Enrollment Process Research Articles

Neoliberalism and managerial governance in the Swedish pre-school sector

ABSTRACT Tax-funded private provision of welfare services in Sweden is among the most extensive in Europe. This paper focuses on a contradictory example of how discrepancies between neoliberal ideals and practice are embedded in the governance of Swedish preschool. Over time, national and local regulations in Sweden have become increasingly comprehensive and moved toward managerial systems. Using Alain Enthoven’s model of managed competition, and drawing on documents and interviews, this paper focuses on two right-wing, urban municipalities with a very high share of preschools operated by private actors, and their organization of local preschool quasi-markets in terms of so-called sponsors concerning five functions: establishing rules of equity, approving all participating private pre-schools, managing the enrollment process, creating price-elastic demand, and managing risk-selection. The findings show how instead of limiting bureaucratic power, municipal managers have been empowered to plan and optimize the organization of the preschool sector in ways discordant with neoliberal ideas.

Point of care lactate for differentiating septic shock from hypovolemic shock in non-ICU settings: a prospective observational study

BackgroundSeptic shock and hypovolemic shock are life-threatening illnesses that necessitate immediate recognition and intervention, as they can result in deadly consequences. While the underlying processes may vary, both entities can exhibit hypotension and organ dysfunction. No studies have been conducted on bedside testing to differentiate between these illnesses. Lactate measurement has been established as a viable option for early detection of septic shock. However, its role in diagnosing hypovolemic shock has yet to be evaluated. The aim of the study was to investigate alterations in lactate levels among diarrheal patients with septic shock and hypovolemic shock following the administration of first fluid resuscitation. MethodsWe conducted a prospective observational study in critically ill diarrheal adults aged ≥18 years in the emergency ward in Dhaka Hospital of icddr,b from 21st October 2021 to 31st May 2023 (total 19 months). The enrollment process was operational between 8:30 AM and 5:00 PM. Diarrheal adults with a diagnosis of sepsis with shock featured with poor peripheral perfusion (characterized by cold periphery and weak or absent pulse and capillary refill time >3 sec) or hypotension (characterized by mean arterial pressure <65 mm-Hg) were enrolled as cases and consecutive diarrheal patients without any obvious features of sepsis with hypovolemic shock (due to severe dehydration) comprised the comparison group.POC lactate test was done at hours 0, 1st and 6th by StatStrip Lactate meters (Nova Biomedical, US) to all enrolled patients. For comparison of POC lactate levels, we used paired t-test for comparing the lactate samples drawn at hour 0, hour 1 and 6 with the septic shock and hypovolemic shock group. Odds ratio (OR) and their 95% confidence intervals (CIs) were used to demonstrate the strength of association. The study was registered at Clinicaltrials.gov (NCT05108467) and received institutional ethical approval (PR-21097). FindingsOf 435 patients, 135 had septic shock and 141 had hypovolemic shock, rest 41 patient responded with fluid bolus. 25% (34/135) of the people in the septic shock group died whereas there is no mortality in the hypovolemic shock group. The number of patients visiting from outside Dhaka city had more septic shock than from inside were higher in comparison with (55% vs. 28%; p <0.001). Statistically significant difference was observed between septic shock and hypovolemic shock group for a median POC lactate in 0, 1st and 6th hours with an OR of 1.07 (95% CI: 0.99, 1.17; p=0.039); 1.48, (95% CI: 1.28, 1.70; p<0.001) and 2.36 (95% CI: 1.85, 3.00; p<0.001), respectively. The gradient of 1st to 2nd sample between septic shock and hypovolemic shock was found to be significantly different (OR:0.74, 95% CI: 0.64, 0.85; p<0.001). InterpretationPOC lactate test can detect septic shock by differentiating hypovolemic shock in diarrheal patients. By providing quick, reliable and accurate result this test can help clinicians quickly diagnose and treat time-sensitive condition, like septic shock. FundingThe study was funded by Global Affairs of Canada (GR-01726). The donors had no role in the design, implementation, analysis, data interpretation or writing manuscript, or decision to publish. The corresponding author had access to all data and takes responsibility for the final approval and submission of the manuscript.

Evaluation and Use of Natural Language Processing (NLP) Reasoning and Classification Models to Support Clinical Trial Patient Identification and Enrollment in the Community Oncology Setting

Clinical trial research in oncology relies heavily on clinical documentation within the electronic medical record (EMR) to ascertain patient eligibility in clinical trials based on inclusion and exclusion criteria. The structured data elements within the EMR serve as the primary information source for defining patient cohorts, with clinical cancer stage and performance status being two pivotal criteria determining trial eligibility. The challenge arises from the inconsistent availability of clinical stage and performance status data within the structured fields of the EMR despite their consistent presence in clinical notes. Additionally, there is a deficiency of standardization of this data that exists in the unstructured field. Hence, due to lack of structured data and standardization of said data, there are limitations in developing artificial intelligence (AI) models. To increase the comprehensiveness of clinical records, a clinical research team at a community oncology practice was consulted to identify requirements and extract essential clinical features from de-identified data. The methods outlined in this paper focused on eliminating false positives to allow future development of Large Language Models (LLM) using the outputted structured fields which resulted in an increase in patient record completeness with high accuracy. The accuracy ranged from 97.5-97.75% for the models that were developed. Out of the 60,000+ patients, the numerical staging, TNM (tumor, node, metastasis) staging, and Karnofsky performance score models added a structured field for 29.62%, 21.01%, and 40.64% patients respectively. Additionally, a semi-supervised NLP algorithm was applied on the performance status algorithm which achieved a mean absolute error (MAE) of 1.57. This work demonstrates the use case of natural language processing (NLP) in optimizing the clinical research enrollment process by providing an efficient and accurate method to detect key clinical values in unstructured patient data. Similar methodology with more advanced algorithms such as LLM can be employed to detect additional patient elements such as molecular biomarkers, imaging reports, postoperative surgical outcomes (i.e., clear margins etc.) and patient treatment outcomes using the extracted structured fields.

Artificial Intelligence Chatbots in Action: Optimizing Benefits Enrollment in Public Administration

This article examines the implementation of artificial intelligence-powered chatbots in public sector benefits enrollment processes, focusing on their potential to streamline operations, enhance user experience, and reduce administrative burdens. Through a comprehensive analysis of case studies in healthcare and social security benefits programs, we demonstrate that chatbots can significantly improve efficiency, accuracy, and accessibility in enrollment procedures. Our findings indicate a 30-40% reduction in processing times and a marked increase in application completion rates. However, challenges related to data privacy, system integration, and user acceptance persist. This article contributes to the growing body of literature on digital transformation in public administration by providing empirical evidence of chatbots' effectiveness in benefits enrollment. We conclude that while chatbots offer promising solutions to longstanding issues in public sector service delivery, their successful implementation requires careful consideration of technical, ethical, and user-centric factors. Our study has important implications for policymakers and public administrators seeking to leverage AI technologies to enhance public service efficiency and accessibility

Caregiver Perspectives on Improving Government Nutrition Benefit Programs.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) provide essential nutrition support for low-income families. However, many eligible families do not receive or fully redeem these benefits. We aimed to understand current and former WIC and SNAP beneficiaries' perceptions of and suggestions for improving both programs. We conducted semistructured phone interviews with caregivers of pediatric patients who were current or former WIC and SNAP beneficiaries at 2 academic pediatric primary care clinics. Interviews were recorded, transcribed, and coded by 2 independent coders using thematic analysis, resolving discrepancies by consensus. Interviews continued until data saturation was reached. We interviewed 40 caregivers who were predominantly Black (88%) mothers (90%), with 53% and 83% currently using WIC and SNAP, respectively. We identified 4 themes related to participation barriers: (1) limited product variety available through WIC, (2) inconvenience and stigma associated with purchasing WIC products, (3) SNAP income-based eligibility criteria, and (4) burdensome SNAP enrollment and recertification processes. We identified 3 themes related to suggestions for improvement: (a) decreasing stigma associated with participation, (b) allowing online or phone-based enrollment, and (c) improving coordination with health care systems. WIC and SNAP beneficiaries identified several modifiable barriers to enrollment and benefits redemption. Pediatric providers should advocate for programmatic improvements that make it easier for families to access and redeem benefits and should consider implementing innovative cross-sector interventions like medical-financial partnerships, direct WIC and SNAP referrals, and data sharing with government assistance offices.

NICU Music Therapy: Lessons Learned from a Randomized Trial

Abstract Mothers of infants hospitalized in the neonatal intensive care unit (NICU) are at risk for developing acute and posttraumatic stress disorder, but mothers’ positive coping may improve with progress in the infant’s well-being. There is a need to investigate complementary therapies that increase infant well-being and decrease maternal stress. A pacifier-activated lullaby (PAL) device is one evidence-based intervention to assist premature infants by playing a few bars of a lullaby after an effective suck, improving feeding behavior and shortening the length of NICU stay. The PAL may be personalized with lullabies sung and recorded by the neonate’s mother or other family. This study’s purpose was to quantify the effect of a PAL intervention on maternal stress symptoms. The experimental PAL intervention included a singing and recording session with a board-certified music therapist with NICU certification. This was a single-site randomized trial comparing the effect of maternal voice recording versus standard conditions. A total of 245 infant–mother dyads were screened; 18 mothers consented to participate and 12 were randomized to one of three conditions: mother’s recorded lullaby for PAL administration, a generic female voice used for the PAL, and no intervention. Barriers arising during the study included lengthy enrollment processes, maternal visitation patterns, and an overly ambitious study design. Despite attempts to mitigate perceived barriers, we did not achieve the enrollment necessary to perform the intended analysis. We, therefore, present lessons learned and possible solutions for future music therapy research in the interest of transparency, reducing publication bias, and replication of problematic design issues in future trials.

Evaluating enrollment processes and eligibility criteria of manufacturer free-drug patient assistance programs for oral anticancer agents used in hematologic malignancies.

117 Background: Increasing costs of oral anticancer agents (OAAs) pose a major barrier to patient adherence and consequently treatment effectiveness. While patient assistance programs (PAPs) may help cover costs, eligibility requirements for these programs are anecdotally reported to be non-transparent and enrollment processes burdensome, limiting their accessibility to patients. Thus, we evaluated the eligibility criteria and enrollment processes of manufacturer free-drug PAPs. Methods: A prospective review of manufacturer free-drug PAPs available for OAAs used in hematologic malignancies was conducted between October 2023 and February 2024. Available PAPs were identified using three online databases: RxAssist, NeedyMeds, and Association of Community Cancer Centers . Financial support program websites were assessed to gather information on eligibility requirements, enrollment processes, and other PAP characteristics. Results: For the 45 OAAs evaluated, 23 manufacturer free-drug PAPs were identified. All PAPs had insurance and income eligibility requirements which varied between programs. Uninsured patients were eligible for all programs, with 4% of programs restricting eligibility to only uninsured patients. The most common income eligibility threshold was 500% federal poverty limit, and requirement details were unavailable for 43.5% of programs. Enrollment could be initiated online, via downloadable form, and by phone-call, with 61% of programs having all three methods of enrollment initiation available to providers (17% to patients), 35% having two to providers (22% to patients), and 4% having only one to providers (52% to patients). Of note, 9% of programs offered no way for patients to independently initiate enrollment. Enrollment for all programs required both patient and provider inputs, and submission methods for some or all enrollment documentation included fax, online portal, email, and mail, with 4% of programs having four methods of submission available, 26% having three, 52% having two, and 17% having only one. Conclusions: The pathways for patients or providers to enroll in Patient Assistance Programs (PAPs) are complex and inconsistent across different programs, often requiring more action from providers than patients. Additionally, there is frequently a lack of transparency in the eligibility requirements for manufacturer free-drug PAPs.

Identifying and mitigating racial/ethnic disparities in clinical trials with screening data.

63 Background: ASCO and Association of Community Cancer Centers (ACCC) released a statement on increasing racial/ethnic equity, diversity, and inclusion (EDI) in cancer trials (1). It included recommendations for clinical practices and research sites to 1) screen every patient for trial eligibility; and 2) routinely collect and analyze screening and enrollment data by patient demographic characteristics, including race/ethnicity. Most of the 62 sites that completed a 2021 pilot study reported that screening data were not readily available by patient race/ethnicity (2). ASCO conducted a follow-up study about challenges, resource needs, and effective strategies for collecting and analyzing these data. Methods: Semi-structured interviews were conducted with research team members from sites that completed the 2021 pilot study. Sites were purposefully selected based on pilot study data quality and insights, diversity of patient population, and site type, size, and region. Sites completed a pre-interview questionnaire on site characteristics and screening and enrollment processes before participating in a 1-hour interview focused on challenges and effective strategies for collecting and analyzing screening and enrollment data, by race/ethnicity. Anticipated themes and relationships, stemming from the pilot study findings, informed a conceptual framework. Up to 20 interviews were planned and halted sooner when there was theme saturation. Results: Thirteen research sites participated in the study, representing academic centers (62%) and community-based practices/health systems (38%) with racially/ethnically diverse patient populations (median 31% non-white; range 11% to 63%). 53 research team members participated in the interviews (typically 4 per site), including investigators (23%), directors/managers (56%), and coordinators (21%). Aggregated responses were interpreted through content analysis and concepts were quantified for both frequency and extensiveness. Several barriers to patient screening, data collection, and analysis were cited, including lack of standardized procedures and documentation, dedicated staff and time, quality and/or accessible data on race/ethnicity and/or screening, and integrated technology that facilitates screening and documentation. Conclusions: Collecting and analyzing screening and enrollment data are critical to identifying and mitigating racial/ethnic disparities in trial access and EDI. Many sites do not systematically screen every patient for a trial and/or document outcomes. Lack of resources, including dedicated staff and time and integrated technology, make it difficult for them to do so in systematic and reliable ways. Greater investment in resources will help to facilitate routine screening of every patient and ensure underrepresented populations are not being overlooked for trials. 1. Oyer et al, JCO, 2022 . 2. Pressman et al, JCO, 2022 .

The Evolution of Paperless Education in Medical Universities: Enhancing Efficiency and Health Outcomes

The adoption of paperless education in medical universities has revolutionized various aspects of academic life, offering enhanced efficiency, cost savings, and improved health outcomes. Traditional paper-based systems in medical education have long been associated with inefficiencies and environmental concerns. The advent of digital technologies has provided opportunities to streamline educational processes, reduce waste, and improve accessibility. This mini review examines the transformative impact of paperless education on medical universities, focusing on its benefits in registration, teaching, education, and exams. The shift to online registration systems has simplified the enrollment process for both students and administrators, allowing for seamless registration, payment, and course selection. Online registration also enables real-time tracking of student progress and facilitates communication between students and faculty. In teaching, digital tools such as e-learning platforms and virtual classrooms offer students flexible learning opportunities, promoting active engagement and knowledge retention. Similarly, the adoption of electronic textbooks and digital libraries has significantly reduced the reliance on printed materials in medical education, fostering self-directed learning and research. Furthermore, digital assessment methods such as online quizzes and remote proctoring have streamlined the examination process, offering greater flexibility in scheduling exams and ensuring the integrity of the assessment process. Economically, the transition to paperless education has resulted in cost savings by eliminating the need for printed materials, storage, and distribution. Additionally, digital technologies enable universities to reach a broader audience, potentially increasing enrollment and revenue. Moreover, paperless education offers health benefits by reducing exposure to allergens and pathogens associated with paper-based materials, and promoting social distancing to reduce the risk of transmission of infectious diseases. In conclusion, the adoption of paperless education in medical universities represents a transformative shift, offering numerous benefits including enhanced efficiency, cost savings, and improved health outcomes. As technology continues to evolve, medical universities need to embrace digital innovations to ensure a sustainable and effective learning environment.

Abstract A154: Mammograms Across Missouri: A Qualitative Evaluation among Healthcare Providers to Improve Breast Cancer Screening in Rural Communities

Abstract Introduction: Breast cancer is the leading cause of cancer-related deaths among women, with rural communities having the highest rates of breast cancer mortality. Despite this burden, many women begin mammography later than recommended and the mammography screening rate remains low, with a previously reported declining trend, particularly among rural women compared to urban women. This study seeks to identify barriers to breast cancer screening and examine strategies to overcome these barriers in rural Missouri. Methods: In partnership with the Missouri Cancer Consortium and the Missouri Comprehensive Cancer Control Programs, we conducted key informant interviews with mammography health providers at health centers in each of ten counties with the highest breast cancer mortality and lowest screening mammography rates in Missouri. Semi-structured interviews included questions about seeking and delivering breast cancer screening as well as provider experiences with patient navigation, mobile mammography, and the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Data were analyzed using a deductive-inductive thematic approach in NVivo 14. Results: We conducted 14 interviews with health providers across 12 health sites. The majority of these sites used patient navigation (67%), mobile mammography (80%), and the CDC NBCCEDP (67%) as strategies to improve access to breast healthcare. Health providers frequently mentioned “no-shows” as a major challenge to providing breast healthcare, along with limited transportation, cost, fear, and competing work priorities as the major barriers faced by patients in seeking breast healthcare. Patient navigation and mobile mammography were beneficial in bringing breast healthcare closer to the community, while the CDC NBCCEDP covered screening and follow-up costs. The main facilitating factors to implementing these strategies were having dedicated staff and funding for patient navigation, and existing partnerships with other health institutions for mobile mammography. However, health providers identified several implementing challenges for the strategies. This included limited staff capacity and difficulty contacting or following up patients to schedule appointments for patient navigation and mobile mammography. For the CDC NBCCEDP, the challenges included difficulty identifying eligible patients and extensive paperwork in the enrollment process. Providers recommended increasing staff capacity to support patient navigation, using digital technology in identifying and enrolling women for the CDC NBCCEDP, and integrating mobile mammography with the CDC NBCCEDP to improve implementation efficiency. Discussion: The integration of multiple component strategies within breast healthcare may address the multi-level barriers women face in accessing breast cancer screening. This study contributes to the identification of organizational supports and informs development of policies needed to enhance the adoption and implementation of strategies that support the effective delivery of breast healthcare. Citation Format: Thembekile Shato, Carmen Vardeman, Sarah J. Chavez, Ashley C. Holmes, Joann Lee, Xarria Lewis, Katie Manga, Misty Phillips, Keisha Windham, Bettina F. Drake. Mammograms Across Missouri: A Qualitative Evaluation among Healthcare Providers to Improve Breast Cancer Screening in Rural Communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A154.

Georeferencing Management for Optimization of Enrollment Slots in the Municipal Education System of Campos dos Goytacazes-RJ

This essay was presented with the aim of suggesting a georeferencing solution to optimize the pre-enrollment process in the education system of Campos dos Goytacazes-RJ. Using a mixed methodological approach that combines qualitative and quantitative analysis, collecting new student requests and georeferencing addresses and routing with the offered options, the study analyzed the current enrollment process and developed a new model guided by georeferencing. This was achieved by collecting geospatial data from students' residences and schools for subsequent geographic distribution analysis. The results demonstrated that the implementation of a georeferencing system not only streamlines parents' decision-making process regarding enrollment options but also significantly reduces the distances traveled by students. This optimization has a direct impact on improving the quality of life and academic performance of students, highlighting the effectiveness of georeferencing as a strategic tool in educational management.

Building community college capacity to enhance student success and equity in dual enrollment

AbstractThis article uses Austin Community College (ACC) as a case study to illustrate how community colleges can build institutional capacity to provide dual enrollment. First, the manuscript synthesizes background literature on the growth of dual enrollment and implications for community colleges. Then, drawing on interviews from relevant stakeholders and institutional data, the authors describe how ACC reorganized internally to streamline dual enrollment structures and processes. In turn the college was able to strengthen partnerships with the school districts, manage growing enrollments, improve the student experience, and prioritize equity.

Medicaid expansion and participation in the Supplemental Nutrition Assistance Program: The role of Integrated Eligibility Systems

AbstractEvidence suggests the Affordable Care Act's Medicaid expansion may increase participation in other public programs, such as the Supplemental Nutrition Assistance Program. This study examines a potential mechanism behind these effects. Before the expansion, most states operated Integrated Eligibility Systems that managed enrollment processes for various public programs. In 2014, many states decoupled Medicaid from these platforms following Medicaid's new eligibility criteria. This research examines the impact of Medicaid expansion on integrated systems and SNAP participation, finding higher SNAP participation rates in states with uninterrupted Integrated Eligibility Systems compared to those that delinked their systems or never had such systems.

Inequities in medicaid home- and community-based services waiver enrollment among people with intellectual and/or developmental disabilities: A nationwide claims-based analysis

BackgroundStates use Medicaid 1915(c) waiver programs to enable access to home- and community-based services for people with intellectual and/or developmental disabilities (I/DD). However, enrollment rates and potential inequities are not well documented, impeding efforts to improve care access and quality for waiver program enrollees, especially for racially minoritized beneficiaries experiencing compounded barriers to services and supports. ObjectiveTo characterize year-by-year 1915(c) waiver program enrollment among Medicaid-enrolled adults with I/DD from 2016 to 2019 and to analyze population-level inequities by type of I/DD and racial/ethnic group. MethodsOur data source was 2016–2019 Medicaid Transformed Medicaid Statistical Information System Analytic Files Demographic and Eligibility files for beneficiaries with Down syndrome, autism, and intellectual disability. We used generalized estimating equation linear models to estimate the associations of type of I/DD and racial/ethnic group with the probability of 1915(c) waiver program enrollment and reported (1) unadjusted estimates and (2) estimates adjusted for demographics with state and year fixed effects. ResultsFrom 2016 to 2019, across all types of I/DD and racial/ethnic groups, unadjusted 1915(c) waiver program enrollment rates ranged from 40 to 60 % nationwide. We found modest growth in 1915(c) I/DD waiver program enrollment but persistent inequities over time. Compared to beneficiaries with intellectual disabilities, beneficiaries with autism were less likely to enroll while beneficiaries with Down syndrome were more likely. While some racial/ethnic groups had higher unadjusted mean enrollment, after adjustment, racially minoritized beneficiaries were 3.66–12.0 percentage points less likely to enroll compared to white non-Hispanic beneficiaries. ConclusionsGiven extensive waiting lists for 1915(c) waiver programs, Medicaid programs should evaluate existing enrollment and authorization processes and consider alternative HCBS program authorities.

NYC Care: A Large Health Care Access Program for Uninsured New York City Residents.

Millions of people living in the United States are excluded from health insurance due to income or immigration status. These 2 groups are more likely to lack access to health care or a regular source of care. NYC Health + Hospitals is addressing this need with NYC Care, a health care access program. The program is designed to be the single point of access for uninsured care citywide and includes a membership card, a 24-hour customer service line, and direct access to primary care medical homes. Health care is coordinated across NYC Health + Hospitals using integrated electronic referrals and a medical record system. The program uses a single enrollment process across safety net health care resources of NYC Health + Hospitals. A 24-hour call center was established to answer questions, make primary care appointments, and make warm handoffs to enrollment staff. Once eligibility is confirmed and patients are enrolled, they are mailed a membership card, a member handbook, and offered a primary care appointment. A multipronged public awareness campaign including citywide, multilingual marketing and outreach via community-based organizations was essential to build trust. NYC Care had 119 203 members at the end of June 2023. Fifty-eight percent had not seen a primary care doctor in the NYC Health + Hospitals system in the prior 36 months. In total, 76 439 had completed 1 or more primary care visits; 53.1% of enrollees with diabetes had improved hemoglobin A 1c , and 73.4% of enrollees with hypertension had improved blood pressure control after 6 months of enrollment. NYC Care demonstrates that municipalities can improve access to care for the uninsured by simplifying steps to affordable health care services, connecting patients directly to patient-centered medical homes, and improving the patient experience. A comprehensive public awareness campaign is also crucial.

Investigating racial and gender disparities in virtual randomized clinical trial enrollment: Insights from the BE ACTIVE study

Randomized clinical trials (RCTs) often suffer from a lack of representation from historically marginalized populations, and it is uncertain whether virtual RCTs (vRCTs) enhance representativeness or if elements of their consent and enrollment processes may instead contribute to underrepresentation of these groups. In this study, we aimed to identify disparities in enrollment demographics in a vRCT, the BE ACTIVE study, which recruited patients within a single health system. We discovered that the proportions of eligible patients who were randomized differed significantly by gender and race/ethnicity (men 1.2%, women 2.0%, P < .001; White 1.8%, Black 1.3%, Hispanic 0.7%, Asian 0.9%; P < .001), and compared with White patients, non-White patients were less likely to have a valid email address on file and were less likely to click on the email link to the study webpage and begin enrollment.

Enrollment Appraisal Using Rule-Based Decision Support System

This study explores the development and evaluation of a web-based enrollment appraisal system utilizing a rule-based decision support system for universities and colleges. Designed for the context of Antique, Philippines, the system leverages a two-tier architecture for efficient processing and secure data management. A user-friendly interface guides applicants through the enrollment process, while a secure server and rule-based engine analyze data against pre-defined eligibility criteria. The Rapid Application Development (RAD) methodology ensured a user-centered design with iterative development cycles incorporating user feedback. Evaluations using McCall's Software Quality Standard and the International Organization for Standardization and International Electrotechnical Commission (ISO/IEC) 25010 standard revealed the system's strengths in technical aspects (security, usability) and overall functionality. User feedback highlighted areas for improvement in interface design, clarity, and user perceptions of data security. The study concludes that the system offers a promising approach for more efficient and transparent enrollment processes. By addressing the feedback received, the system can be further enhanced to improve the user experience and build trust among applicants.

Strategic Integration of AI in Higher Education and Industry: The AI8-Point Model

The AI8-Point Model, derived from extensive experience in technology, AI, and higher education administration, addresses the critical need for cost-effective, high-impact strategies tailored to higher education. Despite the transformative potential of AI in enhancing student engagement, optimizing processes, and improving educational outcomes, institutions often struggle with practical implementation. The AI8-Point Model fills this gap by offering strategies that balance cost and impact. Visualized as a circle divided into four quadrants, the model encompasses phases of student engagement and institutional interaction: pre-enrollment beyond institutional control, pre-enrollment within institutional control, post-enrollment within institutional control, and post-enrollment beyond institutional control. Each quadrant contains specific markers for data collection, strategic planning, and outcome tracking, addressing student aptitude, motivation, marketing strategies, enrollment processes, academic support, faculty development, lifelong learning, and employment outcomes. Integrating methodologies from educational research, business strategy, and technology management, the model is grounded in empirical evidence and personal experience, emphasizing a low-cost, high-value approach to AI applications. This comprehensive framework enables institutions to align initiatives with goals, optimize resource allocation, and track progress effectively, fostering a holistic approach to student success and institutional growth. Additionally, the model’s adaptability extends its value to non-profit and corporate organizations, offering a versatile tool for enhancing strategic initiatives across various sectors.

STRATEGIC DECISION SUPPORT: DEVELOPING A DASHBOARD FOR MANAGERIAL INSIGHTS IN HIGH-LEVEL TVET STUDENTS' ENROLMENT AT UNIVERSITI MALAYSIA PAHANG AL-SULTAN ABDULLAH

The purpose of this study was to create a dashboard with information visualisation to assist Universiti Malaysia Pahang Al-Sultan Abdullah (UMPSA) in managerial decision-making and to critically and hierarchically present data regarding the enrolment of Malaysian Diploma Vocational (MDV) students into high-level Technical Vocational Education and Training (TVET) programs at UMPSA. The Cross Industry Standard Process for Data Mining (CRISP-DM) model was applied in this research followed by dashboard development using Microsoft Power BI. The CRISP-DM model consists of six continuous and connected phases, namely business understanding, data understanding, data preparation, data modelling, data visualisation, and data synchronise and update. The data was obtained from the Undergraduate Records Management Unit, Centre for Academic Management, UMPSA. The database was used in the development of the dashboard to store information in the form of reports and for data visualisation purposes. The findings hope to assist the management of UMPSA in making better decisions and planning the enrolment process of prospective students. The dashboard outlines several initiatives and best practices that should be implemented by the Malaysian Government, the Ministry of Higher Education, and UMPSA through the UMPSA 2021–2025 Strategic Plan to empower the high-level TVET agenda.

Screening failure in clinical trials for patients with head and neck squamous cell carcinoma: A retrospective analysis.

e18009 Background: Clinical trials drive improvements in patient care with head and neck squamous cell carcinoma (HNSCC), presenting opportunities for optimizing clinical outcomes. However, a significant number of patients (pts) miss out on new therapeutic opportunities due to screen failure (SF) after signing the informed consent form. Understanding the circumstances leading to SF might improve enrollment processes. Methods: Retrospective cohort analysis of pts with HNSCC intended for treatment within a clinical trial at the Royal Marsden Cancer Centre but who experienced SF between Jan 2016 and Jan 2024. Demographic and cancer-related characteristics, comorbidities, consent and SF dates, SF causes, and subsequent outcomes after SF were analyzed. Results: 76 pts who experienced SF were identified across 33 different trials. Cohort characteristics and type of trials offered are described in the table. The largest number of SFs was due to exclusion criteria being met in screening tests in 37 pts (49%): Pathology sample did not meet the quality standards in 11 pts (14%); abnormal laboratory tests in 5pts (6%); abnormal echocardiogram/reduced ejection fraction in 5 pts (6%); vessel invasion/ encasement in 4 pts (5%); non-measurable disease in 2 pts (3%); abnormal audiometry in 1pt (1%) among other reasons. The next commonest cause of SF was rapid progression during screening in 28 pts (37%): 11% compromised airway; 11% active bleeding; 5% central nervous system progression and 7% other rapid progression causes. Other causes of SF included: withdrawn consent in 7 pts (9%), comorbidity-related complication in 3 pts (5%) and study termination by sponsor in 2 pts (3%). The median time between consenting and SF was 20 days (range 4-42). After SF, 8% reconsented for the same trial, 56% received standard therapy, and 36% received best supportive care. Conclusions: This study reveals abnormal screening tests and rapid progression as primary causes for SF in patients with HNSCC. Timely referral , airway assessments and improved tissue acquisition could improve enrollment and minimize SF. [Table: see text]