Evidence map›Paper›PMID 42459601›Full record

ArticleJournal of oncology navigation & survivorship2024

Mixed Methods Evaluation of Gaps and Barriers in Delivery of Precision Oncology in Advanced Lung Cancer.

Jacob N Stein, Alayah Johnson-Jennings, Courtney Canter, Mary E Grewe, Marjory Charlot

Abstract read
In one paragraph

Article in Journal of oncology navigation & survivorship, 2024. 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

5 authors.

Jacob N SteinDepartment of Medicine, Division of Oncology, University of North Carolina, Chapel Hill, NC.
Alayah Johnson-JenningsDepartment of Health Behavior, School of Public Health, University of North Carolina.
Courtney CanterNorth Carolina Translational and Clinical Sciences Institute, University of North Carolina, Chapel Hill, NC.
Mary E GreweNorth Carolina Translational and Clinical Sciences Institute, University of North Carolina, Chapel Hill, NC.
Marjory CharlotDepartment of Medicine, Division of Oncology, University of North Carolina, Chapel Hill, NC.

Funding

North Carolina Translational and Clinical Sciences Institute (NC TraCS)UM1TR004406 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI NICHOLAS J SHAHEEN · 2023 to 2026
$37.5M
Cancer Health Disparities Training ProgramT32CA128582 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SMITH, JENNIFER SUSAN, TATE, DEBORAH F. · 2009 to 2023
$3.4M
NCATS NIH HHS UM1 TR004406NCI NIH HHS T32 CA128582
6 · The paper itself

Abstract

Background: Lung cancer is the leading cause of cancer mortality and has well described disparities in outcomes. Significant survival gains in non-small cell lung cancer (NSCLC) have been achieved due to precision oncology, however, shortfalls in its delivery will further exacerbate disparities. Patient navigation is an approach to address cancer care disparities. We sought to characterize the barriers and facilitators to precision oncology through a mixed methods approach. Methods: We performed a cross-sectional study of patient navigators, pathologists, and clinicians in North Carolina (NC). We conducted surveys and interviews to assess barriers and facilitators to effective delivery of precision medicine for patients with advanced NSCLC, including next generation sequencing (NGS) and use of targeted therapies and immunotherapy. We recruited both community-based and academic cancer providers across the state. Results: Fifty-six participants completed the survey, with representation from both community and academic sites, and five completed interviews. Clinicians reported gaps in delivery of precision medicine as well as knowledge gaps, feeling "not at all" or "a little bit" knowledgeable about NGS (19%), liquid biopsy (32%) and targeted therapies (19%). Navigators endorsed common conversations about precision medicine but felt "somewhat" or "very" uncomfortable discussing NGS (38%), targeted therapies (31%), and limited confidence in resolving barriers. Qualitative interviews highlighted potential solutions including financial aid, dedicated pathology support, use of liquid biopsy, and partnership with social work. Conclusion: Academic and community-based clinicians in N.C. reported gaps in delivery of precision oncology in advanced NSCLC. Navigators reported a significant role in precision oncology education and delivery but limited confidence in doing so. Qualitative data highlight potential strategies for improving access. These findings suggest a need for further interventions and education to support clinicians and navigators disseminating precision oncology.

Identifiers

PMID42459601
PMCPMC13372248

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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.