Malignant Digestive System Neoplasm, Malignant Female Reproductive System Neoplasm, Malignant Genitourinary System Neoplasm
Conditions
Brief summary
This study evaluates the use of extended venous thromboembolism prophylaxis (ePPx) following abdominopelvic cancer surgery within the NCI Community Oncology Research Program (NCORP) network, targeting surgeons and surgical advanced practice providers (APPs).
Detailed description
PRIMARY OBJECTIVE: I. To evaluate self-reported utilization of guideline concordant extended venous thromboembolism (VTE) prophylaxis (ePPx) following abdominopelvic cancer surgery within a sample of surgeons practicing within NCORP based on the Part 1 surgeon survey. SECONDARY OBJECTIVES: I. Evaluate site factors (e.g., proportion of publicly insured patients, proportion of Black patients, presence of a medical school, NCI designation) and surgeon factors (e.g., fellowship training, years in practice) associated with surgeon self-reported guideline concordant ePPx utilization (Part 1). II. Conduct semi-structured interviews among a subset of surgeons and surgical APPs to assess: 1) Barriers/facilitators toward ePPx after cancer surgery and 2) Acceptability of clinical decision support tools to support VTE prophylaxis prescribing (Part 2). III. Extract EHR data from select practices to assess the feasibility of query-based electronic health record (EHR) data extraction for identification of (i) patients undergoing cancer surgery, and (ii) prescription of guideline concordant ePPx among eligible patients (Part 3). OUTLINE: This is an observational study. PART 1: Surgeons and APPs complete a survey on study. After completion of surgeon or APP survey, site contact person or Cancer Care Delivery Research (CCDR) lead complete site surveys on study. PART 2: A subset of surgeons and APPs from part 1 complete a semi-structured interview on study. PART 3: Site contact person or CCDR lead complete a survey to identify a EHR Report Specialist on study. EHR Report Specialist performs an EHR Data Extraction and provides feedback on the process in a survey.
Interventions
OTHERNon-Interventional Study
Non-interventional study
Sponsors
Wake Forest University Health Sciences
National Cancer Institute (NCI)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
SURGEON ELIGIBILITY CRITERIA FOR OPEN STEP 0 ENROLLMENT: \* Any surgeon performing gastrointestinal, genitourinary, or gynecologic cancer surgery within an NCORP site, including general surgeons, surgical specialists, urologists, and gynecologists. Surgeons do not need to be involved in research or have a Cancer Therapy Evaluation Program Identification (CTEP ID) to participate in this study SURGICAL APP ELIGIBILITY CRITERIA FOR OPEN STEP 0 ENROLLMENT: \* APPs providing postoperative care to patients operated by surgeons performing gastrointestinal, genitourinary, or gynecologic cancer surgery within an NCORP site, including general surgeons, surgical specialists, urologists, and gynecologists. Surgical APPs do not need to be involved in research or have a CTEP ID to participate in this study SURGEON ELIGIBILITY CRITERIA FOR OPEN STEP 1 ENROLLMENT: \* Must have completed the STOP-VTE Survey - Surgeon electronically (preferred) or on paper and have it transferred to Research Electronic Data Capture (REDCap) by the contact person(s) SURGICAL APP ELIGIBILITY CRITERIA FOR OPEN STEP 1 ENROLLMENT: \* Must have completed the STOP-VTE Survey - APP electronically (preferred) or on paper and have it transferred to REDCap by the contact person(s) SITE ELIGIBILITY PART 1-SITE ENROLLMENT IN OPEN: \* Have at least one eligible surgeon or surgical APP who completed the STOP-VTE Survey - Surgeon/APP
Exclusion criteria
* N/A
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-reported utilization of guideline concordant ePPx for surgeons (Part 1) | After 1 year from start of Part 1 | Will apply only to surgeons completing the Part 1 survey. Will be defined as answering "Yes, all cases or almost all cases" on the survey question asking about prescription of ePPx after discharge. The proportion of surgeons self-reporting utilization of guideline concordant ePPx will be estimated and reported along with an exact 95% confidence interval. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Self-reported utilization of guideline concordant ePPx for surgeons within strata defined by site and surgeon factors (Part 1) | After 1 year from start of Part 1 | Self reported utilization as defined above for the primary outcome measure will be reported within strata defined by: * Site factors (e.g., proportion of publicly insured patients, proportion of Black patients, presence of a medical school, NCI designation) * Surgeon factors (e.g., fellowship training, years in practice) |
| Barriers and facilitators toward ePPx after cancer surgery, and acceptability of clinical decision support tools to support VTE prophylaxis prescribing (Part 2) | After 6 months from start of Part 2 | Themes from qualitative interviews by surgeons and APPs |
| Feasibility (i.e., proportion of practices able to provide data) of EHR queries from selected practices to inform future trial (Part 3) | After 6 months from start of Part 3 | Considered feasible if at least 4 of the 6 practices who agreed to participate are able to provide data on both patients undergoing cancer surgery and prescription of guideline concordant ePPx among eligible patients |
Countries
Puerto Rico, United States
Contacts
CONTACTKaren Craver
STUDY_CHAIRGlenn Lesser, MD
Wake Forest University Health Sciences
Outcome results
None listed