National Healthcare Quality and Disparities Report
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- Adverse Events (2)
- (-) Cancer (28)
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- Diagnostic Safety and Quality (2)
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- Osteoporosis (1)
- Outcomes (3)
- Pain (1)
- Palliative Care (6)
- Patient-Centered Healthcare (3)
- (-) Patient-Centered Outcomes Research (28)
- Patient Experience (1)
- Patient Safety (3)
- Practice Patterns (3)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 28 Research Studies DisplayedReimer T, Lee SJC, Garcia S
Cancer center clinic and research team perceptions of identity and interactions.
The purpose of this study was to determine perceptions of roles of cancer center clinic and research teams. The researchers developed and administered survey to research and clinic staff at a National Cancer Institute-designated comprehensive cancer center. Although there are many similarities between clinic and research teams, the researchers also identified key differences, including perceptions of goal clarity and sharing, understanding and alignment with cancer center goals, and importance of outcomes.
AHRQ-funded; HS022418.
Citation: Reimer T, Lee SJC, Garcia S .
Cancer center clinic and research team perceptions of identity and interactions.
J Oncol Pract 2017 Dec;13(12):e1021-e29. doi: 10.1200/jop.2017.024349..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Kruser JM, Rakhra SS, Sacotte RM
Intensive care unit outcomes among patients with cancer after palliative radiation therapy.
To inform goals of care discussions at the time of palliative radiation therapy (RT) consultation, researchers sought to characterize intensive care unit (ICU) outcomes for patients treated with palliative RT compared to all other patients with metastatic cancer admitted to the ICU. They found that prior treatment with palliative RT is associated with increased in-hospital mortality after ICU admission.
AHRQ-funded; HS000078.
Citation: Kruser JM, Rakhra SS, Sacotte RM .
Intensive care unit outcomes among patients with cancer after palliative radiation therapy.
Int J Radiat Oncol Biol Phys 2017 Nov 15;99(4):854-58. doi: 10.1016/j.ijrobp.2017.06.2463.
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Keywords: Cancer, Intensive Care Unit (ICU), Palliative Care, Patient-Centered Outcomes Research
Borah BJ, Yao X, Laughlin-Tommaso SK
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
The objective of this retrospective analysis of administrative claims from a large U.S. commercial insurance database, was to compare risk of reintervention, long-term clinical outcomes, and health care utilization among women who have bulk symptoms from leiomyoma and who underwent the following procedures: hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided, focused ultrasound surgery.
AHRQ-funded; HS023418.
Citation: Borah BJ, Yao X, Laughlin-Tommaso SK .
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
Obstet Gynecol 2017 Nov;130(5):1047-56. doi: 10.1097/AOG.0000000000002331..
Keywords: Cancer, Comparative Effectiveness, Health Insurance, Outcomes, Patient-Centered Outcomes Research, Surgery, Women
Kelly G, Wang SY, Lucas G
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
In this study, the investigators conducted a process evaluation of ongoing activities of a Patient Advisory Committee (PAC) formed around the development of an individualized decision aid for older women with early stage breast cancer. They indicated that their results suggested that engaging committee members in a process of evaluation and collective reflection during a research collaboration can break down barriers to collaboration, build relationships, create opportunities for co-learning and strengthen researchers' capacity to engage meaningfully with stakeholders.
AHRQ-funded; HS023900.
Citation: Kelly G, Wang SY, Lucas G .
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
Prog Community Health Partnersh 2017;11(3):243-51. doi: 10.1353/cpr.2017.0029..
Keywords: Cancer, Cancer: Breast Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Gingrich AA, Bateni SB, Monjazeb AM
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Neoadjuvant radiotherapy (RT) is increasingly advocated for the management of soft tissue sarcoma (STS). This study sought to characterize the impact of neoadjuvant RT on rates of R0 resection and overall survival (OS) in extremity STS patients undergoing surgery. The authors concluded that preoperative RT independently predicts higher rates of R0 resection for patients with extremity STS undergoing surgical resection. Negative surgical margins and pre- or postoperative RT are associated with improved OS.
AHRQ-funded; HS022236.
Citation: Gingrich AA, Bateni SB, Monjazeb AM .
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Ann Surg Oncol 2017 Oct;24(11):3252-63. doi: 10.1245/s10434-017-6019-8..
Keywords: Adverse Events, Cancer, Mortality, Patient-Centered Outcomes Research, Patient Safety
Fisher KA, Mazor KM
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
This paper comments on the Mack et al. article “Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery”, published in 2017 in The Joint Commission Journal on Quality and Patient Safety, in which Mack et al. categorized all complaints filed at a large outpatient cancer center during a two-year period, put forth a preliminary rating system for assessing complaint severity, and catalogued the actions taken in response to the complaints.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Mazor KM .
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
Jt Comm J Qual Patient Saf 2017 Oct;43(10):495-97. doi: 10.1016/j.jcjq.2017.07.003..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Patient Safety, Quality of Care, Quality Improvement
Kamal AH
Redesigning oncology care delivery: Early wins, lessons learned, and a roadmap.
This editorial, discusses oncology care delivery and comments on an article by Colligan, et al., published, in 2017, in Medical Care, entitled “Two innovative cancer care programs have potential to reduce utilization and spending.”
AHRQ-funded; HS023681.
Citation: Kamal AH .
Redesigning oncology care delivery: Early wins, lessons learned, and a roadmap.
Med Care 2017 Oct;55(10):871-72. doi: 10.1097/mlr.00000000000.
Keywords: Cancer, Healthcare Delivery, Patient-Centered Outcomes Research
Singal AG, Tiro J, Li X
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
This study characterized guideline-concordant hepatocellular carcinoma (HCC) surveillance rates and patient-level factors associated with surveillance among a population-based cohort of patients with cirrhosis. It concluded that, although one third of patients undergo inconsistent HCC surveillance, less than 2 percent of patients receive guideline-concordant biannual HCC surveillance.
AHRQ-funded; HS022418.
Citation: Singal AG, Tiro J, Li X .
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
J Clin Gastroenterol 2017 Aug;51(7):650-55. doi: 10.1097/mcg.0000000000000708.
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Keywords: Cancer, Guidelines, Healthcare Delivery, Patient-Centered Outcomes Research, Practice Patterns
Roydhouse JK, Wilson IB
Systematic review of caregiver responses for patient health-related quality of life in adult cancer care.
The aim of this review is to help cancer researchers select a validated health-related quality of life tool if they anticipate using proxy-reported data. It concluded that the evidence base is strongest for the EORTC (disease-specific tools), COOP/WONCA (generic tools), and MQOL (end-of-life-specific tools).
AHRQ-funded; HS000011.
Citation: Roydhouse JK, Wilson IB .
Systematic review of caregiver responses for patient health-related quality of life in adult cancer care.
Qual Life Res 2017 Aug;26(8):1925-54. doi: 10.1007/s11136-017-1540-6.
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Keywords: Cancer, Caregiving, Patient-Centered Outcomes Research, Quality of Life
Lou I, Chennell TB, Schaefer SC
Optimizing outpatient pain management after thyroid and parathyroid surgery: a two-institution experience.
This study aimed to describe the outpatient narcotic medication needs for patients undergoing thyroid and parathyroid surgery, and to identify predictors of higher requirement. It concluded that overall, 93 percent of patients undergoing thyroidectomy and parathyroidectomy require 20 or fewer oral morphine equivalents by their postoperative visit.
AHRQ-funded; HS023009.
Citation: Lou I, Chennell TB, Schaefer SC .
Optimizing outpatient pain management after thyroid and parathyroid surgery: a two-institution experience.
Ann Surg Oncol 2017 Jul;24(7):1951-57. doi: 10.1245/s10434-017-5781-y.
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Keywords: Cancer, Medication, Pain, Patient-Centered Outcomes Research, Surgery
Iyer AS, Bakitas M
Early palliative care in advanced illness: do right by mama.
This letter describes a case study where the doctor and the family decided not to do aggressive treatment on their mother in her 80’s with metastatic lung cancer and pneumonia. After describing the intubation procedure and the use of mechanical ventilation, the family decided that palliative care was the best option. The doctor emphasizes the use of palliative care as the best outcome for many terminally ill patients.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Bakitas M .
Early palliative care in advanced illness: do right by mama.
JAMA Intern Med 2017 Jun;177(6):761-62. doi: 10.1001/jamainternmed.2017.0764.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Decision Making, Elderly, Palliative Care, Patient-Centered Outcomes Research
Jayadevappa R, Chhatre S, Wong YN
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
This review analyzed the comparative effectiveness of prostate cancer (PCa) treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting and radiation therapy.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Wong YN .
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
Medicine 2017 May;96(18):e6790. doi: 10.1097/md.0000000000006790.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer
Chetta MD, Aliu O, Zhong L
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
This study aims to assess the morbidity associated with various breast reconstruction techniques in irradiated patients. It found that overall complication rates were 45.3 percent and 30.8 percent for patients with implant and autologous reconstruction, respectively. Failure of reconstruction occurred in 29.4 percent of patients with implant reconstruction compared with 4.3 percent of patients with autologous reconstruction.
AHRQ-funded; HS023313.
Citation: Chetta MD, Aliu O, Zhong L .
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
Plast Reconstr Surg 2017 Apr;139(4):783-92. doi: 10.1097/prs.0000000000003168.
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Keywords: Cancer, Cancer: Breast Cancer, Surgery, Adverse Events, Patient-Centered Outcomes Research
Abdelsattar ZM, Hendren S, Wong SL
The impact of health insurance on cancer care in disadvantaged communities.
The extent to which health insurance can mitigate the effects of the social determinants of health on cancer care is unknown. This study of cancer patients diagnosed with the 4 leading causes of cancer deaths between 2007 and 2011 found that patients from disadvantaged communities benefit most from health insurance, and there is a reduction in disparities in outcome.
AHRQ-funded; HS020937; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
The impact of health insurance on cancer care in disadvantaged communities.
Cancer 2017 Apr 1;123(7):1219-27. doi: 10.1002/cncr.30431.
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Keywords: Cancer, Health Insurance, Patient-Centered Outcomes Research, Vulnerable Populations
Dorris K, Liu C, Li D
A comparison of safety and efficacy of cytotoxic versus molecularly targeted drugs in pediatric phase I solid tumor oncology trials.
A systematic review of pediatric phase I solid tumor trials published in 1990-2013 was performed. The published reports were evaluated for patient characteristics, toxicity information, and response numbers. The review concluded that in phase I pediatric solid tumor trials, objective response rates were significantly higher for cytotoxic versus targeted agents. Stable disease rates were similar in targeted and cytotoxic drug trials.
AHRQ-funded; HS022437.
Citation: Dorris K, Liu C, Li D .
A comparison of safety and efficacy of cytotoxic versus molecularly targeted drugs in pediatric phase I solid tumor oncology trials.
Pediatr Blood Cancer 2017 Mar;64(3). doi: 10.1002/pbc.26258.
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Keywords: Patient Safety, Patient-Centered Outcomes Research, Children/Adolescents, Cancer, Medication
Halm EA, Anderson LD, Gerber DE
Understanding the relationship between care volume and clinical outcomes in multiple myeloma.
This editorial discusses an article written by Go et al, entitled Association between treatment facility volume and mortality of multiple myeloma patients, published in the Journal of Clinical Oncology in 2017.
AHRQ-funded; HS022418.
Citation: Halm EA, Anderson LD, Gerber DE .
Understanding the relationship between care volume and clinical outcomes in multiple myeloma.
J Clin Oncol 2017 Feb 20;35(6):580-82. doi: 10.1200/jco.2016.70.4726..
Keywords: Cancer, Mortality, Outcomes, Patient-Centered Outcomes Research
Arvold ND, Cefalu M, Wang Y
Comparative effectiveness of radiotherapy with vs. without temozolomide in older patients with glioblastoma.
It is unknown whether the addition of temozolomide (TMZ) to radiotherapy (RT) is associated with improved overall survival among older glioblastoma patients. This study found that among a large cohort of older glioblastoma patients treated in a real-world setting, the addition of TMZ to RT was associated with a small survival gain.
AHRQ-funded; HS021991.
Citation: Arvold ND, Cefalu M, Wang Y .
Comparative effectiveness of radiotherapy with vs. without temozolomide in older patients with glioblastoma.
J Neurooncol 2017 Jan;131(2):301-11. doi: 10.1007/s11060-016-2294-7.
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Keywords: Cancer, Comparative Effectiveness, Elderly, Medication, Patient-Centered Outcomes Research
Goodwin JS, Zhou J, Kuo YF
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
The researchers compared the risk of jaw osteonecrosis after intravenous (IV) bisphosphonate administered to patients with cancer vs patients without cancer. During follow-up, 40 (0.42 percent) out of 9,482 patients with cancer developed probable jaw osteonecrosis compared with 8 (0.05 percent) out of 16,046 patients without cancer.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Zhou J, Kuo YF .
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
Mayo Clin Proc 2017 Jan;92(1):106-13. doi: 10.1016/j.mayocp.2016.09.015.
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Keywords: Cancer, Osteoporosis, Risk, Medication, Patient-Centered Outcomes Research
Patel HD, Iyoha E, Pierorazio PM
A systematic review of research gaps in the evaluation and management of localized renal masses.
The authors conducted a systematic review to summarize research gaps for the evaluation of composite models for predicting malignancy; use of percutaneous renal sampling for diagnosis; and comparative effectiveness of surgery, thermal ablation, and active surveillance. They recommended incorporation of emerging biomarkers into validated composite models, standardization of biopsy protocols, standard reporting of clinical stage, and performance of prospective studies with objective selection criteria.
AHRQ-funded; 290201200007I.
Citation: Patel HD, Iyoha E, Pierorazio PM .
A systematic review of research gaps in the evaluation and management of localized renal masses.
Urology 2016 Dec;98:14-20. doi: 10.1016/j.urology.2016.08.013.
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Keywords: Cancer, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Indicators (QIs), Research Methodologies
LeBlanc TW, Ritchie CS, Friedman F
Adherence to measuring what matters items when caring for patients with hematologic malignancies versus solid tumors.
The authors sought to assess adherence to Measuring What Matters (MWM) measures by palliative care clinicians caring for patients with hematologic malignancies, compared to those with solid tumors. They found that MWM adherence regarding symptom assessment and meeting emotional needs was lower for patients with hematologic malignancies compared to those with solid tumors. They concluded that this finding suggests two key areas for quality improvement initiatives in palliative care for patients with hematologic malignancies.
AHRQ-funded; HS023681; HS022763.
Citation: LeBlanc TW, Ritchie CS, Friedman F .
Adherence to measuring what matters items when caring for patients with hematologic malignancies versus solid tumors.
J Pain Symptom Manage 2016 Dec;52(6):775-82. doi: 10.1016/j.jpainsymman.2016.09.004.
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Keywords: Cancer, Quality of Care, Palliative Care, Patient-Centered Outcomes Research, Quality Measures
Wang SY, Hsu SH, Gross CP
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
The purpose of this paper is to examine the association between time since cancer diagnosis and health-related quality of life (HRQOL) among cancer survivors in remission. The researchers found that most cancer survivors did not experience poorer mental health, but that survivors of prostate or cervical cancer had lower mental component summary scores after 10 years of diagnosis. They concluded that the level of HRQOL among cancer survivors depends on time since cancer diagnosis and cancer type.
AHRQ-funded; HS023900.
Citation: Wang SY, Hsu SH, Gross CP .
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
Value Health 2016 Jul-Aug;19(5):631-8. doi: 10.1016/j.jval.2016.02.010.
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Keywords: Cancer, Diagnostic Safety and Quality, Health Status, Patient-Centered Outcomes Research, Quality of Life
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Dinan MA, Li Y, Zhang Y
Resource use in the last year of life among patients who died with versus of prostate cancer.
The researchers conducted a retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data of men with prostate cancer. Patients who died of prostate cancer rather than from other causes had more hospice and outpatient use, less inpatient and ICU use, and lower overall costs. Efforts to shift care toward outpatient settings might provide more efficient and judicious care for patients during the end of life.
AHRQ-funded; HS022189.
Citation: Dinan MA, Li Y, Zhang Y .
Resource use in the last year of life among patients who died with versus of prostate cancer.
Clin Genitourin Cancer 2016 Feb;14(1):28-37.e2. doi: 10.1016/j.clgc.2015.07.006.
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Keywords: Cancer, Cancer: Prostate Cancer, Healthcare Costs, Healthcare Utilization, Men's Health, Mortality, Palliative Care, Patient-Centered Outcomes Research
Poonawalla IB, Piller LB, Lairson DR
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
The researchers sought to determine the effectiveness of erythropoietin-stimulating agent (ESA) and granulocyte colony-stimulating factor (CSF) in reducing blood transfusion needs and neutropenia incidence in community-dwelling elderly ovarian cancer patients. They found that erythropoietin-stimulating agents were effective in reducing blood transfusion need. Granulocyte colony-stimulating factors were effective in lowering neutropenia incidence and also were associated with improved survival in elderly ovarian cancer patients.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
Int J Gynecol Cancer 2016 Jan;26(1):95-103. doi: 10.1097/igc.0000000000000564.
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Keywords: Cancer, Treatments, Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research
Dimou F, Sineshaw H, Parmar AD
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
The researchers described treatment patterns and time trends with regard to age and treatment center in the receipt of multimodality therapy for early-stage pancreatic cancer. They concluded that despite increased use of multimodality therapy, it remains underutilized in all patients and especially in older patients. Receipt of multimodality therapy and neoadjuvant therapy is highly dependent on treatment at NCI-designated cancer centers.
AHRQ-funded; HS022134.
Citation: Dimou F, Sineshaw H, Parmar AD .
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
J Gastrointest Surg 2016 Jan;20(1):93-103; discussion 03. doi: 10.1007/s11605-015-2952-7.
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Keywords: Cancer, Disparities, Practice Patterns, Elderly, Patient-Centered Outcomes Research