What StudentsWant to Have in the Post-Pandemic?: A Study about Computing Science Study Preferences and Mode of Study in Southeast Asia

After two years of online learning, minor changes happened in some tiny places which we may not always notice. These changes may impact the school management, education arrangement, and curriculum design: what do students expect from their teachers, and the school? Are they expecting forever online learning, and getting their degree completely online? In this study, we examined 93 final-year students from the school of computing science which mainly used work-based learning applied to learn pedagogy. We analyze their viewpoint on how COVID-19 changed their understanding of teaching and learning: what is the role of teachers and students? And how do they see the arrangement for the internship program? We found that over 92% of students agree that a creditable degree can better secure a job;over 68% of the students believed that face-to-face teaching is still a better choice, but at the same time, over 73% wish to have the materials recorded so that they can access them at their convenience time. We also examined some of the course design elements, especially those related to the internship program, to achieve a possible curriculum improvement for the students in the Asia Pacific region. © 2022 ACM.

Can tourism development and economic growth mutually reinforce in small countries? Evidence from Singapore

This study investigates the causal relationships between international tourism development and the economic growth of a global city-state - Singapore - drilling into the temporal details of the tourism-economy nexus in small countries. Many studies have examined whether the tourism-led growth hypothesis or the economy driven-tourism growth hypothesis holds in large developed and emerging countries. Still, relatively few studies examine small countries' tourism-economy nexus, and the temporal details of the nexus have not been adequately examined. We examine the tourism-economy nexus in Singapore using quarterly data from 1991Q1 to 2020Q4 and the Autoregressive Distributed Lag (ARDL) Model, with the long- and short-run dynamics and the feedback loop of the nexus considered. Our statistical findings show that international tourism development leads economic growth by two quarters in Singapore. Also, there are both 'consistent' and 'contemporaneous' positive feedback loops between tourism development and economic growth, but those loops cannot last for more than a quarter. From the economic perspective, our study reveals that improving tourism activities may accelerate the post-Covid economic recovery of some small countries that rely on tourism. Yet, continuous input is required to sustain the tourism-economy synergy.

Does work from home reshape the urban rental structure? Early evidence from a rental gradient analysis in Auckland

Purpose: This study aims to identify the pandemic's impact on house rents by applying a rental gradient analysis to compare the pre-and post-COVID-19 periods in Auckland. The micro-level household census data from the Integrated Data Infrastructure of Statistics New Zealand is also applied to scrutinise this WFH trend as a robustness check. Design/methodology/approach: Since the outbreak of COVID-19, work-from-home (WFH) and e-commerce have become much more common in many cities. Many news reports have contended that households are leaving city centres and moving into bigger and better houses in the suburbs or rural areas. This emerging trend has been redefining the traditional theory of residential location choices. Proximity to central business district (CBD) is no longer the most critical consideration in choosing one's residence. WFH and e-commerce flatten the traditional bid rent curve from the city centre. Findings: The authors examined micro-level housing rental listings in 242 suburbs of the Auckland Region from January 2013 to December 2021 (108 months) and found that the hedonic price gradient models suggest that there has been a trend of rental gradient flattening and that its extent was almost doubled in 2021. Rents are also found to be increasing more in lower-density suburbs. Research limitations/implications: The results imply that the pandemic has accelerated the trend of WFH and e-commerce. The authors further discuss whether the trend will be a transient phenomenon or a long-term shift. Practical implications: Suppose an organisation is concerned about productivity and performance issues due to a companywide ability to WFH. In that case, some standard key performance indicators for management and employees could be implemented. Forward-thinking cities need to focus on attracting skilful workers by making WFH a possible solution, not by insisting on the primacy of antiquated nine-to-five office cultures. Social implications: WFH has traditionally encountered resistance, but more and more companies are adopting WFH policies in this post-COVID era. The early rental gradient and the micro-level household data analysis all confirm that the WFH trend is emerging and will likely be a long-term shift. Instead of resisting the change, organisations should improve their remote work policies and capabilities for this WFH trend. Originality/value: So far, empirical studies of post-COVID urban restructuring have been limited. This study aims to empirically test such an urban metamorphosis by identifying the spatial and temporal impacts of COVID on house rental gradients in the Auckland Region, New Zealand. The authors apply rental gradient analysis to test this urban restructuring hypothesis because the method considers the spatial-temporal differences, i.e. a difference-in-differences between pre-and post-pandemic period against the distance measured from the city centre. The method can control for the spatial difference and the endogeneity involved. © 2023, Emerald Publishing Limited.

The effect of clinical face shields on aerosolized particle exposure

Background: Face shields protect healthcare workers (HCWs) from fluid and large droplet contamination. Their effect on smaller aerosolized particles is unknown. Materials & methods: An ultrasonic atomizer was used to simulate particle sizes equivalent to human breathing and forceful cough. Particles were measured at positions correlating to anesthetic personnel in relation to a patient inside an operating theatre environment. The effect of the application of face shields on HCW exposure was measured. Results & Conclusion: Significant reductions in particle concentrations were measured after the application of vented and enclosed face shields. Face shields appear to reduce the concentration of aerosolized particles that HCWs are exposed to, thereby potentially conferring further protection against exposure to aerosolized particles in an operating theatre environment.

Single staged treatment of a complex full thickness debridement for hidradenitis suppurativa using NovoSorb Biodegradable Temporizing MatrixTM

Treatment of full skin thickness loss due to surgical debridement for difficult wound beds like necrotizing fasciitis and hidradenitis suppurativa (HS) is commonly treated using wide local excision and split-thickness-skin grafting or muscle flaps. Unfortunately, this strategy often leaves large soft tissue defects and can be complicated by infection and poor graft take, resulting in additional surgeries. Novel approaches using acellular dermal substitutes along with skin grafting are treatment options with favorable cosmetic outcomes and improve functionality by reducing contractures. However, patient non-compliance and various complications such as complex wound care, infection, product fragility and financial implications have contributed to a lack of widespread adaptation. NovoSorb Biodegradable Temporizing Matrix (BTMTM) has been demonstrated to function as a dermal scaffold that has robust handling characteristics and requires minimal wound care. This case report describes the treatment course of a high-risk patient with poor nutrition and a history of a 20 pack-year tobacco smoking, methamphetamine use, phencyclidine use, and marijuana use with recurrent and widespread axillary, inguinal, and gluteal HS. This patient was treated using NovoSorb BTMTM as the primary dermal substitute without subsequent grafting to cover a 400 cm2 left gluteal excision due to patient non-compliance. The covered area subsequently spontaneously epithelized after six months of local home health care during the COVID-19 pandemic. Our results show promise for future use of NovoSorb BTMTM to serve as a single stage surgery option to complete wound healing in high-risk patients. Copyright © 2022 The Authors

Lightweight CNN-Based Deep Neural Networks Application in Safety Measurement

Inspired by the face covering period in the past two years, COVID-19 pandemic has resulted in the mandate of public safety measures such as face mask-wearing in many countries. This paper provides a preliminary feasibility planning on how Artificial Intelligence (AI), Computer Vision (CV) and the Internet of Things (IoT) can work together to implement a face-mask detection system as a public health safety solution. This paper reviews how edge computing can overcome traditional cloud computing issues. This work also examines the current state of computer vision, convolutional neural networks and their potential application in the health and safety domain. This writing serves as an interim report on how the lightweight CNNs and single-shot detectors such as YOLOv5 variants with SSD to train and deploy an object detection system. © 2022 IEEE.

Endocrinologists’ Experiences with Telehealth: Organizational and Logistical Issues with Implementation

Objective: Telehealth use rapidly increased during the COVID-19 public health emergency. While this preserved safe access to care, there was insufficient time to optimize telehealth implementation for its clinical users. We sought to understand endocrinologists’ experiences with synchronous telehealth to identify factors that influence successful implementation and can promote sustained use. Methods: We conducted semi-structured qualitative interviews with a purposive sample of 26 US endocrinologists. We asked about their experiences with telehealth, administrative and organizational factors, and technology-related issues. We also asked for recommendations for supporting clinicians’ continued telehealth use post-pandemic. We used a directed content analysis and rapid coding approach to identify factors affecting telehealth experiences. We noticed close alignment with and mapped findings to the human-organization-technology fit (HOT-fit) framework, which recognizes human, organizational, and technological factors as common elements influencing health information system implementation. Results: We identified the following clinician, organizational, and technology factors from the HOT-fit framework that influenced successful use of telehealth.1) Clinician Factors: Negative attitudes towards telehealth, including resistance towards the technology or concerns that older patients struggle with it, were initial barriers to uptake. However, attitudes were malleable over time. After initial adjustment and training, most clinicians reported enjoying and seeing value in telehealth, and planned to continue using a combination of in-person and telehealth. Although many clinicians voiced fears of missing clinical issues, none reported overlooking findings that would change treatment plans. Clinicians found both benefits and burdens associated with telehealth;flexible scheduling improved work-life balance but some also noted increasing workload.2) Organizational Factors: Clinicians felt most supported in organizations that provided training and technology support for both patients and themselves, attending to technical, logistical, and clinical needs. Telehealth was less stressful when support staff were reallocated to streamline workflow with ancillary tasks. Scheduling practices affected clinician experience: mixed clinics with in-person and telehealth visits combined with overbooking often exacerbated workflow challenges. Payment policies and parity of telehealth and in-person visits were key factors encouraging clinicians’ continued telehealth use.3) Technology factors. Almost all clinicians preferred video visits over those by phone. However, clinicians sought improvements in usability and reliability of platforms for video visits and data sharing. Robust IT support in real time reduced the burden associated with using visit time to perform tech support. Conclusions: Favorable clinician perceptions of telehealth are critical for sustained use. Clinicians initially approached telehealth at varied stages of acceptance and comfort. Perceptions of telehealth can improve with personal experience and organizational efforts that address individual training needs, adequate support staffing, tech support, and efficient workflow. Further telehealth implementation strategies by policymakers and health care leaders in endocrinology should address these aspects affecting clinician experience to maximize future success in telehealth adoption and use post-pandemic.Presentation: No date and time listed

Understanding unmet needs after young stroke: A codesign project to develop a screening tool

Background & Aims: Young stroke survivors (YSS) report unmet needs related to age and life stage that stroke services often overlook. Researchers, advisers with lived experience, and clinicians collaborated to develop the "Young Stroke Unmet Needs Screening Tool". Method(s): Mixed-method codesign project conducted in three phases: 1. Literature review conducted and workshop held with 12 advisers (8 YSS, 4 clinicians) to develop initial tool content. 2. Online survey conducted to examine YSS preferences for methods of meeting needs, and gain feedback on tool's usability and content. 3. A version was then developed for people with communication or cognitive impairment using Principles of Supported Conversation for Adults with Aphasia, and cognitive strategies. Semi-structured interviews and focus groups held to further develop and test both versions. Result(s): 171 online survey responses (68% female, mean age 45 years, IQR 36-51). Respondents' demographic and stroke-related characteristics influenced preferences for methods of meeting needs, including face-to-face contact with professionals, peer support and succinct tip sheets. Interviews and focus groups were held online due to COVID, with 20 YSS (age 24-53yrs, 60% reported cognitive impairments and 80% had mild to moderate-severe language limitation), and 10 family members. Recruitment of people with more severe language limitations required personal invitation rather than advertising via social media or stroke groups. The tools include six domains (Body and Mind, Emotions, Information, Daily Life, Relationships, Social) covering 53 potential needs. Also included is a distress thermometer. Use of the tool was strongly endorsed for both versions. Conclusion(s): These new unmet needs screening tools could be used to identify service needs for young stroke survivors, including those with cognitive and/or communication difficulties. The tools are now being used in a large study to identify care pathway requirements, to inform the development of a bespoke health service for young stroke survivors.

Aerosol precautions and airway complications: a national prospective multicentre cohort study.

The perceived risk of transmission of aerosolised viral particles from patients to airway practitioners during the COVID-19 pandemic led to the widespread use of aerosol precautions, including personal protective equipment and modifications to anaesthetic technique. The risk of these aerosol precautions on peri-operative airway complications has not been assessed outside of simulation studies. This prospective, national, multicentre cohort study aimed to quantify this risk. Adult patients undergoing general anaesthesia for elective or emergency procedures over a 96-hour period were included. Data collected included use of aerosol precautions by the airway practitioner, airway complications and potential confounding variables. Mixed-effects logistic regression was used to assess the risk of individual aerosol precautions on overall and specific airway complications. Data from 5905 patients from 70 hospital sites were included. The rate of airway complications was 10.0% (95%CI 9.2-10.8%). Use of filtering facepiece class 2 or class 3 respirators was associated with an increased risk of airway complications (odds ratio 1.38, 95%CI 1.04-1.83), predominantly due to an association with difficult facemask ventilation (odds ratio 1.68, 95%CI 1.09-2.61) and desaturation on pulse oximetry (odds ratio 2.39, 95%CI 1.26-4.54). Use of goggles, powered air-purifying respirators, long-sleeved gowns, double gloves and videolaryngoscopy were not associated with any alteration in the risk of airway complications. Overall, the use of filtering facepiece class 2 or class 3 respirators was associated with an increased risk of airway complications, but most aerosol precautions used during the COVID-19 pandemic were not.

Phase 2, randomized, double-blind trial of EC-18 versus placebo to mitigate the development and time course of oral mucositis from concomitant chemoradiation for head and neck cancer

Background: Oral mucositis (OM) is a debilitating side effect of concomitant chemoradiotherapy (CRT) for head and neck cancer (HNC). EC-18 may effectively mitigate OM by minimizing the CRT-induced innate immune response. This Phase II, 2-stage trial evaluated safety, tolerability, and efficacy of EC- 18 in reducing the duration, incidence, and trajectory of severe OM (SOM) in HNC patients. Methods: Patients (n = 105) with pathologically confirmed oral cavity, oropharynx, hypopharynx, or nasopharynx squamous cell cancers who received intensity-modulated radiation therapy (IMRT;with ≥ 55 Gy on ≥ 2 oral sites) and weekly or tri-weekly cisplatin were studied. In Stage 1, 24 patients were randomized (n = 6 per arm) to receive 500, 1000, or 2000 mg of EC-18, or placebo. Following independent Data Safety Monitoring Board review, 81 patients in Stage 2 received EC-18 2000 mg (n = 41) or placebo (n = 40) throughout CRT. WHO OM grade was assessed twice weekly during IMRT and then once weekly for up to 6 weeks post-IMRT. The primary efficacy endpoint was duration of SOM during the active and short-term follow-up (STFU) periods in the compliant per-protocol population (PP). Much of Stage 2 was conducted during peak periods of the COVID-19 pandemic which measurably impacted patient compliance relative to test medication dosing and planned radiation. Consequently, to assess efficacy most accurately, the PP population was analyzed (with at least 4 weeks of study drug dosing, minimum cumulative radiation of 55 Gy, 80% study drug compliance in the first 28 days of dosing, and without using not-allowed-therapy). Results: Patient demographics and baseline characteristics were balanced between groups. Adverse events (AEs) were comparable amongst cohorts without drug-related severe AEs. In the PP, the median duration of SOM from baseline through STFU was 0 day in the EC-18 group (n = 22) v 13.5 days in the placebo group (n = 20). SOM incidence through STFU (45.5% v 70%) and opioid use (time to onset: 32.3 v 26.0 days;and duration: 32.8 v 37.5 days) favored EC-18 v placebo. Results of the covariates analyses suggested that EC-18 favorably impacted SOM incidence in patients who experienced SOM treated with weekly low-dose cisplatin (n = 26;37.5% v placebo 70.0%) and HPV+ tumors (n = 29;35.3% v placebo 66.7%;Table). One-year long-term follow-up for tumor outcomes is ongoing. Conclusions: EC-18 safely mitigated the development and the time course of SOM in CRT-treated HNC patients. In addition, EC-18 may provide substantial benefits to subpopulations of HPV+ HNC patients treated with low dose cisplatin.

A Remote, Human-in-the-Loop Evaluation of a Multiple-Drone Delivery Operation

Over time, advances in unmanned aircraft systems (UAS) have enabled a shift in the operational paradigm from one operator managing one aircraft to that of multiple operators working together to manage multiple aircraft. This shift has highlighted the need for effective human-autonomy teaming methods to maintain manageable workload levels for operators as well as high standards of system performance and safety. This paper presents a study aimed at evaluating whether automation can help operators manage workload during small UAS (sUAS) package delivery scenarios featuring contingency situations. These contingency situations, resulting from unplanned UAS Volume Reservations (UVRs), required flight path reroutes for multiple aircraft simultaneously. The study manipulated the number of aircraft affected by the UVRs and the level of automation support. The presence of terrain conflicts was also controlled within each scenario. Due to the COVID-19 pandemic, subjects were not able to gain direct access to the Ground Control System (GCS). Therefore, the study was conducted using a subject-surrogate paradigm that required subjects to relay commands through a verbal protocol from remote locations outside of the lab to a researcher surrogate who had direct control of the GCS interfaces at the lab location. Results show that the automated support condition was associated with faster reroute response times, more efficient reroute maneuvers, and significantly lower levels of perceived workload than the manual reroute condition. However, the automation support level did not significantly impact pilots’ ability to avoid the UVR successfully;pilots were overwhelmingly capable of avoiding the UVR in all conditions. The presence of terrain conflicts primarily impacted pilot performance by leading to multiple uploads per vehicle, which was not typically required when pilots only needed to maneuver laterally. Although subjects did not have direct control over the GCS, subjective ratings indicate that the displays under test provided them with sufficient information to manage their aircraft and promptly respond to the unplanned UVRs. Overall, the objective and subjective data strongly suggest that the verbal protocol and subject-surrogate paradigm were effective methods for collecting data remotely amid the COVID-19 pandemic. © 2022, American Institute of Aeronautics and Astronautics Inc, AIAA. All rights reserved.

COVID-19 PANDEMIC IMPACT ON ALCOHOLIC HEPATITIS HEALTHCARE UTILISATION

Background and Aims: Alcoholic hepatitis (AH) is associated with significant morbidity, mortality and healthcare expenditure. The global SARS-CoV-2 (COVID-19) pandemic and related lockdown measures have potentially contributed to an increase in alcohol misuse. This study examines frequency and patient outcomes of AH admissions to an Australian quaternary liver transplant referral centre. We aimed to ascertain the change in AH severity, ICU admission rates and healthcare utilisation costs over the last 5 years to identify temporal associations with the COVID-19 pandemic. Methods: A retrospective analysis of patients aged 18 years and older fulfilling National Institute on Alcohol Abuse and Alcoholism diagnostic criteria for AH between January 2016 and March 2021 was conducted. Data were collected from electronic medical records and analysed. Primary endpoints were the frequency of AH admissions, ICU admission rates and healthcare costs, which were evaluated with a divergence at the beginning of lockdown restrictions (March 2020 – March 2021 “COVID cohort”) versus the “historical cohort” (January 2016 - February 2020). Results: In total, 105 eligible AH admissions were identified. Overall, 90 day mortality was 18% (19/105). AH admission rate for the COVID cohort was significantly higher at 3.38 cases/month (n = 44) compared to the historical cohort at 1.22 cases/month (n = 61), p < 0.001. The COVID cohort had greater disease severity with a higher Glasgow Alcoholic Hepatitis Score during admission [8.5 (IQR 7-10) vs 7 (IQR 6-9), p = 0.04]. The AH COVID cohort trended towards a greater proportion requiring ICU admission, inotropic support and longer ICU length of stay. Whilst per-episode adjusted healthcare costs were similar across the study, monthly costs of the COVID cohort were higher compared to the historical cohort due to increased admission frequencies [mean (SD) ≥137,549 (54,058) vs ≥38,000 (27,448), p = 0.02 (Figure 1)]. No patients in this study were diagnosed with COVID-19. Conclusion: In this study, alcoholic hepatitis admission frequency and healthcare costs were found to have increased since the COVID-19 pandemic. These observations provide the impetus for future studies to understand how the COVID-19 pandemic has led to increased AH presentations and develop preventative strategies that reduce alcohol related admissions and associated costs (Figure Presented)

Quasi-Experimental Study Comparing CBT, MBCT, Activity-Based Supportive Counselling for Hongkong Delinquent Youth

Purpose: This study compared Cognitive-Behavioral Therapy (CBT), Mindfulness-Based Cognitive Therapy (MBCT), and Activity-based Supportive Counselling (treatment-as-usual;TAU) for reducing delinquency, psychological risk factors, mental health symptoms, and improving the quality of life among at-risk youths in Hong Kong outreaching social services. Methods: In this quasi-experimental study, non-custodial youths with delinquency and mental health issues underwent eight sessions of CBT (n = 24), MBCT (n = 30), or TAU (n = 61). Results: Dependent-sample t-test showed CBT reduced mental health symptoms and delinquency. TAU reduced mental health symptoms and improved quality of life. MBCT resulted in no significant change. Time x group ANCOVA underscored TAU in improving quality of life. Hierarchical linear regression showed decreases in delinquency and mental health symptoms mediated by decreases in psychological risk factors. Discussion: Results suggest that outreaching social service agencies in Hong Kong could enhance their intervention by augmenting the sports and leisure activities of TAU with structured CBT programs.

Recruitment to higher specialty training in anaesthesia in the UK during the COVID-19 pandemic: a national survey.

There were more applications for higher specialty training posts in anaesthesia in the UK starting in August 2021 than in previous years, with approximately two-thirds being unsuccessful. We surveyed applicants to investigate their experience of the recruitment process (response rate 536/1056; 51%). Approximately 61% of respondents were not offered ST3 posts (n = 326). We enquired about their career plans for the next 12-24 months. Most respondents (79%) intended to take up a post equivalent to a third year of core training or a clinical fellow post from August 2021. Other options considered included: pursuing work abroad (17%); embarking on career breaks (16%); taking up higher training posts in intensive care medicine (15%); and permanently leaving medicine (9%). Nine per cent of respondents also expressed plans to pursue training in another medical specialty. Some expressed an intention to pursue further education or research (10%). A large proportion (42%) expressed a lack of confidence in being able to achieve the training requirements to later apply for a higher training post. The majority reported not feeling confident in achieving specialist registration in anaesthesia in the future without a training number (75%), and noted disruption to their wider life plans from the impending time out of training (78%). Sentiment analysis of free-text responses indicated generally negative sentiment about the recruitment process. Themes elicited included: feeling the recruitment process was unfair; burnout and negative impact on well-being; difficulties in making life plans; and feeling undervalued and abandoned. These results suggest that junior anaesthetic doctors in the UK negatively perceived postgraduate training structures and changes to the postgraduate curriculum and experienced difficulties in securing higher training.

The social responsibility of data visualisation in a time of pandemic received (In revised form): 28th may, 2021

In a time of pandemic, media platforms and outlets have a social responsibility to make complex data more accessible, understandable and usable. To this end, health organisations and government officials have made extensive use of data visualisations to manage the global COVID-19 crisis. Motivating people to make the necessary behavioural changes, however, requires data to be presented in an appropriately engaging manner. This paper describes effective ways to present data and how to turn complex raw data into actionable insights. © 2021, Henry Stewart Publications. All rights reserved.

A Novel Program Offering Remote, Asynchronous Subspecialist Input in Thoracic Oncology: Early Experience During a Pandemic

Introduction: AccessHope (AH) is a program developed initially by City of Hope to provide remote subspecialist input on cancer care for patients as a supplemental benefit for specific payers and employers. While offering several platforms, the leading one has been an asynchronous model of review of medical records followed by a detailed assessment of past and current management along with discussion of potential future options in a report sent to the local oncologist. The intent of this program is that the patient can continue to have most or all management in their home environment, with the input and support of a subspecialist in that tumor type available “on demand”. This summary describes an early period of development and growth of this service, focusing in cases of lung cancer, particularly relevant during the COVID-19 pandemic. Methods: Appropriate cases for the eligible “at risk” population were identified by a trigger list of cancer diagnoses associated with a significant degree of risk of poor outcomes that included non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Medical records were solicited from the local medical team, from which a summary narrative and chronology was developed by a team of nurses at AH. This was shared with a physician specialist in thoracic oncology from AH who wrote a summary report within several days that was sent to the local physician, followed by a direct discussion with the recipient. Using descriptive statistics, case metrics focusing on concordance with the current or proposed management plan were tracked, along with recommended changes and clinical trial options, as well as potential cost savings from suggested changes. Results: Over a 19-month period from 4/19 through 11/20, 110 cases were reviewed: 55% male, median age 62.5 yrs (range 33-92);82% NSCLC (12% stage I/II, 16% stage III, 57% stage IV) and 17% SCLC (4% limited, 14% extensive). Median turnaround time for send out of report of 5.0 days. The AccessHope review agreed with the proposed or ongoing treatment in 79 (72%) cases and disagreed in 31 (28%) cases. Even with general agreement in the treatment approach, specific additional recommendations were associated with evidence-based anticipated improvements in efficacy in 76 cases (65%) and improvement in potential for cure in 14 cases (12%, only feasible in patients with curable disease). Specific recommendations associated with cost savings were identified in 14 cases (12%), associated with a total cost savings of $2,096,859. Molecular testing was ordered rarely for SCLC;for NSCLC, NGS was strongly favored and more commonly associated with more advanced stage and non-squamous histology. Conclusion: We have implemented a novel program of asynchronous reviews of cases of patients with lung cancer by thoracic oncology subspecialists and have demonstrated the feasibility of completing reports for a growing volume over the course of the pandemic without requiring travel and enabling patients to receive their care close to home. More than a quarter of these case reviews include recommendations associated with evidence to support improved clinical outcomes, as well as potentially significant cost savings from low value practices unsupported by evidence. Keywords: remote care, pandemic, expert review