When you read about applications of "AI" in medicine, a good Q to ask is "what is the billing code for that 'service'?"
In the case of "screening" for IPV, no indication is required (unlike "assessments").
To document physical abuse, you can use ICD-10 code T74.1. Relevant source:
CapeOx vs FOLFOX for adjuvant treatment in people w stage III colorectal #cancer & a diverting stoma:
- ⬆️ hospitalizations, mostly GI effects (35% vs 18%)
- ⬆️ rate of dose-reducing oxali (92% vs 40%)
- ⬆️ diarrhea, mucositis, HFS
😨 mFOLFOX6 much better for QOL. #CRCSM ascopubs.org/doi/10.1200/...
This is especially important now that we're dealing with Medicaid paperwork requirements because it's so difficult to document gig work (which is disproportionately performed by Black and Hispanic workers, who are in turn more vulnerable to falling through the cracks and losing health coverage).
Unfortunately every complaint I have seen about the Pitt from health care-associated people makes it sound more accurate to real life…
NGL, I kinda did see "rural hospital closures" becoming a hot-button issue. The framing is already so polarized- crowding out similar focus on urban hospital closures (which also lead to bystander effects, e.g., crowding at surviving hospitals & worsen access for urban-dwelling communities of color)
Someone with a platform and a gift for policy/research translation needs to get ahead of this.
“Will it work?”
“I don't know…
But we have a plan.”
“I don't know” does not mean “I have nothing to offer.” It means “I will not pretend to know when I don't, and I will stand with you in the uncertainty.”
Loved this @ascocancer.bsky.social #ArtofOncology by #radonc Dr Sondos Zayed
Something that shouldn’t be lost is @drugmonkey.bsky.social highlighting these are training awards. Overall a devastating blow to the groups targeted.
Not only were grants terminated (which shrinks the pool of people who can stay in science), a huge drop off in new awards also shrinks the pipeline.
Great learning on data science algorithms by Tina Hernandez-Boussard: when a predictive algorithm works @stanford-cancer.bsky.social but fails when used at @massgeneralbrigham.bsky.social because one hospital uses "Depends" to refer to an adult diaper and the other uses "depends" only as a verb...
"You're getting mixed signals as to what you represent, and the kind of work that you should be doing" said Jahn Jaramillo, a Ph.D. candidate at the University of Miami who recently published an analysis of the F31 awards that were terminated after his own grant was terminated. His grant, which had received a perfect peer review score, was on HIV in the Latino immigrant community. In some ways, the grant was squarely within the priorities of the Trump administration, which announced a plan in 2019 to end the HIV epidemic. Miami, where Jaramillo is based, is an area of high priority for that initiative. The work also felt particularly meaningful to Jaramillo, as a way to help communities he is part of.
But now, it feels as if his identities are being weaponized. "I was able to do that kind of community outreach work. You speak the language, you're very close to the community, so you're able to get research participants that perhaps had never engaged in research before," Jaramillo said. But when his grant was terminated halfway through the project, he added, "you're disappointing them, you're confusing them. That has long-term impacts with regards to them trusting research."
Infuriating story
Future Dr. Jaramillo got a perfect score on his proposal. “Diversity” awards are scored w/ the same criteria as others.
The new admin claims they are exchanging “DEI” for “merit”. In practice they are shutting down research mid-project even if they have the highest “merit”
Title page and abstract: Cost-Effectiveness of Maintaining Higher Stem-Cell Collection Thresholds in the Chimeric Antigen Receptor T-Cell Era for Multiple Myeloma Ehsan Malek, MD 1 ; Brian Betts, MD 1 ; Megan Herr, PhD 1 ; Marco Davila, MD 1 ; Shernan Holtan, MD 1 ; James J. Driscoll, MD, PhD 2,3 ; and Han Yu, PhD 1
FIG 3. Cost breakdown by strategy. Stacked bar chart of per-patient costs for the no-boost and boost strategies. In the no-boost arm, all costs are attributable to hospitalization for infection. In the boost arm, upfront reserve collection accounts for the majority of costs, while infection-related costs are markedly lower. Total costs for each strategy represent the sum of upfront collection/storage fees and longitudinal infection-related hospitalization costs. USD, US dollars. Figure demonstrates cost per patient >$20,000 in boost group, under $5000 in no boost group. Majority of costs attributable to cost of stem cell collection up-front.
Should we be reserving stem cells for every patient with #myeloma treated with BCMA CAR T?
Reduces severe infections by over half, but >4x cost. Need risk-stratification (or IVIG) to make sustainable.
Cost effectiveness modeling in #JCOCCI :
ascopubs.org/doi/10.1200/...
@ziadbakouny.bsky.social
This is cool: fullerenes, these neat carbon structures discovered in 1985 @ Rice University, significantly reduced incidence of radiation dermatitis in people with head & neck cancer getting radiation.
Tx groups not perfectly matched, but encouraging study.
ascopubs.org/doi/10.1200/...
This would be terrible.
99% of Medicare Advantage enrollees have prior authorization, a departure from how traditional Medicare has historically operated (though Oz is changing that), which causes delays and denials. What’s more, networks are often very limited, further reducing access to care.
Table 3. Practice Implications for Oncology Providers in Low-Broadband Settings Practice Domain Key Implication Proactive Offering Proactively offer VTVs even in low-broadband regions; patients may adopt VTV when given the option Modality Matching Reserve in-person care for essential physical examinations, labs, transfusions, or imaging, while offering VTV for follow-ups, counseling, and routine check-ins Situational Flexibility Frame VTV as a safe and practical alternative, especially, during adverse weather, long travel distances, or out-of-state circumstances Digital Readiness Build digital comfort through low-stakes trial runs, patient portal tutorials, or staff-led technology coaching to reduce first-visit barriers Relational Care Validate patients' preference for face-to-face care while emphasizing strategies to maintain connection, attention, and trust during VTV Future Planning Normalize VTV as a scalable option that patients may increasingly rely on with aging, mobility limitations, or worsening weather conditions
2. How do people living in low broadband access areas feel about Telehealth visits? Surprisingly open - and asking for more proactive outreach.
ascopubs.org/doi/10.1200/...
TABLE 2. Participant-Reported Measures: Prognostic Perceptions and Hope at the Time of Phase I Clinical Trial Enrollment 27.4% report goal of cancer treatment is to cure cancer, 40% describe themselves as not terminally ill, and 37.8% report never or rarely discussing prognosis with oncologist.
Two important patient-perspective studies JCO OP @jco-asco.bsky.social this week:
1. What do people w/ advanced cancer participating in early-phase clinical trials (ie, Phase 1) understand about their prognosis?
27% believe cancer is curable
38% report never discussing prognosis w/ oncologist.
Shift in #CML care in era of 📈 treatment options: many patients still have poor quality of life when experiencing multiple side effects of their TKIs despite excellent disease control. Justifies need for tx-free remissions, wider STAMPi access @jco-asco.bsky.social
ascopubs.org/doi/10.1200/...
Broken incentives: when a $3K/year cancer treatment may cost patients more than a $200K/year one. 💸
Why isn't structured exercise getting the uptake it should? Follow up in @jco-asco.bsky.social on economics of #ChallengeTrial @csoncol.bsky.social
ascopubs.org/doi/pdf/10.1...
Cancer screenings are supposed to be provided at no cost to the patient, but way too often, patients receive medical bills for ancillary services. Those are medical services delivered solely because of screening but not classified as screening themselves (e.g., anesthesia for colonoscopy).
🚨🚨🚨 NEW PAPER ALERT 🚨🚨🚨
In this @journalgim.bsky.social brief report, @alexhoagland.bsky.social, our clinical co-authors, and I lay out ancillary services to screening mammography and colonoscopy, for which patients receive medical bills.
link.springer.com/article/10.1...
cc: @acscan.bsky.social
In terms of healthcare systems, accessibility of healthcare, area-level concentrated advantage has implications for the profitability of healthcare provision to residents in these areas. Health systems- even non-profit- are incentivized to provide care where residents have greater "ability to pay."
Yes, poverty is frequently racialized AND spatialized. Occupational segregation, residential segregation, etc concentrate disadvantage (e.g., lower educational attainment, lower entry into higher paying professions, lower likelihood of having employer-sponsored health insurance...).
Are you an oncologist? Do you have strong opinions about pros & cons of same-day multi-D clinics for people newly diagnosed w/ solid tumors?
I suspect there's about 95-99% overlap between "yes" answers...
A little data to inform those opinions in @jco-asco.bsky.social:
ascopubs.org/doi/10.1200/...
Surprising finding in JCO OA: Pancreatic cancer patients at a community site were MORE likely to be offered & participate in a clinical trial than those at an academic site. Caveat of selection bias, but credit to these clinics! @pancan.bsky.social
@jco-asco.bsky.social
ascopubs.org/doi/full/10....
New article in @jco-asco.bsky.social gets into the details, but why do you think people are not yet using it?
ascopubs.org/doi/10.1200/...
Fig 2. Medicare projected versus actual utilization of G2211. All physicians were anticipated to report 83.7 million uses of the code but only reported 24.7. Hematology/oncology physicians expected to report 3.2 million but only reported 1.6 million.
Why aren't docs using code G2211?
G2211 is a new billing code for longitudinal care of complex conditions, but overall MDs are using it ~25% the rate anticipated. Other pay was adjusted to make room, so this is in net a loss to MDs providing continuity of care - the thing we want.
Regardless of the partisan affiliation of the sitting president, "price transparency" was always going to be most useful for firms with actual market power versus patient-consumers #InformationAssymetry
Adding to my HPM 756 slides. The point about homicide is especially salient.
Fig 1. Reference characteristics to the article by Ross et al by year of publication. Stacked area chart depicting the distribution of citation characteristics referencing the article by Ross et al, categorized by publication year (2010-2025). Each color represents a distinct citation characteristic: Affirmative, contrastive, assumptive, conceptual, methodologic, perfunctory, and negative. Vertical dashed lines mark two key regulatory events: the 2011 cisplatin label update and the 2015 label revision.
It's taken over 10 years for an erroneous reference to (almost) make it out of the citation chain.
Less about the reference itself (incorrect claim re: cisplatin ototoxicity) and more about our science.
Case report here @jco-asco.bsky.social:
ascopubs.org/doi/10.1200/...
Increasing options for chemotherapy-induced peripheral neuropathy: in a 38-patient RCT, low intensity vibration was safe, well adhered-to, and improved neuropathy + function:
ascopubs.org/doi/10.1200/... #oncsky @jco-asco.bsky.social @ohsuknight.bsky.social