Featured Module (Archived)
(Week of August 26, 2024)
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A new Exemplar Trial educational offering has been posted (1-1.5 hours of primary open access content). Modules include a general overview of the pragmatic trial (backgrounds, methods, results, discussion) and a discussion of the trial using all 12 sections of the curriculum wheel. This website will be updated every Monday (by 12:00 PM Eastern) or Tuesday (if Monday is a holiday).
This exemplar trial, under the direction of Dr. Monika Krzyzanowska (Sunnybrook Health Sciences Centre, University of Toronto, ICES), is titled: Remote, proactive, telephone based management of toxicity in outpatients during adjuvant or neoadjuvant chemotherapy for early stage breast cancer: pragmatic, cluster randomised trial.
Exemplar Trial
Remote, proactive, telephone based management of toxicity in outpatients during adjuvant or neoadjuvant chemotherapy for early stage breast cancer: pragmatic, cluster randomised trialÂ
Primary resources:
Primary resources:
Exemplar Trial Overview - AToM. (13-min video & 16-slide presentation)
Summary: Dr. Monika Krzyzanowska overviews AToM ("Ambulatory Toxicity Management"), a multicentre pragmatic cluster randomised trial to evaluate the effect of proactive, nurse led, telephone based management of symptoms on the number of visits to the emergency department or admissions to hospital.
Krzyzanowska MK, et al. Remote, proactive, telephone based management of toxicity in outpatients during adjuvant or neoadjuvant chemotherapy for early stage breast cancer: pragmatic, cluster randomised trial. BMJ. 2021 Dec 8;375:e066588 (10-page paper)
Summary: Publication in the BMJ describing the AToM pragmatic trial, which answered the question: Does remote, proactive, telephone based management of toxicities during chemotherapy result in fewer visits to the emergency department or admissions to hospital?
Exemplar Trial - AToM: 14-min video & 16-slide presentation.
Summary: Drs. Monika Krzyzanowska and Melanie Powis break down the AToM trial across the 12 sections of the curriculum wheel.
Optional resources:
Optional resources:
Krzyzanowska MK, et al. A Pragmatic Trial of Ambulatory Toxicity Management in Patients Receiving Adjuvant or Neo-adjuvant Chemotherapy for Early Stage Breast Cancer (AToM). ClinicalTrials.gov identifier: NCT02485678. Updated 2020-09-03. (8-section website)
Summary: Public registration of the trial (i.e., study overview, contacts and locations, study plan, collaborators and investigators, publications, study record dates).
Krzyzanowska MK, et al. Ambulatory Toxicity Management (AToM) Pilot: results of a pilot study of a pro-active, telephone-based intervention to improve toxicity management during chemotherapy for breast cancer. Pilot Feasibility Stud. 2019 Mar 8;5:39. (12-page paper)
Summary: Describes a single-arm pilot study to evaluate the feasibility, acceptability, and potential impact of a telephone symptom management intervention on healthcare utilization during chemotherapy for early stage breast cancer.
Krzyzanowska MK, et al. Ambulatory Toxicity Management (AToM) in patients receiving adjuvant or neo-adjuvant chemotherapy for early stage breast cancer - a pragmatic cluster randomized trial protocol. BMC Cancer. 2019 Sep 5;19(1):884. (10-page paper)
Summary: Trial protocol describing a pragmatic covariate constraint-based cluster randomized trial in 20 centres in Ontario, Canada, where centres were randomly allocated to either proactive telephone toxicity management (intervention) or routine care (control). The primary outcome was the cluster-level mean number of emergency department visits and hospitalizations visits per patient evaluated using administrative health data.
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