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Evaluation of adverse drug reaction formatting in drug information mobile phone applications
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In: J Med Libr Assoc (2022)
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Analysis of recreational psychedelic substance use experiences classified by substance
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In: Psychopharmacology (Berl) (2022)
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Factors Associated With Household Transmission of SARS-CoV-2: An Updated Systematic Review and Meta-analysis
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In: JAMA Netw Open (2021)
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Auditory Dysfunction Among Individuals With Neurofibromatosis Type 1
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In: JAMA Netw Open (2021)
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Length and Redundancy of Outpatient Progress Notes Across a Decade at an Academic Medical Center
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In: JAMA Netw Open (2021)
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Factors Associated With Racial/Ethnic Group–Based Medical Mistrust and Perspectives on COVID-19 Vaccine Trial Participation and Vaccine Uptake in the US
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In: JAMA Netw Open (2021)
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Comparison of Emergency Medical Dispatch Systems for Performance of Telecommunicator-Assisted Cardiopulmonary Resuscitation Among 9-1-1 Callers With Limited English Proficiency
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In: JAMA Netw Open (2021)
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Medical Students’ Demographic Characteristics and Their Perceptions of Faculty Role Modeling of Respect for Diversity
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In: JAMA Netw Open (2021)
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Factors Associated With Opting Out of Automated Text and Telephone Messages Among Adult Members of an Integrated Health Care System
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In: JAMA Netw Open (2021)
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Assessment of Length and Readability of Informed Consent Documents for COVID-19 Vaccine Trials
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In: JAMA Netw Open (2021)
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Assessment of Use and Fit of Face Masks Among Individuals in Public During the COVID-19 Pandemic in China
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In: JAMA Netw Open (2021)
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Exposure to Spoken Communication in Children With Cochlear Implants During the COVID-19 Lockdown
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In: JAMA Otolaryngol Head Neck Surg (2021)
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Differences in echocardiography interpretation techniques among trainees and expert readers
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In: J Echocardiogr (2021)
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Variation in Surgeon Proficiency Scores and Association With Digit Replantation Outcomes
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In: JAMA Netw Open (2021)
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Association of Medicaid Expansion With Quality in Safety-Net Hospitals
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In: JAMA Intern Med (2021)
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Association of Risk Factors With Patient-Reported Voice and Speech Symptoms Among Long-term Survivors of Oropharyngeal Cancer
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Aggarwal, Puja; Hutcheson, Katherine A.; Garden, Adam S.; Mott, Frank E.; Goepfert, Ryan P.; Duvall, Amber; Fuller, Clifton D.; Lai, Stephen Y.; Gunn, G. Brandon; Sturgis, Erich M.; Hanna, Ehab Y.; Shete, Sanjay
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In: JAMA Otolaryngol Head Neck Surg (2021)
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Abstract:
IMPORTANCE: Voice and speech production are critical physiological functions that affect quality of life and may deteriorate substantially after oropharyngeal cancer (OPC) treatment. There is limited knowledge about risk factors associated with voice and speech outcomes among survivors of OPC. OBJECTIVE: To identify the risk factors of voice and speech symptoms among long-term survivors of OPC. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study with cross-sectional survivorship survey administration includes cancer-free survivors of OPC who were treated curatively between January 2000 and December 2013 at MD Anderson Cancer Center (Houston, Texas) who participated in a survey from September 2015 to July 2016. Of 906 survivors of OPC with a median survival duration at time of survey of 6 years (range, 1-16 years), patient-rated voice and speech outcomes for 881 were available and analyzed. The data were analyzed from June 30, 2020, to February 28, 2021. MAIN OUTCOMES AND MEASURES: The primary outcome variable was patient-reported voice and speech scores that were measured using the MD Anderson Symptom Inventory–Head and Neck Cancer Module. Voice and speech scores of 0 to 4 were categorized as none to mild symptoms, and scores of 5 to 10 were categorized as moderate to severe symptoms. Risk factors for moderate to severe voice and speech symptoms were identified by multivariable logistic regression. RESULTS: Among 881 survivors of OPC (median [range] age, 56 [32-84] years; 140 women [15.5%]; 837 White [92.4%], 17 Black [1.9%], and 35 Hispanic individuals [3.8%]), 113 (12.8%) reported moderate to severe voice and speech scores. Increasing survival time (odds ratio [OR], 1.17; 95% CI, 1.06-1.30) and increasing total radiation dose (OR, 1.16; 95% CI, 1.00-1.34), Black race (OR, 3.90; 95% CI, 1.02-14.89), Hispanic ethnicity (OR, 3.74; 95% CI, 1.50-9.35), current cigarette smoking at the time of survey (OR, 3.98; 95% CI, 1.56-10.18), treatment with induction and concurrent chemotherapy (OR, 1.94; 95% CI, 1.06-3.57), and late (OR, 7.11; 95% CI, 3.08-16.41) and baseline lower cranial neuropathy (OR, 8.70; 95% CI, 3.01-25.13) were risk factors associated with moderate to severe voice and speech symptoms. Intensity-modulated radiotherapy split-field regimen (OR, 0.31; 95% CI, 0.12-0.80; P = .01) was associated with lower likelihood of moderate to severe voice and speech symptoms. CONCLUSIONS AND RELEVANCE: This large OPC survivorship cohort study identified many treatment-related factors, including increasing total radiotherapy dose, multimodality induction and concurrent chemotherapy regimens, and continued smoking, as well as clinical and demographic factors, as risk factors that were associated with moderate to severe voice and speech symptoms. The key findings in this study were the protective associations of split-field radiation and that longer-term survivors, and those who continued to smoke, had worse voice and speech symptoms. These findings may inform research and effective targeted clinical voice and speech preservation interventions and smoking cessation interventions to maximize voice and speech function and address quality of life among patients with OPC.
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Keyword:
Original Investigation
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URL: https://doi.org/10.1001/jamaoto.2021.0698 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103354/ http://www.ncbi.nlm.nih.gov/pubmed/33956062
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Assessment of Receptive and Expressive Language Skills Among Young Children With Prelingual Single-Sided Deafness Managed With Early Cochlear Implantation
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In: JAMA Netw Open (2021)
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Comparative Efficacy and Acceptability of Psychotherapies for Self-harm and Suicidal Behavior Among Children and Adolescents: A Systematic Review and Network Meta-analysis
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In: JAMA Netw Open (2021)
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Physician Use of Stigmatizing Language in Patient Medical Records
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In: JAMA Netw Open (2021)
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Turkish Validity and Reliability Study of the Speech, Spatial and Qualities of Hearing Scale
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In: Turk Arch Otorhinolaryngol (2021)
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