Siwei Qi - Academia.edu (original) (raw)
Papers by Siwei Qi
Journal of the National Comprehensive Cancer Network
Background: Patients with cancer in Canada are often effectively managed in ambulatory settings; ... more Background: Patients with cancer in Canada are often effectively managed in ambulatory settings; however, patients with unmanaged or complex symptoms may turn to the emergency department (ED) for additional support. These unplanned visits can be costly to the healthcare system and distressing for patients. This study used a novel patient-reported outcomes (PROs)–derived symptom complexity algorithm to understand characteristics of patients who use acute care, which may help clinicians identify patients who would benefit from additional support. Patients and Methods: This retrospective observational cohort study used population-based linked administrative healthcare data. All patients with cancer in Alberta, Canada, who completed at least one PRO symptom-reporting questionnaire between October 1, 2019, and April 1, 2020, were included. The algorithm used ratings of 9 symptoms to assign a complexity score of low, medium, or high. Multivariable binary logistic regressions were used to ...
Journal of Adolescent and Young Adult Oncology
Purpose: Adolescents and young adults (AYAs) with cancer are in a unique situation due to their a... more Purpose: Adolescents and young adults (AYAs) with cancer are in a unique situation due to their age and developmental stage in life and may have different symptoms and concerns than older patients. Patient-Reported Outcomes (PROs) questionnaires, routinely used in Alberta, can help identify the distinct needs of AYAs. We aimed to compare PROs data for AYAs and older adults (OAs) to better understand how the concerns of AYAs differ, which is key to providing individualized care and creating targeted programming and system-level change. Methods: Retrospective data were collected for two patient cohorts who completed at least one PROs questionnaire between October 1, 2019 and April 1, 2020. The AYA cohort was aged 18-39, and the OA cohort was aged 40 and older. Symptoms were compared using mean scores and multiple linear regression, and concerns were compared using counts and multivariate negative binomial regression. Results: AYAs had significantly higher mean scores on depression and anxiety, compared to OAs, and lower mean scores for most physical symptoms. They indicated significantly more concerns in the Emotional and Social/Family/Spiritual domains, and were over three times more likely to indicate Work/School as a concern. Conclusion: AYAs with cancer have distinct concerns that should be addressed to ensure comprehensive, quality cancer care for this population. PROs data are useful in identifying needs and facilitating evidencebased, data-driven change at all levels of the health care system.
Current Oncology
Oncology programs across Canada are reaching capacity as more Canadians are diagnosed with and tr... more Oncology programs across Canada are reaching capacity as more Canadians are diagnosed with and treated for cancer each year. There is an increasing need to share care with family doctors, however it is unclear how this type of care impacts patient experiences, particularly while receiving active treatment. Retrospective data from the 2021 Ambulatory Oncology Patient Satisfaction Survey (AOPSS) in Alberta, Canada was used in this study. A unique question on the Alberta survey asks patients about their family doctor’s involvement during their cancer care. Patient satisfaction across the six domains of person-centred care on the AOPSS was analyzed based on how involved a patient’s family doctor was. Compared to patients who indicated their family doctor was “Not involved”, patients with “Very involved” family doctors had significantly higher satisfaction scores in all six domains of care. The three domains which showed the largest positive impact of family doctor involvement were: Coor...
Patient Experience Journal
Current Oncology, Mar 3, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Open Journal of Leadership, 2014
Radiotherapy and Oncology, 2020
Current Oncology, 2021
Patient-reported experience is associated with improved patient safety and clinical outcomes. Qua... more Patient-reported experience is associated with improved patient safety and clinical outcomes. Quality improvement programs rely on validated patient-reported experience measures (PREMs) to design projects. This descriptive study compares the experience of cancer patients treated with radiation as recorded through the Ambulatory Oncology Patient Satisfaction Survey (AOPSS) or as recorded through Your Voice Matters (YVM) between February and August 2019. Six questions were compared (“overall experience with care”, “discussion of worries”, “involvement in decisions”, “trusting providers with confidential information”, “providing family with information”, and “knowing who to contact”). Positive experience scores were calculated by cohort and by tumor groups. Multivariable logistic regression models evaluated factors associated with positive experience. Two cohorts (220 and 200 patients) met the eligibility criteria for the AOPSS and YVM, respectively. Positive experience was reported si...
The present study, combining qualitative and quantitative methods, investigated 30 university EFL... more The present study, combining qualitative and quantitative methods, investigated 30 university EFL teachers. The study answered the following questions: 1) what is Chinese EFL teachers' understanding of reflective teaching? 2) What are the most common and least common reflective practices, if there is any, among Chinese EFL teachers in universities? 3) How it relates to teachers' background such as educational experience, teaching experience and language proficiency relate to their reflective practices?
Journal of Clinical Oncology, 2021
e13529 Background: Increasing cancer incidence, coupled with a trend in treating patients for lon... more e13529 Background: Increasing cancer incidence, coupled with a trend in treating patients for longer periods of time, presents challenges in addressing all patients’ symptoms/concerns within the allotted time for ambulatory clinic appointments. Consequently, the ability to forecast and monitor the percentage of cancer patients with different symptom complexity levels is extremely valuable. Symptom complexity is a summary score that weighs the severity of all patient reported symptom scores at one time point. If a clinic could predict how many patients may need more time due to complex symptom management needs, clinic-scheduling templates could be adjusted to include a set number of longer appointments. Methods: Auto Regressive Integrated Moving Average (ARIMA) models were utilized to forecast the percentage of patients with a high symptom complexity level within one cancer clinic in Alberta, Canada. Goodness-of-fit measures such as Bayesian information criterion (BIC) and Ljung-Box ...
Current Oncology, 2020
The Ambulatory Oncology Patient Satisfaction Survey (AOPSS) is a standardized instrument to asses... more The Ambulatory Oncology Patient Satisfaction Survey (AOPSS) is a standardized instrument to assess the overall cancer patient experience. This study retrospectively investigated differences in care experiences and satisfaction among ambulatory oncology patients who self-identified as receiving outpatient therapies for curative intent or for symptom or disease control. This cross-sectional study analyzed data from the AOPSS collected between February and April 2019 within the provincial cancer program in Alberta, Canada. There were 2104 participants who returned the survey, representing a 52.7% response rate. This nationally validated survey gathers patient care experiences and satisfaction across six domains of person-centred care. Treatment intent was characterized by adding a new “goal of treatment” question. Statistical analysis was performed using Mann–Whitney U tests and analysis of covariance (ANCOVAs). Cancer patients’ treatment goals were found to be significantly associated...
International Journal of Environmental Research and Public Health, 2021
An increasing incidence of cancer has led to high patient volumes and time challenges in ambulato... more An increasing incidence of cancer has led to high patient volumes and time challenges in ambulatory oncology clinics. By knowing how many patients are experiencing complex care needs in advance, clinic scheduling and staff allocation adjustments could be made to provide patients with longer or shorter timeslots to address symptom complexity. In this study, we used predictive analytics to forecast the percentage of patients with high symptom complexity in one clinic population in a given time period. Autoregressive integrated moving average (ARIMA) modelling was utilized with patient-reported outcome (PRO) data and patient demographic information collected over 24 weeks. Eight additional weeks of symptom complexity data were collected and compared to assess the accuracy of the forecasting model. The predicted symptom complexity levels were compared with observation data and a mean absolute predicting error of 5.9% was determined, indicating the model’s satisfactory accuracy for forec...
Journal of Patient-Reported Outcomes
Cancer patients experience numerous distressing symptoms and concerns across the course of their ... more Cancer patients experience numerous distressing symptoms and concerns across the course of their illness, which negatively influence their quality of life. Regardless of cancer type, unmanaged symptoms can lead to adverse downstream consequences. Patient Reported Outcome Measures (PROMs) can be used to inform patient care and lead to targeted symptom management but simply gathering this information does not improve outcomes for the patient. Patient generated information must be easy for the clinicians to access and interpret if it is to be used to inform care delivery in ambulatory oncology facilities. This pragmatic work responded to this need. One Canadian provincial ambulatory oncology jurisdiction implemented digital tracking of PROMs over time in the provincial Electronic Medical Record (EMR) to support full integration of PROMs into standard care workflows and processes. Due to an inability within the EMR for direct patient entry, a hybrid data-entry was designed where the pat...
Journal of the National Comprehensive Cancer Network
Background: The patient-reported outcomes (PROs) symptom complexity algorithm, derived from self-... more Background: The patient-reported outcomes (PROs) symptom complexity algorithm, derived from self-reported symptom scores using the Edmonton Symptom Assessment System and concerns indicated on the Canadian Problem Checklist, has not been validated extensively. Methods: This is a retrospective chart review study using data from the Alberta Cancer Registry and electronic medical records from Alberta Health Services. The sample includes patients with cancer who visited a cancer facility in Alberta, Canada, from February 2016 through November 2017 (n=1,466). Results: The effect size (d=1.2) indicates that the magnitude of difference in health status between the severe- and low-complexity groups is large. The symptom complexity algorithm effectively classified subgroups of patients with cancer with distinct health status. Using Karnofsky performance status, the algorithm shows a sensitivity of 70.3%, specificity of 84.1%, positive predictive value of 79.1%, negative predictive value of 76...
JCO Oncology Practice
PURPOSE This study reports on a mixed methods evaluation conducted within a provincial cancer pro... more PURPOSE This study reports on a mixed methods evaluation conducted within a provincial cancer program in Alberta, Canada. The purpose was to capture key learnings from a rapid virtual care implementation because of the COVID-19 pandemic and to understand the impact on patient and staff experiences. METHODS Administrative data were collected for 21,362 patients who had at least one virtual or in-person visit to any provincial cancer center from April 1, 2020, to June 10, 2020. Patient surveys were conducted with 397 randomly selected patients who had received a virtual visit. Surveys were also conducted with 396 Cancer Care Alberta staff. RESULTS 14,906 virtual visits took place in this period, and about 40% of weekly visits were virtual. Significant differences were observed in both patient-reported symptom questionnaire completion rates and referrals to supportive care services between patients seen in-person and virtually. Patients receiving active treatments reported significantl...
Global Pediatric Health
CommunityWorks Canada® is a 12-week (30-hour) program that provides social, communication, and jo... more CommunityWorks Canada® is a 12-week (30-hour) program that provides social, communication, and job skill–building activities as well as peer mentorship to youth with autism spectrum disorder. Administration of a pre- and postprogram employment readiness measure (n = 76 participants) demonstrated positive changes as reflected by the participants’ decreased concerns about their responsibility, flexibility, job skills, communication, self-view, and health and safety. Postprogram qualitative interviews and survey data collected from a range of program stakeholders (participants, parents, peer mentors, and community partners/employers) corroborated identified gains in personal development, employment exposure, work proficiency, and comfort in work settings. For community partners/employers and peer mentors, greater understanding about autism spectrum disorder and commitment to inclusive hiring reportedly resulted from program engagement. Implications and recommendations are offered.
Journal of the National Comprehensive Cancer Network
Background: Patients with cancer in Canada are often effectively managed in ambulatory settings; ... more Background: Patients with cancer in Canada are often effectively managed in ambulatory settings; however, patients with unmanaged or complex symptoms may turn to the emergency department (ED) for additional support. These unplanned visits can be costly to the healthcare system and distressing for patients. This study used a novel patient-reported outcomes (PROs)–derived symptom complexity algorithm to understand characteristics of patients who use acute care, which may help clinicians identify patients who would benefit from additional support. Patients and Methods: This retrospective observational cohort study used population-based linked administrative healthcare data. All patients with cancer in Alberta, Canada, who completed at least one PRO symptom-reporting questionnaire between October 1, 2019, and April 1, 2020, were included. The algorithm used ratings of 9 symptoms to assign a complexity score of low, medium, or high. Multivariable binary logistic regressions were used to ...
Journal of Adolescent and Young Adult Oncology
Purpose: Adolescents and young adults (AYAs) with cancer are in a unique situation due to their a... more Purpose: Adolescents and young adults (AYAs) with cancer are in a unique situation due to their age and developmental stage in life and may have different symptoms and concerns than older patients. Patient-Reported Outcomes (PROs) questionnaires, routinely used in Alberta, can help identify the distinct needs of AYAs. We aimed to compare PROs data for AYAs and older adults (OAs) to better understand how the concerns of AYAs differ, which is key to providing individualized care and creating targeted programming and system-level change. Methods: Retrospective data were collected for two patient cohorts who completed at least one PROs questionnaire between October 1, 2019 and April 1, 2020. The AYA cohort was aged 18-39, and the OA cohort was aged 40 and older. Symptoms were compared using mean scores and multiple linear regression, and concerns were compared using counts and multivariate negative binomial regression. Results: AYAs had significantly higher mean scores on depression and anxiety, compared to OAs, and lower mean scores for most physical symptoms. They indicated significantly more concerns in the Emotional and Social/Family/Spiritual domains, and were over three times more likely to indicate Work/School as a concern. Conclusion: AYAs with cancer have distinct concerns that should be addressed to ensure comprehensive, quality cancer care for this population. PROs data are useful in identifying needs and facilitating evidencebased, data-driven change at all levels of the health care system.
Current Oncology
Oncology programs across Canada are reaching capacity as more Canadians are diagnosed with and tr... more Oncology programs across Canada are reaching capacity as more Canadians are diagnosed with and treated for cancer each year. There is an increasing need to share care with family doctors, however it is unclear how this type of care impacts patient experiences, particularly while receiving active treatment. Retrospective data from the 2021 Ambulatory Oncology Patient Satisfaction Survey (AOPSS) in Alberta, Canada was used in this study. A unique question on the Alberta survey asks patients about their family doctor’s involvement during their cancer care. Patient satisfaction across the six domains of person-centred care on the AOPSS was analyzed based on how involved a patient’s family doctor was. Compared to patients who indicated their family doctor was “Not involved”, patients with “Very involved” family doctors had significantly higher satisfaction scores in all six domains of care. The three domains which showed the largest positive impact of family doctor involvement were: Coor...
Patient Experience Journal
Current Oncology, Mar 3, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Open Journal of Leadership, 2014
Radiotherapy and Oncology, 2020
Current Oncology, 2021
Patient-reported experience is associated with improved patient safety and clinical outcomes. Qua... more Patient-reported experience is associated with improved patient safety and clinical outcomes. Quality improvement programs rely on validated patient-reported experience measures (PREMs) to design projects. This descriptive study compares the experience of cancer patients treated with radiation as recorded through the Ambulatory Oncology Patient Satisfaction Survey (AOPSS) or as recorded through Your Voice Matters (YVM) between February and August 2019. Six questions were compared (“overall experience with care”, “discussion of worries”, “involvement in decisions”, “trusting providers with confidential information”, “providing family with information”, and “knowing who to contact”). Positive experience scores were calculated by cohort and by tumor groups. Multivariable logistic regression models evaluated factors associated with positive experience. Two cohorts (220 and 200 patients) met the eligibility criteria for the AOPSS and YVM, respectively. Positive experience was reported si...
The present study, combining qualitative and quantitative methods, investigated 30 university EFL... more The present study, combining qualitative and quantitative methods, investigated 30 university EFL teachers. The study answered the following questions: 1) what is Chinese EFL teachers' understanding of reflective teaching? 2) What are the most common and least common reflective practices, if there is any, among Chinese EFL teachers in universities? 3) How it relates to teachers' background such as educational experience, teaching experience and language proficiency relate to their reflective practices?
Journal of Clinical Oncology, 2021
e13529 Background: Increasing cancer incidence, coupled with a trend in treating patients for lon... more e13529 Background: Increasing cancer incidence, coupled with a trend in treating patients for longer periods of time, presents challenges in addressing all patients’ symptoms/concerns within the allotted time for ambulatory clinic appointments. Consequently, the ability to forecast and monitor the percentage of cancer patients with different symptom complexity levels is extremely valuable. Symptom complexity is a summary score that weighs the severity of all patient reported symptom scores at one time point. If a clinic could predict how many patients may need more time due to complex symptom management needs, clinic-scheduling templates could be adjusted to include a set number of longer appointments. Methods: Auto Regressive Integrated Moving Average (ARIMA) models were utilized to forecast the percentage of patients with a high symptom complexity level within one cancer clinic in Alberta, Canada. Goodness-of-fit measures such as Bayesian information criterion (BIC) and Ljung-Box ...
Current Oncology, 2020
The Ambulatory Oncology Patient Satisfaction Survey (AOPSS) is a standardized instrument to asses... more The Ambulatory Oncology Patient Satisfaction Survey (AOPSS) is a standardized instrument to assess the overall cancer patient experience. This study retrospectively investigated differences in care experiences and satisfaction among ambulatory oncology patients who self-identified as receiving outpatient therapies for curative intent or for symptom or disease control. This cross-sectional study analyzed data from the AOPSS collected between February and April 2019 within the provincial cancer program in Alberta, Canada. There were 2104 participants who returned the survey, representing a 52.7% response rate. This nationally validated survey gathers patient care experiences and satisfaction across six domains of person-centred care. Treatment intent was characterized by adding a new “goal of treatment” question. Statistical analysis was performed using Mann–Whitney U tests and analysis of covariance (ANCOVAs). Cancer patients’ treatment goals were found to be significantly associated...
International Journal of Environmental Research and Public Health, 2021
An increasing incidence of cancer has led to high patient volumes and time challenges in ambulato... more An increasing incidence of cancer has led to high patient volumes and time challenges in ambulatory oncology clinics. By knowing how many patients are experiencing complex care needs in advance, clinic scheduling and staff allocation adjustments could be made to provide patients with longer or shorter timeslots to address symptom complexity. In this study, we used predictive analytics to forecast the percentage of patients with high symptom complexity in one clinic population in a given time period. Autoregressive integrated moving average (ARIMA) modelling was utilized with patient-reported outcome (PRO) data and patient demographic information collected over 24 weeks. Eight additional weeks of symptom complexity data were collected and compared to assess the accuracy of the forecasting model. The predicted symptom complexity levels were compared with observation data and a mean absolute predicting error of 5.9% was determined, indicating the model’s satisfactory accuracy for forec...
Journal of Patient-Reported Outcomes
Cancer patients experience numerous distressing symptoms and concerns across the course of their ... more Cancer patients experience numerous distressing symptoms and concerns across the course of their illness, which negatively influence their quality of life. Regardless of cancer type, unmanaged symptoms can lead to adverse downstream consequences. Patient Reported Outcome Measures (PROMs) can be used to inform patient care and lead to targeted symptom management but simply gathering this information does not improve outcomes for the patient. Patient generated information must be easy for the clinicians to access and interpret if it is to be used to inform care delivery in ambulatory oncology facilities. This pragmatic work responded to this need. One Canadian provincial ambulatory oncology jurisdiction implemented digital tracking of PROMs over time in the provincial Electronic Medical Record (EMR) to support full integration of PROMs into standard care workflows and processes. Due to an inability within the EMR for direct patient entry, a hybrid data-entry was designed where the pat...
Journal of the National Comprehensive Cancer Network
Background: The patient-reported outcomes (PROs) symptom complexity algorithm, derived from self-... more Background: The patient-reported outcomes (PROs) symptom complexity algorithm, derived from self-reported symptom scores using the Edmonton Symptom Assessment System and concerns indicated on the Canadian Problem Checklist, has not been validated extensively. Methods: This is a retrospective chart review study using data from the Alberta Cancer Registry and electronic medical records from Alberta Health Services. The sample includes patients with cancer who visited a cancer facility in Alberta, Canada, from February 2016 through November 2017 (n=1,466). Results: The effect size (d=1.2) indicates that the magnitude of difference in health status between the severe- and low-complexity groups is large. The symptom complexity algorithm effectively classified subgroups of patients with cancer with distinct health status. Using Karnofsky performance status, the algorithm shows a sensitivity of 70.3%, specificity of 84.1%, positive predictive value of 79.1%, negative predictive value of 76...
JCO Oncology Practice
PURPOSE This study reports on a mixed methods evaluation conducted within a provincial cancer pro... more PURPOSE This study reports on a mixed methods evaluation conducted within a provincial cancer program in Alberta, Canada. The purpose was to capture key learnings from a rapid virtual care implementation because of the COVID-19 pandemic and to understand the impact on patient and staff experiences. METHODS Administrative data were collected for 21,362 patients who had at least one virtual or in-person visit to any provincial cancer center from April 1, 2020, to June 10, 2020. Patient surveys were conducted with 397 randomly selected patients who had received a virtual visit. Surveys were also conducted with 396 Cancer Care Alberta staff. RESULTS 14,906 virtual visits took place in this period, and about 40% of weekly visits were virtual. Significant differences were observed in both patient-reported symptom questionnaire completion rates and referrals to supportive care services between patients seen in-person and virtually. Patients receiving active treatments reported significantl...
Global Pediatric Health
CommunityWorks Canada® is a 12-week (30-hour) program that provides social, communication, and jo... more CommunityWorks Canada® is a 12-week (30-hour) program that provides social, communication, and job skill–building activities as well as peer mentorship to youth with autism spectrum disorder. Administration of a pre- and postprogram employment readiness measure (n = 76 participants) demonstrated positive changes as reflected by the participants’ decreased concerns about their responsibility, flexibility, job skills, communication, self-view, and health and safety. Postprogram qualitative interviews and survey data collected from a range of program stakeholders (participants, parents, peer mentors, and community partners/employers) corroborated identified gains in personal development, employment exposure, work proficiency, and comfort in work settings. For community partners/employers and peer mentors, greater understanding about autism spectrum disorder and commitment to inclusive hiring reportedly resulted from program engagement. Implications and recommendations are offered.