7047 Background: While new interventions have improved cancer screening, treatment, and survivorship, the costs and other economic impacts of interventions may affect their uptake and availability. It is unknown what proportion of recently-funded National Cancer Institute (NCI) grants include economic outcomes. Methods: We used the NIH Query/View/Report (QVR) System to determine the number of competitive grants funded by NCI 2015-2020 that included economic outcomes. Grants were identified using the NIH Research, Condition, and Disease Categorization (RCDC) category “Cost Effectiveness Research”; 19 RCDC terms/concepts related to economic analyses; and 18 economic phrases searched for in grant titles, abstracts, and specific aims. The specific aims and abstracts of all grants meeting any of these search criteria were reviewed by an NCI scientist to ensure the presence of economic study outcomes. Results: Among over 13,700 competitive grants awarded by NCI 2015-2020, the search identified 149 grants; following abstract/specific aims review, 102 of these grants (0.74% of all grants) included an economic outcome. Most (69 of 102, 67.6%) included cost-effectiveness analysis; 24 included other cost analyses, 7 assessed financial hardship or similar outcomes, and 2 focused on developing economic methods. Among RCDC terms, more than half (53) listed modeling (9 listing Cancer Intervention and Surveillance Modeling Network), 24 randomized controlled trials, 15 QALYs, 11 implementation science, 3 willingness to pay. The most common cancer sites listed were breast (28), lung (23), cervical (19), and colorectal (17) cancer. Almost half (48) mentioned screening and 24 cancer prevention. Risk factors listed included 28 for smoking, 18 HPV, 8 HIV, 8 physical activity, 6 obesity, 4 nutrition. Ten listed treatment efficacy, 6 chemotherapy, 4 radiation therapy, 3 hormone therapy, and 1 chemoradiation. “Treatment as usual” was listed by 16, symptom management 4, and telehealth 4. Survivors were listed for 15, caregivers 3, health disparity 18, rural 15, young adult 4. The majority of grant mechanisms were R01 (76, 74.5%); 3 were R21/R03, 4 other R mechanisms, 7 K awards, 6 U grants, 6 P, F, or L grants. Conclusions: While this search may not have identified all funded NCI grants over the past 5 years involving economic analyses, we found that less than 1% included economic outcomes. Recommendations to assist NCI in supporting health economics research focused on cancer across the entire care spectrum should be considered.
Background Cancer is a disease of aging, and most people with cancer are older than 65. However, widespread uptake of evidence‐based approaches that facilitate quality care delivery for older adults with cancer are lacking. This project aimed to review National Institutes of Health (NIH) grants funded in the last decade that focused on healthcare delivery in aging and older adults with cancer, and to examine grant‐related characteristics, study designs, and scientific topics included. Methods A search was conducted of all extramural NIH research grants awarded between fiscal year 2012 to 2021. We examined NIH terms; keyword searches of titles, abstracts, and specific aims were implemented to maximize search efficiency. Extraction criteria focused on grant‐related and study characteristics. A priori scientific topics for coding included geriatric assessment, care decision‐making, communication, care coordination, physical and psychosocial functioning/symptoms, and clinical outcomes. Results A total of 48 funded grants met the inclusion criteria. A near‐equal split was observed between R03, R21, and R01 grants. Most grants did not include family caregivers or focus on end‐of‐life care. Most grants included multiple cancers and were conducted during active treatment and in hospital/clinic settings. Common scientific topics included geriatric assessment, care decision‐making, physical and psychosocial functioning/symptoms, communication, and care coordination. Few grants focused on cognitive functioning. Conclusions Several gaps in the portfolio were identified, including family caregiver inclusion, end‐of‐life care, and studies focusing on cognitive functioning.
388 Background: The onset of the COVID-19 pandemic prompted a dramatic increase in the use of telehealth as health systems sought to limit patient exposure to the novel coronavirus. Positive changes in patient-provider synchronous telehealth reimbursement and regulatory policies removed long-standing barriers to telehealth uptake. Recognizing telehealth will remain an integral part of healthcare delivery, staff at the National Cancer Institute (NCI) conducted a grant portfolio analysis to assess current telehealth-related research gaps and opportunities. The goal was to examine 5-year funding trends for grants that evaluate synchronous patient-provider forms of telehealth. Methods: An initial search using NIH tools (QVR and iSearch) identified all research type grants funded by NCI between fiscal years (FY) 2016 and 2021 listing telehealth (and related terms, e.g., telemedicine) within grant titles, abstracts, and specific aims yielded 76 funded applications. Grants were excluded if they did not use synchronous telehealth, were not between a patient and provider, or were not healthcare delivery oriented. We abstracted structured variables for the final grant set (n = 45) including cancer site, stage of the cancer control continuum, patient population(s), and telehealth features. Results: A substantially greater number of telehealth grants were funded in FY20 (n = 15) and FY21 (n = 14) compared to preceding years (mean: 4 per year). The majority (75%) were investigator initiated. Breast (33%), lung (20%), colorectal (15%), and hematological (17%) cancers were most frequently studied. Over 75% of grants focused on active treatment and survivorship populations. Telehealth was most frequently used to deliver psychosocial care (35%), supportive/palliative care (35%), and/or patient self-management support and education (31%). Since 2020, grants were more likely to focus on minority populations (55% vs. 25%. p = 0.05), specify smartphone app integration (38% vs. 19%, p = 0.13), and propose integration with asynchronous data (13% vs. 0%, p = 0.30) versus grants funded from 2016-2019. Conclusions: NCI-funded grants incorporating patient-provider synchronous telehealth have increased since FY20. There are promising indications of increased focus on vulnerable populations and issues surrounding ‘digital divide’ barriers. Gaps remain within the cancer care continuum, particularly cancer screening and end-of-life when telehealth could increase access to care, with minimal patient burden. Results point to promising areas for future research and may inform efforts to advance knowledge regarding the optimal use of telehealth in cancer care delivery.
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