect on non–small cell lung (NSCLC). Design, Setting, Participants Randomized, multisite, comparative effectiveness trial from June 14, 2018, May 4, 2023, at 22 US centers among...
Objectives To evaluate a communication tool called “Best Case/Worst Case” (BC/WC) based on an established conceptual model of shared decision‐making. Design Focus group study. Setting Older adults (four focus groups) and surgeons (two using modified questions from the Decision Aid Acceptability Scale Decisional Conflict to revise tool. Participants Individuals aged 60 older recruited senior centers (n = 37) academic private practices in Wisconsin 17). Measurements Qualitative content...
<h3>Importance</h3> Patients with acute myeloid leukemia (AML) receiving intensive chemotherapy experience substantial decline in their quality of life (QOL) and mood during hospitalization for induction often receive aggressive care at the end (EOL). However, role specialty palliative improving QOL this population is currently unknown. <h3>Objective</h3> To assess effect integrated oncology (IPC) on patient-reported EOL outcomes patients AML. <h3>Design, Setting, Participants</h3> We...
The NCCN Guidelines for Palliative Care provide interdisciplinary recommendations on palliative care patients with cancer. These Insights summarize and context the updated guidelines regarding hospice end-of-life (EOL) care. Updates 2017 include revisions to restructuring of algorithms that address important EOL concerns. were revised clearer guidance oncologists as they cancer who are approaching transition Recommendations interventions reassessment based estimated life expectancy...
Despite advances in the care of patients with cancer over last 10 years, remains second leading cause death United States. Many receive aggressive, in-hospital end-of-life at high cost. There are few data on outcomes after unplanned hospitalization metastatic cancer.In 2000 and 2010, were collected admissions, interventions, survival for admitted to an academic inpatient medical oncology service.The survey included 191 admissions 151 unique patients. The 2010 assessed 149 119 Lung, GI,...
Palliative care has evolved to be an integral part of comprehensive cancer with the goal early intervention improve quality life and patient outcomes. The NCCN Guidelines for Care provide recommendations help primary oncology team promote best possible throughout illness trajectory each cancer. Panel meets annually evaluate update based on panel members' clinical expertise emerging scientific data. These Insights summarize panel's recent discussions highlights updates importance fostering...
LBA3 Background: National guidelines recommend the early integration of palliative and oncology care for patients with advanced cancer, given robust evidence showing that this model improves quality life (QOL) other important outcomes. However, most do not receive (EPC) in outpatient setting due to limited access resources. To overcome these barriers, we conducted a large-scale comparative effectiveness trial EPC delivered via secure video versus person among non-small cell lung cancer...
Chemoimmunotherapy is currently the preferred first-line treatment option for majority of patients with advanced non-small cell lung cancer without driver genetic alterations. Most these patients, however, will experience disease progression within first year after initiation and both their physicians be confronted dilemma optimal second-line treatment. Identification molecular targets, such as
Abstract BACKGROUND: In this study, the authors examined effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus Internet in relieving physical symptom distress patients with non–small cell lung cancer (NSCLC). METHODS: total, 285 informal caregiver‐patient dyads were assigned randomly to receive, for up 25 months, standard care plus training on and access either use a list sites about (the arm) or CHESS arm). Caregivers agreed complete...
To explore high-stakes surgical decision making from the perspective of seniors and surgeons.A majority older chronically ill patients would decline a low-risk procedure if outcome was severe functional impairment. However, 25% Medicare beneficiaries have surgery in their last 3 months life, which may be inconsistent with preferences. How make decisions to contribute this problem unwanted care.We convened 4 focus groups at senior centers 2 surgeons Madison Milwaukee, Wisconsin, where we...
Introduction: The importance of high-quality, timely lung cancer care and the need to have indicators measure timeliness are increasingly discussed in United States. This study explored when why delays occur compared between two states with divergent disease incidence. Methods: Patients small-cell or non–small-cell were recruited through centers, outpatient clinics, community approaches, interviewed over phone. Statistical analysis patient-reported dates included descriptive statistics...
Abstract Objective Patients receiving treatment for advanced cancer suffer significant symptom burden, including co‐occurring pain, fatigue, and sleep disturbance. There is limited evidence effective interventions targeting this common cluster. Methods A randomized controlled trial of a brief cognitive‐behavioral strategies (CBS) intervention was conducted. sample 164 patients with chemotherapy practiced imagery, relaxation, distraction exercises or listened to education recordings...
Introduction: Patients with incurable cancer have poor prognostic awareness. We present a detailed analysis of the dialogue between oncologists and patients in conversations implications. Methods: A total 128 audio-recorded encounters from large multisite trial were obtained, 64 involved scan results. used conversation analysis, qualitative method for studying human interaction, to analyze typical patterns conversational devices. Results: Four components consistently occurred sequential...
Background Expression of programmed-death ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC) is typically evaluated through invasive biopsies; however, recent advances the identification circulating tumor cells (CTCs) may be a less method to assay for these purposes. These liquid biopsies rely on accurate CTCs from diverse populations blood, where some share characteristics with normal blood cells. While many can excluded by their high expression CD45, neutrophils and other immature...
Introduction: High-quality communication and shared decision making (SDM) are crucial elements of effective patient care. SDM conversations intimate logistically challenging to capture. Evaluating alternative methods effectively observe how physicians conduct these may improve research efforts in this core discipline medicine.
Immunotherapies are increasingly used to treat advanced cancers and can extend survival in some patients. The potential for longer may inflate prognosis expectations among patients caregivers delay palliative care. This review sought identify issues impacting that influence specialized care use the context of immunotherapies. A scoping was conducted with guidance from JBI Manual Evidence Synthesis. Studies were identified using MEDLINE, EMBASE, CINAHL Complete, AgeLine, Cochrane Library, APA...