Citations

300 Background: The National Radiation Oncology Registry (NROR) is developing an IT infrastructure to support the efficient collection, aggregation, and analysis of data concerning cancer patients treated with radiotherapy across the United States. Methods: Detailed requirements were developed to emphasize the following distinguishing goals for the system: 1) streamline the process of data collection by minimizing manual data entry; 2) support the collection of patient-reported outcomes (PROs) and their linkage with clinician-observed outcomes; 3) facilitate data integration within the NROR and between the NROR and other registries; 4) allow for evolution of the system in response to new learning; and 5) promote sustainability and ongoing improvement through an open standard of interoperability. Results: An innovative technical architecture has been designed to meet the goals described. The system maximizes efficiency through automated extraction and electronic transfer of data from radiation oncology information systems. PROs are collected directly from patients via a web-based portal and linked to data submitted from participating institutions. A data dictionary has been developed based on national standards and controlled vocabularies to facilitate data integration. Contemporary forms-based database technology is used in combination with traditional relational technology to permit both flexible evolution of the system and efficient data analysis. A unique “gateway” architecture and open transmission standard makes it possible for commercial products to interoperate with the registry in the future. Conclusions: The NROR prototype system will be launched later this year to collect data for a pilot registry of prostate cancer patients. Its performance and usability will be important factors in the success of the pilot. If effective, the platform will support the expansion of the NROR to benefit patients, clinicians, researchers, payors, device manufacturers, and policy-makers by capturing reliable, population-based information on radiation treatment delivery and health outcomes.

BACKGROUND AND OBJETIVESDue to the potential risks associated with stent placement, European Society Gastrointestinal Endoscopy does not recommend prophylactic insertion of stents in patients without symptoms. The aim was to compare complication rates, need of surgery, colostomy formation, and survival between stent placement prior to start of chemotherapy (SEMS group) and upfront ChT (ChT group) in patients with endoscopically non‐transverable metastatic left‐sided colorectal cancer.METHODSGender, age, CEA, tumor location, sites of metastatic disease, peritoneal involvement, liver involvement, and angiogenesis inhibitors administration, were recorded. Complication rates, need of surgery, stoma creation, and survival were compared between both groups by univariate and multivariate test. Complications of SEMS placement in both groups were compared.RESULTSWe studied 75 men and 40 women, with a mean age of 66.3 years. Overall complication and perforation rates were similar but patients in the ChT group had a significant higher need of surgery and subsequent stoma creation. Perforation after SEMS placement rates were higher in patients receiving ChT than in patients without ChT. Survival was related to peritoneal carcinomatosis and administration of biological agents.CONCLUSIONSSEMS placement prior to ChT administration dismissed the need of subsequent surgery and decreased the rates of permanent stoma formation.

ObjectiveTo report the point prevalence of primary Sjögren's syndrome (SS) in the first US population‐based study.MethodsCases of all potential primary SS patients living in Olmsted County, Minnesota, on January 1, 2015, were retrieved using Rochester Epidemiology Project resources, and ascertained by manual medical records review. Primary SS cases were defined according to physician diagnosis. The use of diagnostic tests was assessed and the performance of classification criteria was evaluated. The number of prevalent cases in 2015 was also projected based on 1976–2005 incidence data from the same source population.ResultsA total of 106 patients with primary SS were included in the study: 86% were female, with a mean ± SD age of 64.6 ± 15.2 years, and a mean ± SD disease duration of 10.5 ± 8.4 years. A majority were anti‐SSA positive (75%) and/or anti‐SSB positive (58%), but only 22% met American–European Consensus Group or American College of Rheumatology criteria, because the other tests required for disease classification (ocular dryness objective assessment, salivary gland functional or morphologic tests, or salivary gland biopsy) were rarely performed in clinical practice. According to the physician diagnosis, the age‐ and sex‐adjusted prevalence of primary SS was 10.3 per 10,000 inhabitants, but according to classification criteria, this prevalence was only 2.2 per 10,000. The analysis based on previous incidence data projected a similar 2015 prevalence rate of 11.0 per 10,000.ConclusionThe prevalence of primary SS in this geographically well‐defined population was estimated to be between 2 and 10 per 10,000 inhabitants. Physicians rarely used tests included in the classification criteria to diagnose the disease in this community setting.

Introduction Sedentariness is associated with chronic health conditions, impaired cognitive function and obesity. Work contributes significantly to sedentariness because many work tasks necessitate sitting. Few sustained solutions exist to reverse workplace sedentariness. Here, we evaluated a chair and an under-table device that were designed to promote fidgeting while seated. Our hypothesis was that an under-table leg-fidget bar and/or a fidget-promoting chair significantly increased energy expenditure. We compared these devices with chair-based exercise and walking. Materials and methods We measured energy expenditure and heart rate in 16 people while they sat and worked using a standard chair, an under-desk device that encourages leg fidgeting and a fidget-promoting chair. We compared outcomes with chair-based exercise and walking. Results Energy expenditure increased significantly while using either an under-table leg-fidget bar or a fidget-promoting chair, when compared to the standard office chair (standard chair, 76±31 kcal/hour; leg-fidget bar, 98±42 kcal/hour (p<0.001); fidget chair, 89±40 kcal/hour (p=0.03)). However, heart rate did not increase significantly in either case. Bouts of exercise performed while seated provided energetic and heart rate equivalency to walking at 2 mph. Conclusions Chairs and devices that promote fidgeting can increase energy expenditure by ∼20–30% but not increase heart rate. Dynamic sitting may be among a lexicon of options to help people move more while at work.

A multiplex antibody-mediated capture technique reveals patient-specific protein complexes.