Contact

  • Academic
    rjpizzit@stanford.edu
    University - Student Department: Symbolic Systems Program Position: Undergraduate
    University - Student Department: French and Italian Position: Undergraduate
    University - Student Department: Linguistics Position: Graduate

Additional Info

  • Mail Code: 5017

All Publications

  • Extraction of Unstructured Electronic Health Records to Evaluate Glioblastoma Treatment Patterns. JCO clinical cancer informatics Swaminathan, A., Ren, A. L., Wu, J. Y., Bhargava-Shah, A., Lopez, I., Srivastava, U., Alexopoulos, V., Pizzitola, R., Bui, B., Alkhani, L., Lee, S., Mohit, N., Seo, N., Macedo, N., Cheng, W., Wang, W., Tran, E., Thomas, R., Gevaert, O. 2024; 8: e2300091

    Abstract

    Data on lines of therapy (LOTs) for cancer treatment are important for clinical oncology research, but LOTs are not explicitly recorded in electronic health records (EHRs). We present an efficient approach for clinical data abstraction and a flexible algorithm to derive LOTs from EHR-based medication data on patients with glioblastoma multiforme (GBM).Nonclinicians were trained to abstract the diagnosis of GBM from EHRs, and their accuracy was compared with abstraction performed by clinicians. The resulting data were used to build a cohort of patients with confirmed GBM diagnosis. An algorithm was developed to derive LOTs using structured medication data, accounting for the addition and discontinuation of therapies and drug class. Descriptive statistics were calculated and time-to-next-treatment (TTNT) analysis was performed using the Kaplan-Meier method.Treating clinicians as the gold standard, nonclinicians abstracted GBM diagnosis with a sensitivity of 0.98, specificity 1.00, positive predictive value 1.00, and negative predictive value 0.90, suggesting that nonclinician abstraction of GBM diagnosis was comparable with clinician abstraction. Of 693 patients with a confirmed diagnosis of GBM, 246 patients contained structured information about the types of medications received. Of them, 165 (67.1%) received a first-line therapy (1L) of temozolomide, and the median TTNT from the start of 1L was 179 days.We described a workflow for extracting diagnosis of GBM and LOT from EHR data that combines nonclinician abstraction with algorithmic processing, demonstrating comparable accuracy with clinician abstraction and highlighting the potential for scalable and efficient EHR-based oncology research.

    View details for DOI 10.1200/CCI.23.00091

    View details for PubMedID 38857465

  • Disparities in Postoperative Communication Patterns Among Spanish-Speaking Pediatric Patients with Hydrocephalus. The Journal of pediatrics Ruiz Colón, G. D., Pizzitola, R. J., Grant, G. A., Prolo, L. M. 2023: 113678

    Abstract

    To determine if differences exist in postoperative communication patterns or healthcare utilization among English-speaking patients (ESPs) and Spanish-speaking patients (SSPs) with childhood hydrocephalus.A single-institution, retrospective cohort study was conducted. Through simple random sampling, fifty ESPs and fifty SSPs (<18 years old) who underwent a ventriculoperitoneal shunt (VPS) or endoscopic third ventriculostomy (ETV) were identified. Demographics, communication with clinic (eg, number of calls/messages postoperatively), and healthcare utilization were collected. Multiple linear regressions assessed the significance of predictors on communication frequency and utilization.SSPs were more likely to have a comorbidity and VPS than ESPs. SSPs had longer median postoperative length of stay (p<0.01) and 30-day readmission (p<0.01) than ESPs. Only 18% of SSPs communicated with clinic; 11 total calls/messages from SSPs versus 57 from ESPs (p<0.01). The most common reason for outreach among both cohorts was a new symptom. ESP outreach most frequently resulted in reassurance or medical course changes on an outpatient basis (30% ESPs vs. 0% SSPs, p=0.04), whereas SSP outreach most frequently resulted in guidance to present to the emergency department (ED, 3% ESPs vs. 36% SSPs, p<0.01). Language remained a significant predictor for number of calls/messages even after adjusting for comorbidity, operation type, and insurance (p<0.01).Despite having more complex disease, only 18% of SSPs communicated with the neurosurgical team postoperatively and were more frequently sent to the ED for management. Future research will explore communication barriers and preferences to ensure postoperative care is timely and patient-centered.

    View details for DOI 10.1016/j.jpeds.2023.113678

    View details for PubMedID 37611737