Hematologic Markers of Lung Metastasis in Stage IV Colorectal Cancer

Abu-Shawer, Mohammad; Abu-Shawer, Osama; Souleiman, Mamoun; Akkawi, Mohammad; Alshakhatreh, Osama; Altamimi, Tamer Salhab; Al-Omari, Saleh; Al‐Hussaini, Maysa

doi:10.1007/s12029-018-0089-0

Cited by 13 publications

(14 citation statements)

References 36 publications

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“…It provides a state of the art cancer care for both the citizens of Jordan and many neighboring countries. The center treats over 6000 new cases and its outpatient clinics have almost 300,000 encounters annually [25].…”

Section: Introductionmentioning

confidence: 99%

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

et al. 2020

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Background: Between the need for transparency in healthcare, widely promoted by patient's safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option. We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center regarding medical error disclosure. Methods: This is a cross-sectional self-administered questionnaire study. The questionnaire was piloted and no major modifications were made. A day-long training workshop consisting of didactic lectures, short and long case scenarios with role playing and feedback from the instructors, were conducted. Physicians who attended these training workshops were invited to complete the questionnaire at the end of the training, and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments. Descriptive statistics were used to present demographics and KAP. The differences between response\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance. Results: Eighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). Sixty Five percent of physicians were males and the mean number of years of experience was 16.5 years. Eighty-Seven percent (n = 73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan's Law on Medical and Health Liability (66.7% vs 45.5%, p-value = 0.017) and the Law was more likely to affect their decision on error disclosure (61.8% vs 36.4%, p-value = 0.024). Conclusion: Formal training workshops on disclosing medical errors have the power to positively influence physicians' KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the health care system.

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Section: Introductionmentioning

confidence: 99%

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

et al. 2020

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“…It provides a state of the art cancer care for both the citizens of Jordan and many neighboring countries. The center treats over 6,000 new cases and its outpatient clinics have almost 300,000 encounters annually [25].…”

Section: Introductionmentioning

confidence: 99%

Disclosure of Medical Errors: Physicians’ Knowledge, Attitudes and Practices (KAP) in an Oncology Center

Mansour

Ammar

Al-Tabba

et al. 2020

Preprint

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Background Between the need for transparency in healthcare, widely promoted by patient’s safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option. We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center regarding medical error disclosure.Methods This is a cross-sectional self-administered questionnaire study. The questionnaire was piloted and no major modifications were made. A day-long training workshop consisting of didactic lectures, short and long case scenarios with role playing and feedback from the instructors, were conducted. Physicians who attended these training workshops were invited to complete the questionnaire at the end of the training, and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments.Descriptive statistics were used to present demographics and KAP. The differences between response\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance. Results Eighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). Sixty Five percent of physicians were males and the mean number of years of experience was 16.5 years. Eighty-Seven percent (n=73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan’s Law on Medical and Health Liability (66.7% vs 45.5%, p-value = 0.017) and the Law was more likely to affect their decision on error disclosure (61.8% vs 36.4%, p-value= 0.024).Conclusion Formal training workshops on disclosing medical errors have the power to positively influence physicians’ KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the health care system.

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“…This would eventually lead to a diminished immune response, thus a poor outcome. 19 Nomograms are not new to the medical field, but their use as predictive tools has become increasingly common in modern medicine. 20 Nomograms are now utilized in many fields; an important example is oncology, 21 by incorporating not only tumor characteristics, but other patient specific, and disease determining variables.…”

Section: Introductionmentioning

confidence: 99%

<p>Hematological Indices of Distant Metastases and Prognostic Nomogram in Gastro-Pancreatic and Biliary Tract Cancers</p>

Mansour¹,

Abu-Shawer²,

Lattouf³

et al. 2020

CMAR

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The predictive value of inflammatory parameters as indicators of poor overall survival (OS) has been well studied in various tumors. This study aimed to explore the association of neutrophil-lymphocyte ratio (NLR), among other parameters in upper gastrointestinal tract tumors with distant metastases and OS. Patients and Methods: Retrospective analysis was done for 945 patients (males n= 539, 57.0%) with a median of 57 years (range 19-90 years) treated at King Hussein Cancer Center (KHCC) for gastric (n=501), pancreatic (n=355), and biliary (n=89) carcinoma. NLR, and other parameters were calculated at primary presentation, and the association between the parameters with baseline distant metastases and OS was studied. The optimal cutoff value of NLR was based on receiver operating characteristic curve (ROC) analysis. A prognostic nomogram was then constructed to explore how accurately the OS can be predicted. Results: Patients with high baseline NLR (>3.2) had more distant metastases on presentation than patients with low NLR (≤3.2), (p-value <0.001). Age older than 57 years was associated with poor median OS (8.7 versus 10.6 months, p-value= 0.04). In addition, the location of the tumor as stomach versus biliary tract (Odds Ratio 0.443 95% CI 0.281-0.699), and pancreas versus biliary tract (Odds Ratio 1.193, 95% CI 0.749-1.902, p-value <0.001) proved to be significant. In multivariate analysis, age older than 57 years (p-value =0.0033, HR 0.792, 95% CI 0.678-0.925), location of the tumor (p-value <0.0001), presence of distant metastasis (p-value <0.0001, HR 2.063, 95% CI 1.760-2.419), and NLR (p-value <0.0001, HR 1.045, 95% CI 1.028-1.062) remained significant. Nomogram confirmed the significance of NLR as an independent prognostic factor for OS (HR = 1.62, 95% CI: 1.31-2.01, p-value <0.0001). Conclusion: Our results suggested that high baseline inflammatory markers are associated with distant metastases and poor OS. The utilization of this association in management of cancer patients still warrants further investigation.

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Hematologic Markers of Lung Metastasis in Stage IV Colorectal Cancer

Abstract: Results are suggesting that different hematologic markers obtained from a cheap test (CBC) could potentially be used to predict the likelihood of lung metastasis in stage IV CRC. Prospective studies are needed to further assess the immune cells' role in tumor metastasis promotion.

Cited by 13 publications

References 36 publications

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

Disclosure of Medical Errors: Physicians’ Knowledge, Attitudes and Practices (KAP) in an Oncology Center

<p>Hematological Indices of Distant Metastases and Prognostic Nomogram in Gastro-Pancreatic and Biliary Tract Cancers</p>

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