scholarly journals Contralateral Prophylactic Mastectomy: Long-Term Consistency of Satisfaction and Adverse Effects and the Significance of Informed Decision-Making, Quality of Life, and Personality Traits

2011 ◽  
Vol 18 (11) ◽  
pp. 3110-3116 ◽  
Author(s):  
Marlene H. Frost ◽  
Tanya L. Hoskin ◽  
Lynn C. Hartmann ◽  
Amy C. Degnim ◽  
Joanne L. Johnson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Adverse Effects ◽  
Personality Traits ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Informed Decision ◽  
Informed Decision Making

Patient decision making, satisfaction, and quality of life following contralateral prophylactic mastectomy.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e19610-e19610 ◽  
Author(s):  
R. Tuli ◽  
R. A. Chandra ◽  
E. Sugar ◽  
J. P. Christodouleas ◽  
R. A. Flynn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Patient Decision Making ◽  
Patient Decision

scholarly journals COVID-19 containment policies through time may cost more lives at metapopulation level

2020 ◽  
Author(s):  
Konstans Wells ◽  
Miguel Lurgi
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Informed Decision ◽  
Mitigation Strategies ◽  
Disease Spread ◽  
Informed Decision Making ◽  
Short Term ◽  
Care Systems

AbstractThe rapid and pandemic spread of COVID-19 has led to unprecedented containment policies in response to overloaded health care systems. Disease mitigation strategies require informed decision-making to ensure a balance between the protection of the vulnerable from disease and the maintenance of global economies. We show that temporally restricted containment efforts, that have the potential to flatten epidemic curves, can result in wider disease spread and larger epidemic sizes in metapopulations. Longer-term rewiring of metapopulation networks or the enforcement of feasible long-term measures that decrease disease transmissions appear to be more efficient than temporarily restricted intensive mitigation strategies (e.g. short-term mass quarantine). Our results may inform balanced containment strategies for short-term disease spread mitigation in response to overloaded health care systems and longer-term epidemiological sizes.

Contentment With Quality of Life Among Breast Cancer Survivors With and Without Contralateral Prophylactic Mastectomy

2006 ◽  
Vol 24 (9) ◽  
pp. 1350-1356 ◽  
Author(s):  
Ann M. Geiger ◽  
Carmen N. West ◽  
Larissa Nekhlyudov ◽  
Lisa J. Herrinton ◽  
In-Liu A. Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Prophylactic Mastectomy ◽  
Care Delivery ◽  
Contralateral Prophylactic Mastectomy ◽  
Psychosocial Outcomes ◽  
Health Perception

Purpose To understand psychosocial outcomes after prophylactic removal of the contralateral breast in women with unilateral breast cancer. Methods We mailed surveys to women with contralateral prophylactic mastectomy after breast cancer diagnosis between 1979 and 1999 at six health care delivery systems, and to a smaller random sample of women with breast cancer without the procedure. Measures were modeled on instruments developed to assess contentment with quality of life, body image, sexual satisfaction, breast cancer concern, depression, and health perception. We examined associations between quality of life and the other domains using logistic regression. Results The response rate was 72.6%. Among 519 women who underwent contralateral prophylactic mastectomy, 86.5% were satisfied with their decision; 76.3% reported high contentment with quality of life compared with 75.4% of 61 women who did not undergo the procedure (P = .88). Among all case subjects, less contentment with quality of life was not associated with contralateral prophylactic mastectomy or demographic characteristics, but was associated with poor or fair general health perception (odds ratio [OR], 7.0; 95% CI, 3.4 to 14.1); possible depression (OR, 5.4; 95% CI, 3.1 to 9.2); dissatisfaction with appearance when dressed (OR, 3.5; 95% CI, 2.0 to 6.0); self-consciousness about appearance (OR, 2.0; 95% CI, 1.1 to 3.7); and avoiding thoughts about breast cancer (modest: OR, 2.2; 95% CI, 1.1 to 4.5; highest: OR, 1.7; 95% CI, 0.9 to 3.2). Conclusion Most women undergoing contralateral prophylactic mastectomy report satisfaction with their decision and experience psychosocial outcomes similar to breast cancer survivors without the procedure.

scholarly journals Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study

2017 ◽  
Vol 35 (20) ◽  
pp. 2306-2314 ◽  
Author(s):  
Richard M. Hoffman ◽  
Mary Lo ◽  
Jack A. Clark ◽  
Peter C. Albertsen ◽  
Michael J. Barry ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Decision Making ◽  
Treatment Decision ◽  
Localized Prostate Cancer ◽  
Factors Associated ◽  
Decision Regret ◽  
Long Term Survivors

Purpose To determine the demographic, clinical, decision-making, and quality-of-life factors that are associated with treatment decision regret among long-term survivors of localized prostate cancer. Patients and Methods We evaluated men who were age ≤ 75 years when diagnosed with localized prostate cancer between October 1994 and October 1995 in one of six SEER tumor registries and who completed a 15-year follow-up survey. The survey obtained demographic, socioeconomic, and clinical data and measured treatment decision regret, informed decision making, general- and disease-specific quality of life, health worry, prostate-specific antigen (PSA) concern, and outlook on life. We used multivariable logistic regression analyses to identify factors associated with regret. Results We surveyed 934 participants, 69.3% of known survivors. Among the cohort, 59.1% had low-risk tumor characteristics (PSA < 10 ng/mL and Gleason score < 7), and 89.2% underwent active treatment. Overall, 14.6% expressed treatment decision regret: 8.2% of those whose disease was managed conservatively, 15.0% of those who received surgery, and 16.6% of those who underwent radiotherapy. Factors associated with regret on multivariable analysis included reporting moderate or big sexual function bother (reported by 39.0%; OR, 2.77; 95% CI, 1.51 to 5.0), moderate or big bowel function bother (reported by 7.7%; OR, 2.32; 95% CI, 1.04 to 5.15), and PSA concern (mean score 52.8; OR, 1.01 per point change; 95% CI, 1.00 to 1.02). Increasing age at diagnosis and report of having made an informed treatment decision were inversely associated with regret. Conclusion Regret was a relatively infrequently reported outcome among long-term survivors of localized prostate cancer; however, our results suggest that better informing men about treatment options, in particular, conservative treatment, might help mitigate long-term regret. These findings are timely for men with low-risk cancers who are being encouraged to consider active surveillance.

scholarly journals More harm than good? Building a framework to identify adverse effects of public health interventions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Stratil ◽  
K Oliver ◽  
P von Philipsborn ◽  
A Movsisyan ◽  
E A Rehfuess
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Adverse Effects ◽  
Adverse Events ◽  
Informed Decision ◽  
Health Interventions ◽  
Decision Makers ◽  
Informed Decision Making ◽  
Public Health Interventions ◽  
Integrate Framework

Abstract Background While the importance of adverse events of medical interventions is widely recognized, adverse effects of public health interventions remain a neglected topic. This project aims to develop a framework to guide researchers and decision-makers to systematically reflect on and identify potential adverse effects of public health interventions. Methods We conducted a mixed-method systematic review of theoretical and conceptual publications on adverse events of public health interventions to develop a preliminary framework employing best-fit framework synthesis. We used the WHO-INTEGRATE framework as a starting point for the synthesis, a multidimensional evidence-to-decision framework developed for complex interventions in complex systems. Results The framework includes two interlinked parts: The first maps domains in which potential adverse events might arise. Drawing on the WHO-INTEGRATE framework, these domains include aspects related to health, but also domains related to societal, economic, and environmental implications. The second part maps general mechanisms through which public health interventions can lead to adverse effects (e.g. reactive behaviour change, increase of labelling and stigmatization, and exposure to environmental risk-factors). Conclusions The framework will be advanced in the second phase of the project through empirical studies of harmful effects in public health interventions, which we will identify through an overview of systematic reviews. Adverse effects of public health interventions are currently not sufficiently considered in research and practice. Taking them into account is essential for informed decision-making and establishing appropriate countermeasures. Our framework could be a valuable asset for researchers and policy makers in developing, implementing and evaluating public health interventions. Key messages Awareness of the adverse effects of public health interventions is essential for informed decision-making and establishing countermeasures. This framework supports researchers and decision-makers in systematically reflecting on and identifying adverse events when developing, piloting, implementing or evaluating public health interventions.

Long-term follow-up outcomes and treatment among patients previously treated with Zizao Yangrong granules (ZYG) for egfris–related skin xerosis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24054-e24054
Author(s):  
Chongxiang Xue ◽  
Jia Li ◽  
Xingyu Lu ◽  
Huijuan Cui
Keyword(s):  
Quality Of Life ◽  
Vitamin E ◽  
Adverse Effects ◽  
Survival Data ◽  
Progression Free Survival ◽  
Complete Response ◽  
Dermatologic Toxicity

e24054 Background: Traditional Chinese medicine (TCM) has broad prospects in the treatment of targeted drugs–related dermatologic toxicity. In our previous study (ChiCTRIOR-17013498), Zizao Yangrong granules (ZYG) made effect on EGFRIs-related xerosis and improve the quality of life. However, some people still doubt that TCM could affect therapeutic benefit for patients treated with EGFRIs. Methods: Patients with EGFRIs related xerosis who underwent ZYG and vitamin E ointment from May 2016 to January 2018 were retrospectively reviewed. Survival data and quality of life data analysis were performed. Besides, patients who used ZYG for more than 8 weeks were also summarized, followed by telephone follow-up and questionnaire survey. Results: Of 68 participates randomly assigned, 54 patients were successfully followed up. Median PFS in Vitamin E Ointment plus ZYG group was 41.6 months, and that in Vitamin E Ointment group was 40.9 months, with no statistical difference (HR 0.85, 95% CI 0.48 to 1.51, P = 0.586). Subsequently, 19 patients who used ZYG for longer than 8 weeks were also included. 2 patients reported complete response, 14 patients reported partial response, and 3 patients reported no response. The overall effective rate was 84.2%. The total DLQI score of patients with long-term intervention of ZYG was 4.47±3.10. Compared with baseline DLQI score (7.00±2.91), the DLQI of patients after ZYG intervention has been significantly improved (P = 0.000). During the continuous use of ZYG treatment, incidence of adverse effects was 57.9%. Treatment-related adverse reactions were mostly mild, with no grade 3/4 adverse events. Conclusions: ZYG did not affect progression free survival of patients treated with EGFRIs. And long time-scale ZYG intervention could continuously relieve EGFRI-related xerosis and significantly improve the quality of life of patients without serious adverse effects. Clinical trial information: ChiCTRIOR-17013498.

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