Browsing by Subject "Physician survey"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Breaking the Age Barrier: Physicians' Perceptions of Candidacy for Allogeneic Hematopoietic Cell Transplantation in Older Adults
    (Elsevier, 2021) Mishra, Asmita; Preussler, Jaime M.; Bhatt, Vijaya Raj; Bredeson, Christopher; Chhabra, Saurabh; D'Souza, Anita; Dahi, Parastoo B.; Danaher Hacker, Eileen; Gowda, Lohith; Hashmi, Shahrukh K.; Howard, Dianna S.; Jakubowski, Ann; Jayani, Reena; Koll, Thuy; Olin, Rebecca L.; Popat, Uday R.; Rodriguez, Cesar; Rosko, Ashley; Sabloff, Mitchell; Sorror, Mohamed L.; Sung, Anthony D.; Ustun, Celalettin; Wood, William A.; Burns, Linda; Artz, Andrew; School of Nursing
    Background: Despite continued increases in use of allogeneic hematopoietic cell transplantation (alloHCT) among older adults, no standardized geriatric assessment (GA) has been established to risk-stratify for transplant-related morbidity. We conducted a survey of transplant physicians to determine perceptions of the impact of older age (≥60 years) on alloHCT candidacy, and utilization of tools to gauge candidacy. Methods: We conducted a 23-item, online cross-sectional survey of HCT physicians caring for adults in the United States between May and July 2019. Results: Of the 770 invited HCT physicians, 175 (22.7%) completed the survey. The majority of respondents were 41–60 years old, male, and practiced in a higher volume teaching hospital. When considering regimen intensity, 29 physicians (17%) stated they would consider a myeloablative regimen for patients ≥70 years, and 141 (82%) would consider reduced intensity/non-myeloablative conditioning for patients ≥70 years. Almost all (90%) endorsed the need for a specialized assessment of pre-HCT vulnerabilities to guide candidacy decisions for older adults. Most physicians reported their centers rarely (33%) or never (46%) utilize a dedicated geriatrician/geriatric-oncologist to assess alloHCT candidates ≥60 years. Common barriers to performing a GA included uncertainty about which tools to use, lack of knowledge and training, and lack of appropriate clinical support staff. Conclusions: Many alloHCT physicians will consider alloHCT in patients up to age 75 years and not uncommonly, in patients older than that. However, application of tools and domains varies widely to assess candidacy in older adults. Incorporation of a standardized pre-transplant health assessment tool for risk stratification is a significant unmet need.
  • Thumbnail Image
    Item
    Effects of coronavirus disease 2019 on the Society for Vascular Surgery Vascular Quality Initiative arterial procedure registry
    (Elsevier, 2021-06) Natarajan, Jay P.; Mahenthiran, Ashorne K.; Bertges, Daniel J.; Huffman, Kristopher M.; Eldrup-Jorgensen, Jens; Lemmon, Gary W.; Medicine, School of Medicine
    In the present report, we have described the abrupt pivot of Vascular Quality Initiative physician members away from standard clinical practice to a restrictive phase of emergent and urgent vascular procedures in response to the coronavirus disease 2019 (COVID-19) pandemic. The Society for Vascular Surgery Patient Safety Organization queried both data managers and physicians in May 2020 to discern the effects of the COVID-19 pandemic. Approximately three fourths of physicians (74%) had adopted a restrictive operating policy for urgent and emergent cases only. However, one half had considered "time sensitive" elective cases as urgent. Data manager case entry was affected by both low case volumes and low staffing resulting from reassignment or furlough. A sevenfold reduction in arterial Vascular Quality Initiative case volume entry was noted in the first quarter of 2020 compared with the same period in 2019. The downstream consequences of delaying vascular procedures for carotid artery stenosis, aortic aneurysm repair, vascular access, and chronic limb ischemia remain undetermined. Further ramifications of the COVID-19 pandemic shutdown will likely be amplified if resumption of elective vascular care is delayed beyond a short window of time.