Publications by authors named "Lauren F Cornell"

7 Publications

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Mental Health and Chemical Dependency Services at US Cancer Centers.

J Natl Compr Canc Netw 2021 Mar 4:1-10. Epub 2021 Mar 4.

1Department of Psychiatry & Psychology.

Background: It is standard of care and an accreditation requirement to screen for and address distress and psychosocial needs in patients with cancer. This study assessed the availability of mental health (MH) and chemical dependency (CD) services at US cancer centers.

Methods: The 2017-2018 American Hospital Association (AHA) survey, Area Health Resource File, and Centers for Medicare & Medicaid Services Hospital Compare databases were used to assess availability of services and associations with hospital-level and health services area (HSA)-level characteristics.

Results: Of 1,144 cancer centers surveyed, 85.4% offered MH services and 45.5% offered CD services; only 44.1% provided both. Factors associated with increased adjusted odds of offering MH services were teaching status (odds ratio [OR], 1.76; 95% CI, 1.18-2.62), being a member of a hospital system (OR, 2.00; 95% CI, 1.31-3.07), and having more beds (OR, 1.04 per 10-bed increase; 95% CI, 1.02-1.05). Higher population estimate (OR, 0.98; 95% CI, 0.97-0.99), higher percentage uninsured (OR, 0.90; 95% CI, 0.86-0.95), and higher Mental Health Professional Shortage Area level in the HSA (OR, 0.99; 95% CI, 0.98-1.00) were associated with decreased odds of offering MH services. Government-run (OR, 2.85; 95% CI, 1.30-6.22) and nonprofit centers (OR, 3.48; 95% CI, 1.78-6.79) showed increased odds of offering CD services compared with for-profit centers. Those that were members of hospital systems (OR, 1.61; 95% CI, 1.14-2.29) and had more beds (OR, 1.02; 95% CI, 1.01-1.03) also showed increased odds of offering these services. A higher percentage of uninsured patients in the HSA (OR, 0.92; 95% CI, 0.88-0.97) was associated with decreased odds of offering CD services.

Conclusions: Patients' ability to pay, membership in a hospital system, and organization size may be drivers of decisions to co-locate services within cancer centers. Larger organizations may be better able to financially support offering these services despite poor reimbursement rates. Innovations in specialty payment models highlight opportunities to drive transformation in delivering MH and CD services for high-need patients with cancer.
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http://dx.doi.org/10.6004/jnccn.2020.7657DOI Listing
March 2021

Current Management and Treatment Options for Breast Pain.

Mayo Clin Proc 2020 03;95(3):574-580

Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL.

Breast pain is a commonly experienced symptom in women of all ages and can significantly impact quality of life. Fear of cancer prompts many patients to report their pain, although risk for malignancy is low in the absence of a palpable mass or other abnormal finding on breast examination. All patients with breast pain should have a thorough history and physical examination to determine if diagnostic imaging is indicated. Management of breast pain without anatomic or radiographic abnormalities depends on pain type and severity. Often, no intervention is required. However, for women with pain that adversely impacts daily living, short-term therapies may be considered. For mild to moderate pain, a trial of conservative, nonpharmacologic strategies should be tried first. For those with severe symptoms impacting quality of life, a trial of pharmacologic therapy can be considered after appropriate counseling for medication-related adverse effects. Herein, we have provided a concise summary of a generalized approach to classification, assessment, and management of breast pain.
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http://dx.doi.org/10.1016/j.mayocp.2019.12.014DOI Listing
March 2020

Implementation of a New Guideline and Educational Sessions to Reduce Low-Value Continuous Pulse Oximetry Among Hospitalized Patients.

South Med J 2018 02;111(2):87-92

From the Departments of Internal Medicine, Medical Scientist Training Program, and Nursing Administration, Mayo Clinic, Jacksonville, Florida.

Objectives: The use of continuous pulse oximetry (CPOX) is ubiquitous among hospitalized patients, despite limited evidence that it improves clinical outcomes. The objective of this study was to reduce the use of CPOX among hospitalized patients in the nonintensive care unit and nonprogressive care unit settings.

Methods: This interventional trial included the creation a new local guideline for CPOX use and subsequent staff education. CPOX use, patient acuity, hospital length of stay, and code blue events were measured before and after the intervention.

Results: Postintervention there was a clinically significant and sustained decrease in CPOX use of 18% over 1 year. There were no significant changes postintervention in hospital length of stay or number of code blue events.

Conclusions: Development of a guideline for CPOX use and staff education successfully led to a decrease in CPOX use, without an increase in hospital length of stay or code blue events.
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http://dx.doi.org/10.14423/SMJ.0000000000000766DOI Listing
February 2018

Sexual Function and Breast-Specific Sensuality Remain Important After Breast Cancer Surgery.

Ann Surg Oncol 2017 Nov 13;24(12):3475-3476. Epub 2017 Sep 13.

Division of Hematology and Oncology, Mayo Clinic Florida, Jacksonville, FL, USA.

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http://dx.doi.org/10.1245/s10434-017-6086-xDOI Listing
November 2017

60-Year-Old Woman With Headache and Fatigue.

Mayo Clin Proc 2017 09 8;92(9):e121-e125. Epub 2017 Jul 8.

Advisor to residents and Consultant in Consultative and Diagnostic Medicine, Mayo Clinic, Jacksonville, FL. Electronic address:

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http://dx.doi.org/10.1016/j.mayocp.2016.11.019DOI Listing
September 2017

60-Year-Old Woman With Headache and Fatigue.

Mayo Clin Proc 2017 09 8;92(9):e121-e125. Epub 2017 Jul 8.

Advisor to residents and Consultant in Consultative and Diagnostic Medicine, Mayo Clinic, Jacksonville, FL. Electronic address:

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http://dx.doi.org/10.1016/j.mayocp.2016.11.019DOI Listing
September 2017

Breast cancer brain metastases: Molecular subtype, treatment and survival.

Breast Dis 2016 ;36(4):133-141

Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA.

Background: No clear guidelines exist for management of breast cancer brain metastases (BCBM).

Objective: We assessed the relationship between patient and tumor characteristics, treatment, and overall survival (OS).

Methods: We conducted a retrospective review of 196 patients who received brain radiation for BCBM between 2009-2013 at Mayo Clinic. Primary tumor characteristics were collected, including simplified molecular subtype. Other characteristics included patient's ECOG, number of brain lesions at BCBM diagnosis, and treatment received, including neurosurgery, whole-brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS). The primary endpoint was OS from time of BCBM diagnosis.

Results: Single-variable analysis revealed patients with HER2+ breast cancer had improved OS (HR = 0.6, p = 0.008). Compared to patients with 1-3 brain lesions, the risk of death in patients with leptomeningeal disease was 2.5-fold higher (p = 0.003). Worsening ECOG status was associated with worsening OS. Patients who received SRS and WBRT had improved OS (HR = 0.37, p < 0.001) compared to patients receiving WBRT alone.

Conclusions: Patients with the best OS had an ECOG of 0, HER2+ disease, and 1-3 brain lesions. The best OS was associated with the combination of neurosurgery and radiation therapy. A comprehensive treatment plan including neurosurgical evaluation and radiation therapy should be considered for patients with BCBM.
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http://dx.doi.org/10.3233/BD-160237DOI Listing
March 2017