News in brief: Discharge summary abbreviations cause confusion; Women under represented as PIs; More evidence for ICI use in liver cancer

Discharge summary abbreviations cause confusion

Medical abbreviations used by specialists in hospital discharge summaries are often confusing to the GPs who receive them and also ambiguous for hospital colleagues and junior doctors, an Australian study has found.

A retrospective audit of 802 discharge summaries at a Queensland regional health service found that they contained an average of 17 abbreviations, and almost one in five GPs were unable to interpret at least one of them.

Almost all (94%) of GPs said that ambiguous abbreviations had a negative impact on patient care and 60% said they spent too much time of clarifying them. Abbreviations could also have multiple possible meanings in different contexts and led to confusion for 15% of junior doctors working in other departments of the same hospital, the study found.

While most had no problems with abbreviations such as Hb and IHD, the abbreviations that had widest range of misinterpretations or ‘don’t know’ responses included NAD, DEM, PE, LC, TGA, TCH and BAE.

The study authors said hospitals should adopt a standardised list of acceptable abbreviations for medical documentation, which is made available to both hospital medical staff and GPs.

They also noted that abbreviations were very location specific, with marked differences between those used by Melbourne and Sydney hospitals.

The findings are published in the Internal Medicine Journal.

Women under represented in PIs

Gender inequity persists in the running of Australian oncology research with female representation as lead investigators as low as 4% in some academic cancer trials, a study shows.

A review of principal investigators for 321 Australian oncology group trials found that 37% overall were women.

The lowest representation of female principal investigators was 4.2% for the Australia and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP), followed by 11.3% for the Australasian Gastrointestinal Trials Group (AGITG), 33.3% for the TransTasman Radiation-Oncology Group (TROG) and Australasian Leukaemia and Lymphoma Group (ALLG), 41.7% for the Cooperative Trials Group for Neuro-Oncology (COGNO), 43.7% for the Breast Cancer Trials (BCT) group, 44% for the Cancer Research in Primary Care (PC4) group, 46.9% for Melanoma And Skin Cancer Trials (MASC), 54.8% for the Palliative Care Clinical Studies Collaborative (PaCCSC), 55.2 % for the Australia and New Zealand Sarcoma Association (ANZSA) and 80% for the Australia and New Zealand Gynaecological Oncology Group (ANZGOG).

The number of female principal investigators by craft groups were 66/158 for medical oncology, 29/86 for radiation oncology and 5/59 for surgical oncology.

“Proactive strategies to address the imbalance should be adopted,” said study author Dr Vi Luong of Monash Health, Melbourne, who presented the results at the recent COSA 2021 meeting.

More evidence for ICI use in liver cancer

Immune checkpoint inhibitors (ICIs) have a role in the management of unresectable hepatocellular carcinoma (HCC).

A meta-analysis of three RCTs totaling 1,657 patients, found ICIs were associated with significantly improved overall survival, progression-free survival, and overall response rate, compared with standard therapies.

In addition, the rate of grade 3 or 4 treatment-related adverse events was lower with ICIs than with sorafenib (OR, 0.44; 95% CI, 0.20-0.96; P = .04).

The researchers said the main driver of the overall benefit associated with ICIs in their meta-analysis was the IMbrave150 study, which evaluated the combination of anti–PD-L1 plus anti–VEGF therapy.

They said atezolizumab plus bevacizumab should be preferentially used in the first-line setting in eligible patients, however the best choice for second line therapy was not clear.

Read more in JAMA Network Open

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