The emergence of a novel coronavirus (SARS-CoV-2, causing coronavirus disease 2019 or COVID-19) has disrupted the US medical care system. Telemedicine has rapidly emerged as a critical technology enabling health care visits to continue while supporting social distancing to reduce the risk of COVID-19 transmission among patients, families, and clinicians. This model of patient care is being utilized at major cancer centers around the USA-and tele-oncology (telemedicine in oncology) has rapidly become the primary method of providing cancer care. However, most clinicians have little experience and inadequate training in this new form of care delivery. Because many practicing oncology clinicians are not familiar with telemedicine technology and the best practices for virtual communication, we strongly believe that training in this field is essential. Utilizing best practices of communication skills training, this paper presents a brief tele-oncology communication guide (Comskil TeleOnc) to address the timely need to maximize high-quality care to patients with cancer. The goal of the Comskil TeleOnc Guide is to recognize, elicit, and effectively respond to patients' medical needs and concerns while utilizing empathic responses to communicate understanding, alleviate distress, and provide support via videoconferencing. We recommend five strategies to achieve the communication goal outlined above: (1) Establish the clinician-patient relationship/create rapport, (2) set the agenda, (3) respond empathically to emotions, (4) deliver the information, and (5) effectively end the tele-oncology visit. The guide proposed in this paper is not allencompassing and may not be applicable to all health care institutions; however, it provides a practical, patient-centered framework to conduct a tele-oncology visit.

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OBJECTIVE Racial/ethnic-specific estimates of the influence of gestational diabetes mellitus (GDM) on type 2 diabetes remain underexplored in large population-based cohorts. We estimated racial/ethnic differences in the influence of GDM on diabetes risk and glycemic control in a multiethnic, population-based cohort of postpartum women. RESEARCH DESIGN AND METHODS Hospital discharge and vital registry data for New York City (NYC) births between 2009 and 2011 were linked with NYC A1C Registry data between 2009 and 2017. Women with baseline diabetes (n = 2,810) were excluded for a final birth cohort of 336,276. GDM on time to diabetes onset (two A1C tests of ≥6.5% from 12 weeks postpartum onward) or glucose control (first test of A1C <7.0% following diagnosis) was assessed using Cox regression with a time-varying exposure. Models were adjusted for sociodemographic and clinical factors and stratified by race/ethnicity. RESULTS The cumulative incidence for diabetes was 11.8% and 0.6% among women with and without GDM. The adjusted hazard ratio (aHR) of GDM status on diabetes risk was 11.5 (95% CI 10.8, 12.3) overall, with slight differences by race/ethnicity. GDM was associated with a lower likelihood of glycemic control (aHR 0.85; 95% CI 0.79, 0.92), with the largest negative influence among Black (aHR 0.77; 95% CI 0.68, 0.88) and Hispanic (aHR 0.84; 95% CI 0.74, 0.95) women. Adjustment for screening bias and loss to follow-up modestly attenuated racial/ethnic differences in diabetes risk but had little influence on glycemic control. CONCLUSIONS Understanding racial/ethnic differences in the influence of GDM on diabetes progression is critical to disrupt life course cardiometabolic disparities.

<p>  </p> <p><strong>Background. </strong>Racial/ethnic specific estimates of the influence of gestational diabetes mellitus on type 2 diabetes remain underexplored in large population-based cohorts. We estimated racial/ethnic differences in the influence of gestational diabetes on diabetes risk and glycemic control in a multiethnic population-based cohort of postpartum women.</p> <p><strong>Methods.</strong> Hospital discharge and vital registry data for New York City (NYC) births between 2009 and 2011 were linked with NYC A1C Registry data between 2009-2017. Those with baseline diabetes (n=2,810) were excluded for a final cohort of 336,276 births. Gestational diabetes on time to diabetes onset (two A1c tests of <em>≥ </em>6.5% from 12 weeks postpartum onward) or glucose control (first test of A1c<7.0% following diagnosis) was assessed using Cox regression with a time varying exposure. Models were adjusted for sociodemographic and clinical factors and stratified by race/ethnicity.     </p> <p><strong>Results. </strong>The cumulative incidence for diabetes was 11.8% and 0.6% among those with and without gestational diabetes. Gestational diabetes status on diabetes risk was aHR 11.5 (95% CI:10.8, 12.3), overall, with slight differences by race/ethnicity. Gestational diabetes was associated with lower likelihood of glycemic control (aHR: 0.85, 95% CI: 0.79 0.92), with the largest negative influence among Black (aHR: 0.77, 95% CI: 0.68, 0.88) and Hispanic (aHR: 0.84, 95% CI: 0.74, 0.95) individuals. Adjustment for screening bias and loss to follow-up modestly attenuated-racial/ethnic differences in diabetes risk but had little influence on glycemic control.</p> <p><strong>Conclusions. </strong>Understanding racial/ethnic differences in the influence of gestational diabetes on diabetes progression is critical to disrupt lifecourse cardiometabolic disparities.</p>

<p>  </p> <p><strong>Background. </strong>Racial/ethnic specific estimates of the influence of gestational diabetes mellitus on type 2 diabetes remain underexplored in large population-based cohorts. We estimated racial/ethnic differences in the influence of gestational diabetes on diabetes risk and glycemic control in a multiethnic population-based cohort of postpartum women.</p> <p><strong>Methods.</strong> Hospital discharge and vital registry data for New York City (NYC) births between 2009 and 2011 were linked with NYC A1C Registry data between 2009-2017. Those with baseline diabetes (n=2,810) were excluded for a final cohort of 336,276 births. Gestational diabetes on time to diabetes onset (two A1c tests of <em>≥ </em>6.5% from 12 weeks postpartum onward) or glucose control (first test of A1c<7.0% following diagnosis) was assessed using Cox regression with a time varying exposure. Models were adjusted for sociodemographic and clinical factors and stratified by race/ethnicity.     </p> <p><strong>Results. </strong>The cumulative incidence for diabetes was 11.8% and 0.6% among those with and without gestational diabetes. Gestational diabetes status on diabetes risk was aHR 11.5 (95% CI:10.8, 12.3), overall, with slight differences by race/ethnicity. Gestational diabetes was associated with lower likelihood of glycemic control (aHR: 0.85, 95% CI: 0.79 0.92), with the largest negative influence among Black (aHR: 0.77, 95% CI: 0.68, 0.88) and Hispanic (aHR: 0.84, 95% CI: 0.74, 0.95) individuals. Adjustment for screening bias and loss to follow-up modestly attenuated-racial/ethnic differences in diabetes risk but had little influence on glycemic control.</p> <p><strong>Conclusions. </strong>Understanding racial/ethnic differences in the influence of gestational diabetes on diabetes progression is critical to disrupt lifecourse cardiometabolic disparities.</p>