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A survey of multidisciplinary healthcare providers utilizing the KNOWintegrativeoncology.org educational platform
Background
Although the vast majority of cancer patients use natural health products (NHPs), 59% of oncology healthcare providers (HCP) report not receiving any education on NHPs. KNOWintegrativeoncology.org (KNOW) is a web-based educational platform that provides up-to-date evidence on NHPs used in cancer care with a user-friendly interface. KNOW is a database of human studies systematically gathered from MEDLINE and EMBASE. We surveyed HCPs before and after accessing KNOW to identify their information needs regarding NHPs in cancer care, their preferred way to receive information, barriers they face accessing NHP information, and to obtain feedback on the website.
Methods
Recruitment was done through Beaumont Health Systems, the Society for Integrative Oncology, and the Andrew Weil Centre for Integrative Medicine, University of Arizona. HCPs who consented completed an initial survey and then a follow-up survey after being given access to KNOW for 4–6 weeks. Participants were required to access KNOW at least three times before completion of the follow-up survey.
Results
A total of 65 participants completed the initial survey, with 60% (
n
= 39) from the conventional medical community, 33% (
n
= 21) from the integrative medicine community, and 7% (
n
= 5) from the research community. The majority of participants (82%;
n
= 53) preferred educational websites to email updates, podcasts/webinars, in-house experts, PubMed searches and smartphone apps. The most common barriers identified to accessing information on NHPs were time, accessibility at point-of-care, and credibility of sources. A high number of participants were lost to follow up, with 18 participants demographically representative of the initial sample of 65 completing the follow-up survey. Half (
n
= 9) of participants stated accessing the KNOW website changed their clinical practice. Close to 90% (
n
= 16) reported they would recommend KNOW to a colleague.
Conclusion
Oncology HCPs reported preferring to use, and already relying on, numerous web-based educational platforms to gather information on NHPs, with time, accessibility, and credibility being common barriers to obtaining information. Our study findings highlight the promise of the KNOW web-based educational platform in reducing barriers to accessing up-to-date information on NHPs in busy cancer care settings.
Journal Article
The Development of Highly Sensitive Search Filters for Complementary and Alternative Medicine-Specific, Natural Therapies for Use in Integrative Oncology
Introduction: To develop highly sensitive filters in MEDLINE and Embase for CAM-specific, natural therapies (dietary, supplemental, intravenous, physical and mental/ emotional) relevant to oncologic medicine. Systematic searches using these filters will be run sequentially for cancer topics by tumor type and symptom (e.g., breast cancer, peripheral neuropathy, thoracic cancers), from which we will write structured research summaries on all identified therapies. Methods: We used PubMed's dietary supplement subset as our base. We consulted with naturopathic doctors to identify and add vocabulary for further concepts. Building on previous work wherein a line-by-line version of PubMed's CAM subset was created in OVID MEDLINE, we developed a MEDLINE version of the expanded dietary supplement subset. We translated and adjusted this strategy for use in OVID Embase. Beginning with breast cancer, we ran multi-file searches and removed duplicates in OVID to reduce the deduplication burden. We compiled and circulated screening packages in Reference Manager. After tagging potentially relevant records, we exported them to Mendeley for additional tagging and full-text retrieval. We created a structured template for each relevant trial, including citation, study design, population, intervention, comparator, outcomes, side effects and interactions, to be used to present peer-reviewed data about human trial natural therapies in oncologic medicine. Results: We retrieved 54,061 records on CAM-specific, natural therapies in breast cancer. After deduping in OVID followed by further deduplication in Reference Manager, we reduced the number to 44,383. From this we identified and tagged 827 potentially relevant records and another 370 as \"maybe\" potentially relevant. We have finalized the tagging template from which we will derive our peerreviewed evidence summaries. Work is ongoing and we will further report developments as they occur. Discussion: Our customized CAM-specific, natural therapies filter has allowed us to efficiently and systematically identify evidence-based CAM material in MEDLINE and Embase for breast cancer. Relevant records have been tagged and will be developed into electronic evidence-based summaries. Our experience with breast cancer will allow us to fine-tune processes for further high-priority topics in integrative oncology. Translating these filters to additional databases (e.g., PsycINFO, CINAHL, AMED) will also be explored.
Journal Article
Noah's Ark
Tears in bathwater the flood of rivers like veins, tracing the flow from dumpsites to pathology reports. poison we make we spray we clean with Dumping dumping in food, in walls In the IV, chemo solution Hair falling sanity slipping The hair of the dog that bit you was your faithful...
Magazine Article
Geology : investigating the science of the Earth
The history and development of the geological sciences.
Book
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Book Review
A dead log
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Book Review