Patterns of inpatient care for prostate cancer in men with spina bifida.
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2020-04
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Abstract
BACKGROUND:Advances in medical care have increased the long-term survival of patients with spina bifida. Despite this growing population, limited knowledge is available on age-related illnesses in adults with spina bifida, particularly prostate cancer for which there is no published data. OBJECTIVE:Our aim was to describe inpatient care for prostate cancer in men with spina bifida in the United States. METHODS:We performed a descriptive, retrospective study utilizing the 1998 to 2014 National Inpatient Sample from the Healthcare Cost and Utilization Project. Weights were applied to the sample to make national level inferences. We identified all adult encounters (≥18 years old) with prostate cancer and spina bifida. RESULTS:We identified 253 encounters (mean age 64.9 years). Most were Caucasian (67.5%) and had public insurance (61.6%). 44% of encounters included a major urologic procedure. 38.4% of encounters included prostatectomies, 28.3% included lymph node dissections, and 7.8% included cystectomies. Robotic surgery was performed in 9.4%. Mean length of stay was 5.6 days (95% CI: 3.7, 7.5). The average total cost was $14,074 (95% CI: $8990.3, $19,158.6). CONCLUSIONS:In this first-ever exploration of inpatient care for prostate cancer in men with spina bifida, we found that length of stay and total costs were higher in men with spina bifida. Almost half of encounters included a prostatectomy, cystectomy, and/or lymph node dissection. More detailed investigations are necessary to assess comparative treatment outcomes and complications, including prevalence and mortality rates of prostate cancer among adult men with SB.
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Johnston, Ashley W, Steven Wolf, Muhammad H Alkazemi, Gina-Maria Pomann, Hadley Wood, John S Wiener and Jonathan C Routh (2020). Patterns of inpatient care for prostate cancer in men with spina bifida. Disability and health journal, 13(2). p. 100866. 10.1016/j.dhjo.2019.100866 Retrieved from https://hdl.handle.net/10161/20589.
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Scholars@Duke
Gina-Maria Pomann
Gina-Maria Pomann, PhD, is Associate Professor of Biostatistics and Bioinformatics and Director of the Biostatistics, Epidemiology, and Research Design (BERD) Methods Core at Duke University School of Medicine. She serves on the Duke AI Health Faculty Council, leading the development of AI collaborations across Duke to address challenges in healthcare. She also serves as Associate Professor at the Duke-NUS Centre for Quantitative Medicine in Singapore. She has developed functional data methodology and predictive modeling techniques for brain imaging, and has broad experience collaborating with investigators across biomedical fields such as Neurology, Surgery, Urology, Hospital Medicine, among others. Dr. Pomann has extensive leadership and administration experience, including the development and oversight of more than 30 teams of biostatistics and data science staff, faculty, and students, working on long term (multi-year) collaboration agreements with clinical and translational researchers. Under her leadership, the BERD Core has facilitated over 1600 collaborations that have generated more than 800 peer-reviewed publications.
In addition to directing the BERD Core Training and Internship Program (BCTIP), Dr. Pomann is Co-Principal Investigator on multiple NIH-funded training programs. She co-leads the Quantitative Methods for HIV/AIDS Research Program, offering internships, mentoring, and workshops for HIV researchers; and the Quantitative Team Science (QuanTS) Program, which provides open-access educational videos and a 7-month training program for quantitative scientists to improve their collaboration skills. She also serves as the co-Lead of the Community Development and Education Core of the Duke Multiscale Immune Systems Modeling (MISM) Center of Excellence. She was a co-founder of the biostats4you educational website and contributes to numerous other workforce development programs such as the Duke AI Health Fellowship Program.
John Samuel Wiener
As a general pediatric urologist, Dr. Wiener is involved with all aspects of pediatric urology as a clinician and researcher. His research interests are most focused, however, on the urologic management of neurogenic bladder and spina bifida and the molecular biology involving development of the genitourinary tract and disorders.
Dr. Wiener is the principal investigator at Duke for The National Spina Bifida Patient Registry and Urologic Management of Young Children with Spina Bifida protocol administered by the Centers for Disease Control and Prevention. These projects began at Duke in 2011 and 2015, respectively.
Dr. Wiener was previously a project director for the P50 Center for Undiagnosed Pediatric and Urogenital Disorders.
Dr. Wiener has served in national leadership positions in pediatric urology including President of the Society of Fetal Urology, Executive Council of Society for Pediatric Urology, and the Examination Committee of the American Board of Urology. He is currently on the Board of Directors of the Spina Bifida Association
Jonathan Charles Routh
I am a pediatric urologist and health services researcher who is interested in caring for children with urological problems, conducting research on how to improve that care, and mentoring young researchers to ensure that the next generation does both better than I currently can.
My clinical interests include minimally-invasive surgery, neurogenic and non-neurogenic voiding dysfunction, complex urologic reconstruction (particularly in children with spina bifida), and pediatric urologic oncology (particularly Wilms tumor and rhabdomyosarcoma). My research has been funded by awards from the NIH, CDC, FDA, and multiple foundations and industry partners, and during my time on faculty at Duke I have had the pleasure of collaborating with many groups and individuals around the world on a number of projects. Over the past 15 years, I have formally mentored nearly 3 dozen undergraduates, medical students, urology residents, post-doctoral students, and junior faculty members across multiple disciplines (pediatrics, urogynecology, urology, and nursing).
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