Abstract IA013: Increasing Diversity in Pediatric Cancer Clinical Trials: Challenges and Opportunities
Notice bibliographique
Résumé
Abstract Although childhood cancer is the leading cause of death by disease past infancy in the US, with 17,000 children younger than 21 years being diagnosed annually, survival has improved dramatically, and is now greater than 80% overall. Because of unequal access to services and adverse Social Determinants of Health (SDOH) affecting underserved populations, disparities in survival exist among minoritized youth with cancer. For example, Hispanic children have higher incidence of certain cancers and poorer survival rates than non-Hispanic White children. Minorities are severely under-represented in research. This means that cancer outcomes data are largely based on data from non-Hispanic White participants, and there is incomplete information to adequately assess treatment benefits for minorities. We showed that 53% of Latino parents declined research participation, compared to 20% of non-Hispanic White parents, in our institution. There are several barriers to informed consent for clinical trials. First, there are no mandates to ensure comprehension, and informed consent forms are complex, long, and difficult to understand. This leaves parents of children with cancer with an incomplete understanding of risks, procedures, randomization, alternative treatments, and the voluntary nature of clinical trial participation. Furthermore, pediatric cancer often requires urgent treatment, leaving little time for decision-making. We developed COMPRENDO (ChildhOod Malignancy Peer REsearch NavigatiOn), a peer-navigation intervention to improve research literacy and diversity in pediatric cancer clinical trials. In this intervention, trained peer-navigators, who have the lived experience of having a child diagnosed with cancer, provide in-hospital support. The goals of COMPRENDO are to improve parents’ informed consent experience and comprehension of informed consent for cancer treatment, to explain to parents terms to be discussed by the oncologist during the treatment conference, to introduce to parents concepts of clinical trials and research, and to facilitate and empower shared decision-making. In a pilot study at Rady Children’s Hospital-San Diego, this intervention showed a significant increase in comprehension of therapeutic trials, particularly in Hispanic and Spanish-speaking parents. The demographics of children with cancer enrolled in clinical trials should be comparable to the US population, and approaches to improve enrollment must also be tailored to specific settings. Structural barriers for participation of minorities should be considered during study and informed consent design and planning. Strategies to increase clinical trial enrollment of minority individuals include: Provider-level training on patient-provider communication, development of linguistically appropriate tools, and promotion of culturally aware staff. Key strategies at the patient-level include building trust; education and awareness of clinical trials; implementation of culture, language, and health literacy-concordant interventions; and initiatives to address adverse SDOH. Citation Format: Paula Aristizabal. Increasing Diversity in Pediatric Cancer Clinical Trials: Challenges and Opportunities [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pediatric Cancer Research; 2024 Sep 5-8; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl):Abstract nr IA013.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,200 | 0,375 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,004 |
| Communication savante | 0,006 | 0,009 |
| Science ouverte | 0,004 | 0,013 |
| Intégrité de la recherche | 0,003 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,016 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».