ABSTRACT
Background: Sarcomas are rare cancers with complex diagnoses, requiring multimodal management in referral Centers with a dedicated Disease Multidisciplinary Team (DMT). COVID-19 pandemic imposed a sudden revolution in care management leading to activation of digital health tools such as virtual DMT meetings. We investigated how transition from face-to-face (FTF) to virtual meetings (VM) impacted clinical practice in a Sarcoma referral Center in Italy. Method(s): An online survey was administered to the participants of the Sarcoma DMT meetings held between 2020 and 2022 at Regina Elena National Cancer Institute of Rome. The survey consisted of 40 questions inquiring the experience of professionals in DMT meetings, opinions about FTF/VM, future perspectives. Moreover, we retrospectively analyzed the registries of DMT meetings held from March 9th 2019 to March 8th 2022 and we defined three 12-months periods by using the date of National lockdown beginning in Italy (March 9th 2020) as cutoff: a pre-covid, a covid, a post-covid phase. Result(s): A total of 22 healthcare professionals answered the survey: 18 medical doctors, 1 psychologist and 3 data/case managers. The most important changes in VM were better quality of clinical approach and research (22%), technological innovation (50%), and better logistical setting (95%). Between participants, 90% were highly/moderately satisfied with the depth of discussion, 100% declared that attendance was similar (68%) or increased (32%) compared to FTF, 86% thought that decision-making process was not affected, and 95% were still able to interact adequately and access relevant patients' data. 91% thought that VM could be approved hereafter and 100% that would facilitate DMT expansion globally. The median participation rate in Institutional Sarcoma DMT meetings was 58% (95% confidence interval (CI) 55%-60%), 62% (95% CI 48%-71%), and 64% (95% CI 61%-68%) respectively in the pre-covid, covid, and post-covid periods (p 0.0159). Compared to the re-discussed cases, the new ones rose from 30.1% in the pre-covid to 37.9% in the covid and 42.3% in the post-covid period (p<0.0001). Conclusion(s): VM guarantees a great standard of effectiveness in health assistance and should be a suitable or additional tool for the management of patients in clinical practice. Legal entity responsible for the study: IRCCS Regina Elena National Cancer Institute (IRE). Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest.Copyright © 2023 European Society for Medical Oncology
ABSTRACT
Background: Sarcomas are extremely rare and disabling tumours causing physical impairments as well as psychological issues. The Health-related quality of life (HRQoL) in these patients (pts) is impaired as a consequence of their illness and its treatments. It is widely demonstrated the harmful impact of covid19 pandemic and its effects on the HRQoL of the general population and especially on cancer pts. We investigated this important aspect in sarcoma pts. Material (patients) and Methods: We performed a retrospective observational study including pts with diagnosis of soft tissue (STS) and bone sarcoma (BS) referred to Regina Elena National Cancer Institute in Rome and with histological diagnosis obtained during the year preceding (Control group-Ctg) or following (Covid group-Covg) the start of covid19 lockdown in Italy (March 9th 2020). Patients were evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), with scores analysed as continuous scales, and with the Distress Thermometer (DT), where the pts were accounted for as having low/ absent (score 0-4) or high distress (5-10). Result(s): We enrolled a total of 115 pts, 76 in the Ctg and 39 in the Covg;43 women and 72 men. Median age was 55 years (range 94-21). In the Ctg and in the Covg respectively, the most common diagnosis was STS (N=52 vs 27) followed by BS (N=24 vs 12). Most pts had a localized disease at diagnosis (N=64 vs 34) and only 17 (N=12 vs 5) had distant metastasis. The first treatment received was surgery in 75 pts (N=52 vs 23), chemotherapy in 30 pts (N=18 vs 12), concomitant chemo-radiotherapy in 4 pts (N=3 vs 1), and 6 pts (N=3 vs 3) had a follow-up strategy. In the Covg, compared with the Ctg, we found a decline in Social functioning (average score (mu)=81,64;SD=30,54 vs 91,38;SD=16,24 respectively;p=0,027) as well as an increase in financial difficulties (mu=11,95;SD=22,31 vs 3,93;SD=13,29;p=0,017) and increased nausea (mu=5,13;SD=13,31 vs 1,12;SD=4,24;p=0,018). We also found a higher rate of patients with emotional distress in the Covg (50% vs 71,8% p=0,025). Worsening, although not statistically significant, was observed in almost all questionnaire domains. Conclusion(s): Our study suggests that the covid19 pandemic had a detrimental effect on HRQoL in sarcoma patients. This study makes an effort on the strong need of improvement psychological support for both emotional and physical effects in our pts.
ABSTRACT
Quality technical education on healthcare technologies is still inaccessible to young adults in low-resource settings due to high costs, low-tech environments, and gaps in learning materials. The online and open-source collaborative Project-Based Learning (PBL) methodology intends to introduce early-career engineers into the development of healthcare technologies by allowing students from all around the world, regardless of background or place of origin, to engage in collaborative design methods, the use of open-source resources and learning experiences from experts in the field. This paper discusses a case study in which the aforementioned methodology was implemented, the "COVID-19 Innovation Competition and Design Bootcamp 2020", which brought together 105 participants from 22 countries, mostly in Africa, to conceptualize the design of 10 medical devices in two weeks for an integral management of the COVID-19 pandemic that is applicable to other infectious disease outbreaks. The presented experience demonstrates that highly formative virtual PBL experiences can be carried out, in a cost-effective way and in connection with real societal needs, for which remarkable solutions can be found, by virtue of multidisciplinary and international cooperation. Our findings demonstrate that even if it is difficult to reach the degree of project completion achievable with longer-term and on-site design-build experiences, on-line PBL has been shown to promote students' professional skills in an effective way.