Evidence map›Paper›PMID 36479547›Full record

ArticlePalliative medicine reports2022

Preferences and Attitudes of Cardiologists in Management of Patients with Cancer.

Ibrahim Azar, Stephani Wang, Vikram Dhillon, Jacqueline Kenitz, Dawn Lombardo, Roderick Deano, Syed Mahmood, Hirva Mamdani, Anthony F Shields, Philip Agop Philip and 2 more

Open access · goldAbstract read
In one paragraph

Article in Palliative medicine reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Ibrahim AzarDivision of Hematology-Oncology, Department of Medicine, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.ORCID https://orcid.org/0000-0002-1008-1807
Stephani WangDivision of Cardiology, Department of Medicine, University of California, Irvine, California, USA.
Vikram DhillonDivision of Hematology-Oncology, Department of Medicine, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.
Jacqueline KenitzDivision of Cardiology, Department of Medicine, Albany Medical College, Albany, New York, USA.
Dawn LombardoDivision of Hematology-Oncology, Department of Medicine, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.
Roderick DeanoDivision of Cardiology, Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA.
Syed MahmoodDivision of Cardiology, Department of Medicine, Weill Cornell Medical Center, New York, New York, USA.
Hirva MamdaniDivision of Hematology-Oncology, Department of Medicine, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.
Anthony F ShieldsDivision of Hematology-Oncology, Department of Medicine, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.
Philip Agop PhilipDivision of Hematology-Oncology, Department of Medicine, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.
Michael StelliniDivision of Palliative Care, Department of Medicine, Wayne State University and Karmanos Cancer Institute, Detroit, Michigan, USA.
Joshua Schulman-MarcusDivision of Cardiology, Department of Medicine, Albany Medical College, Albany, New York, USA.
The Barbara Ann Karmanos Cancer Institute · USAlbany Medical Center Hospital · USCornell University · USUniversity of California, Irvine · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: With recent improvements in survival of cancer patients and common use of high-value care at end of life, the management of cardiovascular disease (CVD) in patients with cancer is increasingly important. To our knowledge, there are no current U.S. data examining how the presence and extent of cancer influence cardiologists' decision making for common cardiovascular conditions. Methods: An anonymous online vignette-based survey of cardiologists was conducted at five U.S. institutions investigating how the extent of gastrointestinal and thoracic malignancies (prior/localized, metastatic) would influence treatment recommendations for atrial fibrillation (AF), aortic stenosis, unstable angina (UA), and obstructive coronary artery disease (CAD). Results: Thirty-three percent (86/259) of cardiologists completed the survey between September and November 2019. Participants were 67% male, 51% below age 40, and 58% had five or more years of clinical experience. Majority of cardiologists practiced at teaching hospitals (72%) and were noninterventional (63%). Cardiologists were more likely to recommend procedural interventions for patients with localized cancer than for those with metastatic disease: AF (left atrial appendage occlusion: 20% vs. 8%), atrial stenosis (aortic valve repair: 83% vs. 11%), UA (left heart catheter: 70% vs. 27%), and obstructive CAD (percutaneous coronary intervention: 81% vs. 38%). In patients with metastatic cancer, most cardiologists sought an oncology (82%) or a palliative care (69%) consultation. However, a persistent trend of undertreatment in patients with localized cancers and overtreatment in patients with end-of-life disease was apparent. Conclusions: Cardiologists were less likely to recommend invasive cardiovascular therapies to patients with metastatic cancer. This preference pattern likely reflects the influence of comorbidities and quality of life expectation on cardiologists' treatment recommendations but may also be related to the stigma of advanced cancer. Better communication between cardiologists and oncologists is necessary to provide a personalized care of patients with cancer and CVD that would maximize treatment benefit with least morbidity.

Indexed as

cardio-oncologyhigh value carephysician communication

Identifiers

PMID36479547
PMCPMC9712055
OpenAlexW4309531785

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.