Yacoub A Yousef1, Ibrahim Al-Nawaiseh2, Mustafa Mehyar2, Iyad Sultan3, Maysa Al-Hussaini4, Imad Jaradat5, Mona Mohammad2, Reem AlJabari2, Nakhleh Abu-Yaghi6, Carlos Rodriguez-Galindo7, Ibrahim Qaddoumi7, Matthew Wilson8. 1. Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan. Electronic address: yyousef@khcc.jo. 2. Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan. 3. Pediatric Oncology, King Hussein Cancer Centre, Amman, Jordan. 4. Pathology and Laboratory Medicine, King Hussein Cancer Centre, Amman, Jordan. 5. Radiation Oncology, King Hussein Cancer Center, Amman, Jordan. 6. School of Medicine, University of Jordan, Amman, Jordan. 7. St. Jude Children's Research Hospital, Memphis, Tennessee. 8. St. Jude Children's Research Hospital, Memphis, Tennessee; Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee.
Abstract
PURPOSE: To evaluate the efficacy of integrating a telemedicine-based twinning partnership and centralized care for retinoblastoma on survival and eye salvage. DESIGN: Four hundred seventy-eight retinoblastoma patients treated at a tertiary referral cancer center (King Hussein Cancer Centre [KHCC]) from 2003 through 2019. PARTICIPANTS: Four hundred seventy-eight retinoblastoma patients treated at KHCC after implementing a telemedicine-based program with St. Jude Children's Research Hospital. METHODS: We reviewed the outcomes of retinoblastoma patients who were treated at KHCC after implementing a telemedicine-based eye salvage program with St. Jude Children's Research Hospital, and we compared that with outcomes for retinoblastoma patients who were treated before implementing a telemedicine-based retinoblastoma service at KHCC. MAIN OUTCOME MEASURES: We analyzed patient demographics, clinical characteristics, treatments received, consultation type and duration, and long-term patient outcomes before and after implementing the twinning program. RESULTS: Over 17 years, 813 eyes from 478 children with retinoblastoma were treated at KHCC. Three hundred thirty-five patients (70%) had bilateral disease. Six patients (4%) with unilateral disease and 66 patients (20%) with bilateral disease had a family history of retinoblastoma. After the twinning program was established in 2003, the mortality rate decreased from 38% to 5% (P < 0.0001), and the overall eye salvage rate increased from 4% to 61% (98% for group A, 93% for group B, 81% for group C, and 48% for group D; P < 0.0001). Initially, all cases were discussed via telemedicine, but as knowledge transfer increased, the proportion of cases that required discussion decreased to less than 3% 10 years later. Similarly, treatment changes based on consultations decreased from 70% to 7% after 10 years. Both survival and eye-salvage rates were comparable at the early and later stages of implementing the twinning program. At a median follow-up of 120 months, 5% of patients had died of metastases or secondary neoplasms, 81% were alive, and 14% were lost to follow-up. CONCLUSIONS: Centralization of care at a single center in developing countries can achieve patient outcomes comparable with those of developed countries via twinning and telemedicine. This benefit can extend to a large region because two thirds of patients treated at KHCC were non-Jordanians.
PURPOSE: To evaluate the efficacy of integrating a telemedicine-based twinning partnership and centralized care for retinoblastoma on survival and eye salvage. DESIGN: Four hundred seventy-eight retinoblastomapatients treated at a tertiary referral cancer center (King Hussein Cancer Centre [KHCC]) from 2003 through 2019. PARTICIPANTS: Four hundred seventy-eight retinoblastomapatients treated at KHCC after implementing a telemedicine-based program with St. Jude Children's Research Hospital. METHODS: We reviewed the outcomes of retinoblastomapatients who were treated at KHCC after implementing a telemedicine-based eye salvage program with St. Jude Children's Research Hospital, and we compared that with outcomes for retinoblastomapatients who were treated before implementing a telemedicine-based retinoblastoma service at KHCC. MAIN OUTCOME MEASURES: We analyzed patient demographics, clinical characteristics, treatments received, consultation type and duration, and long-term patient outcomes before and after implementing the twinning program. RESULTS: Over 17 years, 813 eyes from 478 children with retinoblastoma were treated at KHCC. Three hundred thirty-five patients (70%) had bilateral disease. Six patients (4%) with unilateral disease and 66 patients (20%) with bilateral disease had a family history of retinoblastoma. After the twinning program was established in 2003, the mortality rate decreased from 38% to 5% (P < 0.0001), and the overall eye salvage rate increased from 4% to 61% (98% for group A, 93% for group B, 81% for group C, and 48% for group D; P < 0.0001). Initially, all cases were discussed via telemedicine, but as knowledge transfer increased, the proportion of cases that required discussion decreased to less than 3% 10 years later. Similarly, treatment changes based on consultations decreased from 70% to 7% after 10 years. Both survival and eye-salvage rates were comparable at the early and later stages of implementing the twinning program. At a median follow-up of 120 months, 5% of patients had died of metastases or secondary neoplasms, 81% were alive, and 14% were lost to follow-up. CONCLUSIONS: Centralization of care at a single center in developing countries can achieve patient outcomes comparable with those of developed countries via twinning and telemedicine. This benefit can extend to a large region because two thirds of patients treated at KHCC were non-Jordanians.
Authors: Saima Amin; Mays AlJboor; Mario D Toro; Robert Rejdak; Katarzyna Nowomiejska; Rashed Nazzal; Mona Mohammad; Maysa Al-Hussaini; Jakub Khzouz; Sara Banat; Reem AlJabari; Imad Jaradat; Mustafa Mehyar; Iyad Sultan; Ibrahim AlNawaiseh; Yacoub A Yousef Journal: Clin Ophthalmol Date: 2021-01-07
Authors: Yacoub A Yousef; Ibrahim Qaddoumi; Ibrahim Al-Nawaiseh; Mona Mohammad; Dalia AlRimawi; Mario Damiano Toro; Sandrine Zweifel; Robert Rejdak; Rashed Nazzal; Mustafa Mehyar; Imad Jaradat; Iyad Sultan; Maysa Al-Hussaini Journal: J Cancer Date: 2022-02-07 Impact factor: 4.207
Authors: Paula Aristizabal; Luke P Burns; Nikhil V Kumar; Bianca P Perdomo; Rebeca Rivera-Gomez; Mario A Ornelas; David Gonda; Denise Malicki; Courtney D Thornburg; William Roberts; Michael L Levy; John R Crawford Journal: JCO Glob Oncol Date: 2020-11
Authors: Yacoub A Yousef; Mays Al Jboor; Mona Mohammad; Mustafa Mehyar; Mario D Toro; Rashed Nazzal; Qusai H Alzureikat; Magdalena Rejdak; Mutasem Elfalah; Iyad Sultan; Robert Rejdak; Maysa Al-Hussaini; Ibrahim Al-Nawaiseh Journal: Front Pharmacol Date: 2021-07-12 Impact factor: 5.810