Evidence map›Paper›PMID 42171813›Full record

Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

Recruitment strategies for a multisite telehealth trial for rural cancer survivors with ostomies.

Robert S Krouse, Stephanie B Wheeler, Scott Appel, Virginia Sun, Matthew E Nielsen, Rebecca L Hoffman, Tullika Garg, Sarah M Popek, Robert P Sticca, Allison A Aka and 4 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Robert S KrouseDepartment of Surgery, University of Pennsylvania Perelman School of Medicine, Leonard Davis Institute of Health Policy, Corporal Michael J. Crescenz Veterans Affairs Medical Center, 3400 Spruce St, Philadelphia, PA, 19104, USA. robert.krouse@pennmedicine.upenn.edu.ORCID http://orcid.org/0000-0002-7176-461X
Stephanie B WheelerDepartment of Health Policy and Management, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Scott AppelBiostatistics Analysis Center, University of Pennsylvania, Philadelphia, PA, USA.
Virginia SunDivision of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA.
Matthew E NielsenDepartment of Urology, University of North Carolina, Chapel Hill, NC, USA.
Rebecca L HoffmanDivision of Colorectal Surgery, Geisinger Medical Center, Danville, PA, USA.
Tullika GargDepartment of Urology, Geisinger Health System, PA, Danville, USA.
Sarah M PopekDepartment of Surgery, University of New Mexico, Albuquerque, NM, USA.
Robert P SticcaDepartment of Surgery, University of North Dakota, ND, Grand Forks, USA.
Allison A AkaDepartment of Surgery, Loma Linda University Health, Loma Linda, CA, USA.
Cedrek L McFaddenDepartment of Surgery, University of South Carolina School of Medicine Prisma Health-Upstate, Greenville, SC, USA.
Walid M HeshamDivision of General Surgery, Lancaster General Hospital, Lancaster, PA, USA.
Marcia GrantDivision of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA.
Michael HolcombPreviously Affiliated: Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOstomies, the surgical exteriorization of bowel for urine or stool, are part of the treatment of some cancers. We completed a randomized clinical trial testing a curriculum to help cancer survivors with ostomies in rural areas delivered by telehealth. The aim of this report is to describe modifications necessary to complete accrual in this population of cancer survivors.

methodsRural cancer survivors with ostomies at least 6 weeks postoperatively were randomized to group educational sessions via telehealth versus usual care. The curriculum was delivered once per week over 5 weeks; primary patient reported endpoints were at 6 months. Initial sites were University of North Carolina, City of Hope National Medical Center, and Geisinger Medical Center. Rurality was initially defined utilizing the rural-urban commuting area (RUCA) codes as 4+ (excluding RUCA 1, 2, 3).

resultsThis study was open from August 16, 2019, to February 9, 2024. Accrual was more challenging after the COVID pandemic began in March 2020. Multiple modifications were needed to address trial recruitment challenges. Our amendments included adding six sites across the USA, expanding inclusion criteria to include RUCA 3 and then RUCA 2, and adding distance from ostomy nursing care, first to those living greater than 45 miles, and subsequently more than 25 miles.

conclusionsAccrual to cancer survivorship trials may be difficult, and unpredictable circumstances such as the worldwide pandemic may require research teams to be flexible and creative with recruitment strategies. Modifications may be necessary to ensure accrual yet maintain study integrity.

trial registrationThis study was registered on Clinicaltrials.gov (NCT # 03913715) on 5/29/2019.

Indexed as

Cancer SurvivorsOstomyPatient SelectionAgedFemaleHumansMaleMiddle AgedRural PopulationTelemedicineCancer survivorsOstomyRuralTelemedicine

Identifiers

PMID42171813
PMCPMC13197238

What OpenQuestion holds

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Registered trials

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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.