Friday, June 21, 2019

The Need for Clinical Trial Navigators - The New York Times

Since a Phase I trial has prolonged my life for almost seven years, I find it perplexing that fewer than 5 percent of adult American cancer patients enroll in clinical studies. Why do so few people — with various stages and types of cancer — participate in research that can improve care?

One obstacle may be the baffling scaffolding scientists erect around their studies. For example, cancer is a disease of aging, but many clinical trials on cancer drugs exclude older people from participating.

One study, in The Journal of Clinical Oncology, found that older patients "are underrepresented in cancer clinical trials relative to their disease burden."

In another study on the exclusion of large segments of cancer populations, published last year in The Oncologist, researchers argued that "the criteria for participation in some clinical trials may be overly restrictive and limit enrollment."

But the problem of low enrollment is often attributed to patient resistance. The reluctance of some patients makes perfect sense to me. Fear about unforeseen side effects escalates when consent forms, like the ones I signed, state that a new regimen cannot cure but might kill patients.

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Wednesday, June 19, 2019

Rude Surgeons May Have Worse Patient Outcomes : Shots - Health News : NPR

As a group, surgeons are not well known for their bedside manner. "The stereotype of the abrasive, technically gifted ... surgeon is ubiquitous among members of the public and the medical profession," write the authors of a 2018 article in the AMA Journal of Ethics. While poor manners aren't commonly accepted in most professional circles, representations of surgeons in popular culture often link technical prowess with rude behavior, and some surgeons have even argued that insensitivity can be helpful in such an emotionally strenuous profession.

A study published Wednesday in JAMA Surgery challenges these ideas. The study, which looked at interactions between surgeons and their teams, found that patients of surgeons who behaved unprofessionally around their colleagues tended to have more complications after surgery. Surgeons who model unprofessional behavior can undermine the performance of their teams, the authors write, potentially threatening patients' safety.

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