ABSTRACT
INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic has limited in-person opportunities such as away rotations and residency interviews within academic urology. Twitter may serve as a vital tool mitigating these barriers and expanding the field. Our study aims to re-evaluate Twitter usage among academic urology programs in 2020 compared to 2009-2019. METHODS: We evaluated 83,000 tweets from 113/133 U.S. academic urology program twitter accounts during 2009-2020 through the Application Programming Interface on April 2, 2021. Text patterns were interpreted as positive, neutral, or negative via sentiment analysis. Tweets, number of followers, @mentions, hashtags, and account creations were analyzed. We captured word cloud (visualization of most frequent words) and trigram (most frequent three-word combinations) analysis. RESULTS: Our data revealed that 2020 depicted a record number of tweets (22,544) and account creations (23). For all programs, the median (IQR) number of tweets and followers was 1,748 (872- 3,051) and 2,201 (1,509-3,956). The University of North Carolina (8,707) tweeted the most. However, Johns Hopkins (5,365) had the most followers. The most frequently mentioned account in both 2009- 2019 and 2020 was the American Urological Association (@americanurological). @uro-res and @uroresidency ranked higher in 2020 than previously. Compared to 2009-2019, positive sentiment increased by 3%, while negative decreased by 2%. Word cloud analysis identified urology and resident as the most prominent words in 2020, shifting from urology and cancer (2009-2019). Trigram analysis revealed 2009-2019 tweets pertained around (risk, prostate, cancer) whereas 2020 tweets revolved around (virtual, open, house), suggesting a context shift to program recruitment. CONCLUSIONS: Our novel findings reveal that urology programs are capitalizing Twitter to promote residency recruitment and education via increased tweets and account creations, which will have far-reaching implications on urology's future.
ABSTRACT
INTRODUCTION AND OBJECTIVE: Minority communities disproportionately shouldered poor COVID-19 outcomes, however the impact of the pandemic on prostate cancer (PCa) surgery is unknown. To that end, we sought to determine the racial impact on PCa care during the first wave of the pandemic. METHODS: Using a multi-institutional collaborative we evaluated practice patterns for Black and White patients with untreated non-metastatic PCa during the initial COVID-19 lockdown (March-May 2020) compared to prior (March-May 2019). Patient and practice characteristics were compared by race using Fisher's exact and Pearson's chi-square to compare categorical variables and Wilcoxon rank sum to evaluate continuous covariates. We determined the covariate-adjusted impact of year and race on surgery, using logistic regression models with a race year interaction term. RESULTS: Among the 647 men with non-metastatic PCa, 269 received care during the pandemic and 378 prior. Surgery was significantly less likely in Black men (1.3% v 25.9%;p<0.001), despite similar COVID-19 risk factors, biopsy Gleason grade group, and comparable surgery rates prior (17.7% vs. 19.1%;p=0.75). Black men had higher PSA (8.8 vs. 7.2 p=0.04) and were younger (38.2% vs. 24.4% <60 yr;p=0.09). Regression results demonstrated an 94% reduced odds of surgery (OR=0.06, 95% CI 0.007-0.43;p=0.006) for Black patients, with no change for White patients (OR=1.41, 95% CI 0.89-2.21;p=0.142), after adjusting for covariates. Changes in surgical volume varied by site (33% increase to complete shutdown), with sites that experienced the largest reduction in cancer surgery, caring for a greater proportion of Black patients (figure). CONCLUSIONS: In a large multi-institutional regional collaborative, odds of prostatectomy declined only among Black patients during the initial wave of the COVID-19 pandemic. While localized prostate cancer does not require immediate treatment, this study illuminates systemic inequities within healthcare. Public health efforts are needed to fully recognize the unintended consequence of diversion of cancer resources to the pandemic in order to develop balanced mitigation strategies as viral rates continue to fluctuate.
ABSTRACT
Objective: In early 2020, our research teams at Northwestern University, NorthShore University HealthSystem, University of Michigan, and Fox Chase Cancer Center prepared to launch the final year of interventions for an NCI-funded RCT titled REASSURE ME (R01 CA193331). This study examines the extent to which training in mindfulness helps men diagnosed with prostate cancer on active surveillance and their partners be able to cope with the uncertainties of this treatment approach. Challenges associated with COVID-19 and shelter-in-place orders abruptly halted in-person study activities, prompting our team to quickly pivot and rethink how best to proceed. Methods: Our strategy consisted of four primary components:( 1) examining COVID-19's impact on the research (what affect, if any, it had on the study's purpose, design, procedures, findings);(2) re-evaluating plans underway before COVID-19 struck (including recruitment, interventions, data collection, multisite communications);(3) determining if video-conferencing would be a viable delivery solution, and if so, how to adapt content for that platform;and (4) identifying best resources/practices for the virtual environment. Results: Preparations for an additional year of the study included: (1) holding site meetings to determine funding needs, (2) requesting an NIH no-cost extension, and (3) submitting modifications to each site's Institutional Review Board. Procedural changes/additions included: (a) online intervention trainings and creation of tutorial aids for the research team;(b) video-conferencing training sessions, tutorial aids, and ongoing technical assistance for research participants;(c) development of online versions of the treatment and control interventions;(d) postal delivery of paper-based intervention materials/supplies to research participants;(e) electronic/postal qualitative data collection;and (f) establishing a coordinating assistant to be on call for intervention facilitators during sessions. Conclusion: The unprecedented constraints of COVID-19 presented our team with the opportunity to re-envision and develop a new approach for online delivery of mindfulness that can be used by future researchers.