Maciej M Mrugala1, Quinn T Ostrom2, Shelley M Pressley3, Jennie W Taylor4, Alissa A Thomas5, Jeffrey S Wefel6, Scott L Coven7, Alvina A Acquaye8, Chas Haynes3, Sameer Agnihotri9, Michael Lim10, Katherine B Peters11, Erik P Sulman12,13, Joanne T Salcido14, Nicholas A Butowski4, Shawn Hervey-Jumper4, Alireza Mansouri15, Kathy R Oliver16, Alyx B Porter1,17, Farshad Nassiri18, David Schiff19, Erin M Dunbar20, Monika E Hegi21, Terri S Armstrong8, Martin J van den Bent22, Susan M Chang4, Gelareh Zadeh18, Milan G Chheda23. 1. Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA. 2. Department of Medicine, Epidemiology & Population Sciences, Baylor College of Medicine, Houston, Texas, USA. 3. Society for Neuro-oncology, Houston, Texas, USA. 4. Department of Neurological Surgery, University of California, San Francisco, California, USA. 5. Department of Neurological Sciences, University of Vermont Larner College of Medicine, Burlington, Vermont, USA. 6. Departments of Neuro-Oncology and Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 7. Division of Pediatric Hematology/Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA. 8. Neuro-oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA. 9. Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 10. Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA. 11. Departments of Neurology and Neurosurgery, Duke University, Durham, North Carolina, USA. 12. Department of Radiation Oncology, NYU Grossman School of Medicine, New York, New York, USA. 13. Brain and Spine Tumor Center, Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA. 14. Pediatric Brain Tumor Foundation, Asheville, North Carolina, USA. 15. Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania, USA. 16. International Brain Tumour Alliance, Tadworth, UK. 17. Departments of Neurologic Surgery and Hematology Oncology, Mayo Clinic, Phoenix, Arizona, USA. 18. Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. 19. Departments of Neurology, Neurological Surgery and Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA. 20. Piedmont Brain Tumor Center, Atlanta, Georgia, USA. 21. Neuroscience Research Center, Lausanne University Hospital and University of Lausanne, Epalinges, Switzerland. 22. Brain Tumor Institute, ErasmusMC Cancer Institute, Rotterdam, The Netherlands. 23. Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.
Abstract
BACKGROUND: It remains unknown how the COVID-19 pandemic has changed neuro-oncology clinical practice, training, and research efforts. METHODS: We performed an international survey of practitioners, scientists, and trainees from 21 neuro-oncology organizations across 6 continents, April 24-May 17, 2020. We assessed clinical practice and research environments, institutional preparedness and support, and perceived impact on patients. RESULTS: Of 582 respondents, 258 (45%) were US-based and 314 (55%) international. Ninety-four percent of participants reported changes in their clinical practice. Ninety-five percent of respondents converted at least some practice to telemedicine. Ten percent of practitioners felt the need to see patients in person, specifically because of billing concerns and pressure from their institutions. Sixty-seven percent of practitioners suspended enrollment for at least one clinical trial, including 62% suspending phase III trial enrollments. More than 50% believed neuro-oncology patients were at increased risk for COVID-19. Seventy-one percent of clinicians feared for their own personal safety or that of their families, specifically because of their clinical duties; 20% had inadequate personal protective equipment. While 69% reported increased stress, 44% received no psychosocial support from their institutions. Thirty-seven percent had salary reductions and 63% of researchers temporarily closed their laboratories. However, the pandemic created positive changes in perceived patient satisfaction, communication quality, and technology use to deliver care and mediate interactions with other practitioners. CONCLUSIONS: The pandemic has changed treatment schedules and limited investigational treatment options. Institutional lack of support created clinician and researcher anxiety. Communication with patients was satisfactory. We make recommendations to guide clinical and scientific infrastructure moving forward and address the personal challenges of providers and researchers.
BACKGROUND: It remains unknown how the COVID-19 pandemic has changed neuro-oncology clinical practice, training, and research efforts. METHODS: We performed an international survey of practitioners, scientists, and trainees from 21 neuro-oncology organizations across 6 continents, April 24-May 17, 2020. We assessed clinical practice and research environments, institutional preparedness and support, and perceived impact on patients. RESULTS: Of 582 respondents, 258 (45%) were US-based and 314 (55%) international. Ninety-four percent of participants reported changes in their clinical practice. Ninety-five percent of respondents converted at least some practice to telemedicine. Ten percent of practitioners felt the need to see patients in person, specifically because of billing concerns and pressure from their institutions. Sixty-seven percent of practitioners suspended enrollment for at least one clinical trial, including 62% suspending phase III trial enrollments. More than 50% believed neuro-oncology patients were at increased risk for COVID-19. Seventy-one percent of clinicians feared for their own personal safety or that of their families, specifically because of their clinical duties; 20% had inadequate personal protective equipment. While 69% reported increased stress, 44% received no psychosocial support from their institutions. Thirty-seven percent had salary reductions and 63% of researchers temporarily closed their laboratories. However, the pandemic created positive changes in perceived patient satisfaction, communication quality, and technology use to deliver care and mediate interactions with other practitioners. CONCLUSIONS: The pandemic has changed treatment schedules and limited investigational treatment options. Institutional lack of support created clinician and researcher anxiety. Communication with patients was satisfactory. We make recommendations to guide clinical and scientific infrastructure moving forward and address the personal challenges of providers and researchers.
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