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Real-World Evidence in Localized Pancreatic: Coping with Uncertainty in Unselected Populations

Journal of Cancer Therapy 2024年第4期15卷 164-178页

作者： María I. Pamies Ramón Diana Ibarra Anguita paula rodríguez payá Alvaro Muñoz Abad David Sánchez García María Valero Revert Beatriz Grau Mirete Mariano Martínez Marín Alicia Calero Amaro Lorena rodríguez Cazalla Javier Gallego Plazas Medical Oncology Department Elche University Hospital Elche (Alicante) Spain General Surgery Department Elche University Hospital Elche (Alicante) Spain General Surgery Department Vega Baja Hospital Orihuela (Alicante) Spain

Background: Localized pancreatic cancer, including resectable (R), borderline resectable (BR) and locally advanced unresectable disease (LAU), is considered in clinical guidelines for diverse treatment options based on clinical trials in selected populations. Hence, exploring with real world evidence (RWE) clinicians’ preferences for treatment options and their results seems pertinent. Methods: In a set of consecutive patients with localized pancreatic cancer assisted in a third level hospital from January 2013 to December 2022, medical records, symptoms, diagnostic process, distribution between subtypes, and treatment plans, with safety and efficacy results, were assessed. Results: A total of 152 patients with localized disease were included (43.4% R, 21.0% BR, 33.6% LAU). The population characteristics exemplified differences between daily practice and clinical trials. Tumor location and symptoms were as expected. Treatment plan was conditioned by PS or comorbidities in 23.0% of patients. In patients with R disease, surgery followed by different adjuvant chemotherapy (CT) regimes was the antineoplastic treatment of choice (64.8%) with efficacy results (OS 37.5 months;95% CI 18.4 - 56.7), in the range of contemporary standards. The common use of neoadjuvant CT for BR disease (94.4%), with surgery in 50% of them, and its results (OS 30.8 months;95% CI 10.5 - 51.2) reflected current controversies of treatment recommendations and evolution in this scenario. Paliative CT with or without radiotherapy was the standard specific treatment in LAU disease (95.1%) with survival results (PFS: 10.8 months;95% CI 8.8 - 12.7. OS: 20.3 months;95% CI 13.5 - 27.2) that justify the distinct character and the specific study of this entity. Conclusion: RWE for localized pancreatic cancer aroused from the analysis of this population confirms the distinct nature of patients assisted in daily practice, as well as mirrors the complexity of decision making in clinical assumptions in which a

关键词： Real-World Evidence Localized Pancreatic Cancer

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Journal of Sport and Health Science 2022年第6期11卷 716-724页

作者： Zachary Yukio Kerr Avinash Chandran Aliza K.Nedimyer Allison E.Rothschild Melissa C.Kay paula Gildner K.Hunter Byrd Juliet K Haarbauer-Krupa Johna K.Register-Mihalik Department of Exercise and Sport Science University of North Carolina at Chapel HillChapel HillNC 27599-8700USA Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center University of North CarolinaChapel HillNC 27599-8700USA Injury Prevention Research Center University of North CarolinaChapel HillNC 27510USA Human Movement Science Curriculum University of North CarolinaChapel HillNC 27599-8700USA Department of Health Behavior Gillings School of Public HealthUniversity of North CarolinaChapel HillNC 27599-7400USA School of Health Professions University of Southern MississippiHattiesburgMS 39406USA National Center for Injury Prevention and Control Centers for Disease Control and PreventionAtlantaGA 30341USA

Objective:Parents may use various information sources to obtain information about sport-related concussions(SRC).This study examined SRCrelated information sources used by parents of United States middle school children(age:10-15 years).Methods:A panel of 1083 randomly selected ***,aged≥18 years and identifying as parents of middle school children,completed an online questionnaire capturing parental and child characteristics,and utilization and perceived trustworthiness of various sources of SRC-related *** logistic regression models identified factors associated with utilizing each *** odds ratios(OR)with 95%confidence intervals(95%CIs)excluding 1.00 were deemed ***:Doctors/healthcare providers(49.9%)and other healthcare-related resources(e.g.,Centers for Disease Control and Prevention,WebMD)(37.8%)were common SRC-related information sources;64.0%of parents utilized≥1 of these *** sources were considered“very”or“extremely”trustworthy for SRC-related information among parents using these sources(doctors/healthcare providers:89.8%;other healthcare-related resources:70.9%).A 10-year increase in parental age was associated with higher odds of utilizing doctors/healthcare providers(adjusted odd ratio(OR_(adjusted))=1.09,95%CI:1.02-1.16)and other healthcare-related resources(OR_(adjusted)=1.11,95%CI:1.03-1.19).The odds of utilizing doctors/healthcare providers(OR_(adjusted)=0.58,95%CI:0.40-0.84)and other healthcare-related resources(OR_(adjusted)=0.64,95%CI:0.44-0.93)were lower among parents whose middle school children had concussion histories versus the parents of children who did not have concussion ***:One-third of parents did not report using doctors/healthcare providers or other healthcare-related resources for SRC-related *** associated with underutilization of these sources may be targets for future *** education for healthcare providers and e

关键词： Information seeking Media use Traumatic brain injury

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How the FBI Solved a $3 Million Heist：Does crime pay？The anatomy of an inside job

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空中英语教室（高级版．彭蒙惠英语） 2016年第12期 34-35,47,48页

作者： paula Mcmahon

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小仓鼠汉密尔顿

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中学生英语 2021年第41期 18-21页

作者： paula Moore 李明娟

Once upon a time there was a smart little hamster named *** lived in a shop owned2by a man named *** didn't pay much attention3to *** had no cage4,so he went anywhere in the shop he *** would put out some bread for Hamilton every now and *** mostly Hamilton was on his own,climbing around to look for food and water.

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