Change in practice in gynecologic oncology during the COVID-19 pandemic: a social media survey

Abstract

ObjectiveCOVID-19 has affected gynecologic cancer management. The goal of this survey was to evaluate changes that occurred in gynecologic oncology practice during the COVID-19 pandemic.MethodsA anonymous survey consisting of 33 questions (https://sites.google.com/view/gyncacovidfmartinelli) regarding interaction between gynecologic cancers and COVID-19 was distributed online via social media from April 9 to April 30, 2020. Basic descriptive statistics were applied. Analytics of survey-diffusion and generated-interest (visualizations, engagement rates, response rate) were analyzed.ResultsThe survey received 20 836 visualizations, generating an average engagement rates by reach of 4.7%. The response rate was 30%. A total of 86% of respondents completed the survey, for a total of 187 physicians surveyed across 49 countries. The majority (143/187; 76%) were gynecologic oncologists, and most were ≤50 years old (146/187; 78%). A total of 49.7% (93/187) were facing the early phase of the COVID-19 pandemic, while 26.7% (50/187) and 23.5% (44/187) were in the peak and plateau phases, respectively. For 97.3% (182/187) of respondents COVID-19 affected or changed their respective clinical practice. Between 16% (27/165) (before surgery) and 25% (26/102) (before medical treatment) did not perform any tests to rule out COVID-19 infection among patients. The majority of respondents did not alter indications of treatment if patients were COVID-19-negative, while treatments were generally postponed in COVID-19-positive patients. Treatments were considered priority for: early stage high-risk uterine cancers (85/187; 45%), newly diagnosed epithelial ovarian cancer (76/187; 41%), and locally advanced cervical cancer (76/187; 41%). Treatment of early stage low-grade endometrioid endometrial cancer was deferred according to 49% (91/187) of respondents, with hormonal treatment as the option of therapy (31%; 56/178). A total of 77% (136/177) of respondents reported no changes in (surgical) treatment for early stage cervical cancer in COVID-19-negative patients, while treatment was postponed by 54% (96/177) of respondent, if the patient tested COVID-19-positive. Neoadjuvant chemotherapy for advanced ovarian cancers was considered by over one-third of respondents as well as hypofractionation of radiation treatment for locally advanced cervical cancers.ConclusionCOVID-19 affected the treatment of gynecologic cancers patients, both in terms of prioritization and identification of strategies to reduce hospital access and length of stay. Social media is a reliable tool to perform fast-tracking, worldwide surveys.

The impact of the COVID-19 coronavirus pandemic on the surgical management of gynecological cancers: Analysis of the multicenter database of the French SCGP and the FRANCOGYN group

“…The study by F. MARTINELLI, A. GARBI. [7] , carried out on social networks in 49 countries and questioning 187 consultants on the changes in management of gynecological cancers, found similar results to our study. In their study, a change in treatment strategy with respect to chemotherapy was found in 30 to 40% of cases, a halt in laparoscopic surgery in 30% of cases and an increase in treatment with radiotherapy in 24% of cases.…”

Trends in academic productivity in the COVID-19 era: analysis of neurosurgical, stroke neurology, and neurointerventional literature

“…Surveys of physicians across varied specialties have unanimously demonstrated marked disruptions in clinical practice due to the pandemic. 7–10 Interestingly, these disruptions encompass not only elective procedural volumes but also reductions in urgent and emergent procedures. Studies have reported decreased admissions for ischemic stroke, 11 a substantial reduction in mechanical thrombectomy volumes, 12 and a sharp decline in the number of stroke imaging evaluations at the height of the pandemic.…”

The professional and personal impact of the coronavirus pandemic on US neurointerventional practices: a nationwide survey

“…Surveys designed to address highpriority issues in other medical specialties have unanimously demonstrated marked disruptions in clinical practice. [27][28][29][30] Although the present study did not specifically address the effects of COVID-19 on neurovascular research, a concomitant study has also revealed widespread disruptions in aneurysm and stroke clinical trials due to missed enrollments and protocol deviations from missed clinical or imaging follow-up 31 These broad vantage points are particularly important given the widespread fears about resurgent infection, 32 33 with the persistence of the virus in communities across the US. This data helps inform current responses, but also future ones in the event of subsequent pandemics.…”