Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder with variable expressivity. We present a 62-year-old patient with a rare, late-onset disease course featuring a novel mutation in ACVRL1, a signal transducer in the TGFβ/BMP pathway.
Evidence regarding opinions on integrative modalities by patients and physicians is lacking. Methods. A survey study was conducted assessing how integrative modalities were valued among hematology/oncology patients and hematologists and oncologists at a major tertiary medical center. Results. 1008 patients and 55 physicians were surveyed. With the exception of support groups, patients valued nutrition services, exercise therapy, spiritual/religious counseling, supplement/herbal advice, support groups, music therapy, and other complimentary medicine services significantly more than physicians (P ≤ 0.05). Conclusion. With the exception of support groups, patients value integrative modalities more than physicians. Perhaps with increasing education, awareness, and acceptance by providers and traditional institutions, integrative modalities could be equally valued between patients and providers. It is possible that increased availability and utilization of integrative oncology modalities at tertiary hospital sites could improve patient satisfaction, quality of life, and other clinical endpoints.
Among the various MET aberrations, MET amplification and METex14 have emerged as valid predictive biomarkers for MET inhibition. Despite challenges that have limited the development of MET inhibitors, we can learn from the latest efforts in biomarker-based therapy to better identify the patients who will benefit from treatment with these agents.
See related articles by Hong et al., p. 2403 and Van Cutsem et al., p. 2414
125 Background: Few studies have been reported in oncology regarding elements of physician agenda. We aim to compare elements of a doctor office visit agenda between hem/onc physicians (MD) and patients (pts). Methods: Pts and MDs were enrolled to completed a five question survey. Pts were asked: “My doctor” Focuses more on quantity of life and less on quality of life, spends enough time with me, addresses symptoms, addresses chemo side effects, and addresses prognosis. MDs were asked the same questions but worded: "I” spend enough time with pts for example. Answers were recorded on a 5 point scale (1 = highly disagree, 2 = disagree, 3 = neutral, 4 = agree,5 = highly agree) and converted into 2 categories (1,2,3 = neutral/disagree vs 4,5 = agree). Fisher’s exact test with 2 sided p-value was used to compare significance between MD & pts. Results: 1008 pts and 55 MDs were enrolled between 06/2013 - 10/2015. Pt mean age 55 (18-88) with 45% male and 55% female. Racial profile: 16% white, 14% black, 2% Asian/Pacific Islander. Ethnicity: 62% of pts were Hispanic vs. 38% not Hispanic, & 6% other. A significant number of pts feel MDs focus more on quantity of life vs. quality of life (64% pt vs 26% MD p < 0.0001) and MD spend enough time (94% pt vs 82% MD p < 0.05). No differences were seen for symptoms (92% vs 87% p = 0.2), side effects (92% vs 94% p = 1.0), or prognosis (91% vs 96% p = 0.3) pt vs MD respesctively. Conclusions: Pts feel MDs focus more on quantity of life vs. the quality of life. MDs feel they focus more on quality of life vs. quantity of life. Perhaps bridging the gap in what constitutes “quality of life” may improve patient satisfaction. Furthermore MDs underestimate the time spent with their patients. Perhaps MD are spending too much time with some patients resulting in inefficient office visits.
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