AUCTORES
Globalize your Research
Chat with us
Research Article | DOI: https://doi.org/10.31579/2639-4162/042
1 Department of Radiation Medicine Oregon Health and Science University
2 Department of Neurological Surgery Oregon Health and Science University
3 Department of Radiation Oncology Indiana University School of Medicine
4 Department of Radiation Medicine Oregon Health and Science University
5 Department of Radiation Medicine Oregon Health and Science University
6 Department of Neurosurgery University of Florida Gainesville, Fl
7 Department of Neurological Surgery Oregon Health and Science University 8Department of Radiation Medicine Oregon Health and Science University
*Corresponding Author: Brandon Lucke-Wold, Department of Neurosurgery University of Florida Gainesville, Fl.
Citation: Wencesley Paez, Rohi Gheewala, Shearwood McClelland, Jerry J. Jaboin, Charles R. Thomas, Brandon Lucke-Wold., (2021) Three-Year Experience of a Multidisciplinary Central Nervous System Clinic Model for Radiation Oncology and Neurosurgery (RADIANS) in a Community Hospital Setting. J. General medicine and Clinical Practice. 4(1) DOI:10.31579/2639-4162/042
Copyright: ©2021 Brandon Lucke-Wold, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 27 January 2021 | Accepted: 08 April 2021 | Published: 16 April 2021
Keywords: central nervous system; metastatic disease; multidisciplinary clinic; neurosurgery; radians; radiation oncology; radiation therapy
Background: As academic centers partner and establish healthcare systems with community hospitals, delivery of subspecialty, multidisciplinary care in community hospital settings remains a challenge. Improving outcomes for central nervous system (CNS) disease is related to integrated care between neurosurgery (NS) and radiation oncology (RadOnc) specialties. Our multidisciplinary community hospital-based clinic, RADIANS, previously reported high patient approval of simultaneous evaluation with NS and RadOnc physicians. Three-year experience is now reported.
Methods: Prospectively collected clinical and demographic patient data over three years was done, and surveys administered. Descriptive statistics reported as mean and percentages for patient characteristics, diagnosis, treatment and outcomes.
Results: Between August 2016 and August 2019, 101 patients were evaluated. Mean age and distanced traveled was 61.2 years, and 54.9 miles, respectively. Patient Satisfaction Score was 4.79 (0-5 Scale, 5-very satisfied). Most common referral source was medical oncologists. Seventy-two patients had malignant CNS disease (brain mets 28; spine mets 27; both 6; primary brain 9; primary spine 2), 29 had benign CNS disease. Post-evaluation treatment: radiation therapy (RT) only (n=29), neurosurgery (NS) only (n=16), both RT and NS (n=22), and no RT/NS intervention (n=34). Fractionated stereotactic radiosurgery was most common RT delivered; craniotomy with tumor resection was most common NS performed. Treatment outcomes: local control=61/67 (91%); radiation necrosis or radiation-induced myelitis=2/51 (3.9%).
Conclusions: The RADIANS multidisciplinary community hospital-based CNS clinic model is first of its kind to be reported, continuing strong patient approval at extended follow-up. Data indicates the model serves as a regional referral center, delivering evidence-based treatment modalities for complex CNS disease in community hospital settings, yielding high rates of local control and low rates of grade 3 or 4 radiation-induced toxicity.
SHORT TITLE: RADIANS: Multidisciplinary CNS Clinic
Central Nervous System Disease
In 2019, it is estimated that 23,800 adults (13,400 men and 10,400 women) in the United States will be diagnosed with primary malignant tumors of the brain and spinal cord. Brain tumors alone account for nearly 85% of all primary CNS tumors. Brain and other CNS malignancies are considered the 10th leading cause of death for men and women, and roughly 35% have a five-year survival rate when diagnosed. [1,2] It is without question indeed, that the care of patients with CNS disease, both malignant and benign, requires the expertise of specialized providers in a collaborative and multidisciplinary approach to administer the best treatment options and optimize patient outcomes and care.
Multidisciplinary Clinics
Currently with managed care at the forefront of healthcare systems, medical centers are encouraged to develop and implement clinical delivery systems that collaborate with different providers and specialists with the overall goal to improve quality of care, reduce practice variation, define and measure treatment outcomes, and to minimize treatment costs. This is certainly more evident in the setting of cancer care, such that it provides patients with the opportunity to see their providers in one clinic, lessens the travel burden, and allows for concurrent provider visits. [3] Numerous MDC modeling and approaches have been reported for cancer care. The findings have shown to increase overall survival, slow disease progression, improve patient compliance, increase adherence to treatment guidelines, promote early treatment intervention, and decrease treatment costs. [4-8]
RADIANS
In the fall of 2016, the novel RADIANS (RADIation oncology And NeuroSurgery) clinic was formed at a local community hospital as a collaboration between radiation oncology and neurosurgery physicians to evaluate central nervous system disease in one clinic setting. The MDC was formed to align with the delivery of quality of care, as outlined by the American Society of Clinical Oncology (ASCO) [9] for the better part of the community for which it serves. The RADIANS clinic proved to be highly favorable from the patient’s view in terms of overall experience and satifisfaction. [10]
METHODS
With approval from the Institutional Review Board (IRB), a prospective patient registry was developed, and clinical and demographic data were collected. Data was stored in a secure database where only IRB-approved research team members had access. Patients that were referred into the RADIANS clinic were seen simultaneously by both physicians, the radiation oncologist and neurosurgeon, in a single clinic visit setting. Prior imaging and workup were reviewed before the initial visit. Discussion regarding diagnosis and treatment options were done and questions were answered. Family members and/or caregivers were included in the discussion with the consent and approval of the patient. A patient survey was given to all patients prior to the conclusion of their visit to collect data regarding overall patient experience and satisfaction. Patients had the option of completing the survey before leaving the clinic or returning the survey in the mail.
In total, 101 patients were evaluated in RADIANS from August 2016 through August 2019 with CNS disease. Patient characteristics are presented in Table 1.
The mean patient age was 61.2 years and females nearly doubled the number of males seen (F=65; M=36). Patients travelled an average of 54.9 miles (median = 13.0; range = 0.3 to 340) for their initial clinic visit. Patient Satisfaction Score (PSC) was 4.79 (respondents, n=39). PSC was calculated on a 0-5 scale, 0=not satisfied and 5=very satisfied.
Patterns of referral were as following: approximately half (42.6%, n=43) were referred from medical oncologists. Systemic disease status of patients evaluated in RADIANS showed eighty percent having a Karnofsky Performance Status (KPS) of ³ 70 and about two-thirds (61.4%, n=62) had at least one co-morbidity, while 12.9% (n=13) had three or more at the time of their initial visit. The two most common co-morbidities seen in the clinic were chronic obstructive pulmonary disease (26.7%, n=27) and hypertension (25.7%, n=26). Twenty patients had an Obesity Class I classification [BMI (kg/m2) = 30-34.9] and 15 had an Obesity Class II classification [BMI (kg/m2) = 35-39.9]. [11]
Patients with eleven different histologies were evaluated in RADIANS, see Table 2. Lung cancer (26.7%, n=27) was the most common metastatic cancer diagnosis, of which 73% (20/27) were non-small cell lung cancer. Breast cancer (17.8%, n=18) was the second most commonly seen metastatic malignancy. Of the primary brain malignancies evaluated, glioblastoma (81.8%, 7/9) was most commonly diagnosed. Among patients with primary benign CNS brain lesions, meningiomas were most commonly diagnosed (83.3%, 15/18).
More than half of patients evaluated at the RADIANS clinic received radiation therapy with no surgical intervention (54.5%), with fractionated stereotactic radiosurgery being the most common type (74.5%) of radiation therapy delivered. Two patients with a diagnosis of glioblastoma (2/7, 28.6%) received tumor treating fields (TTF), one of whom received both conventional fractionated RT and TTF to follow, see Table 3.
Nearly a quarter of patients (24%) received both radiation and neurosurgical intervention. Craniotomy with mass resection was the most common neurosurgical intervention [Table 3]. Since the beginning of this study, 22 patients are deceased, and 6 patients have entered hospice. Of the 22 patients, 86% (n=19) had stage IV metastatic cancer. A low rate of radiation necrosis or myelitis (2/51, 3.9%), and a high rate of local control (61/67, 91%) was experienced.
The Multidisciplinary Tumor Board provides patients with CNS malignancies the most coordinated care for their complex diseases. Current models have shown success in both pediatric and adult CNS disease. [12,13] Research also shows that multidisciplinary teams result in better clinical and organizational outcomes for patients. [14] While the use of weekly or monthly multidisciplinary tumor boards to review select oncologic cases has been adopted at many institutions, formal single-site, single-day multidisciplinary clinics have not been common.
When the RADIANS MDC clinic model was first established, investigators hypothesized that the model would optimize patient and physician time by reducing clinic visits and avoiding unnecessary duplication of tests, while improving quality of care, delivering evidence-based treatment modalities, and providing access for on-going clinical trials. Contrary to standard tumor boards, this model serves a unique role for the patient and their caregivers because of its direct involvement with patients and their caregivers in the discussion of their treatment plan. Despite advances in surgical procedures, chemotherapy, and targeted molecular and radiation therapies, breakdown in the continuum of cancer treatment can remain high. [15] This breakdown is attributed to failure of communication with involved providers resulting into delays in treatment, increased patient anxiety, decreased patient satisfaction, and declines in quality of life. [16]
One unique feature of the RADIANS clinic is that it is based at a small community hospital. Patient approval remains high since the initial published report back in July 2018. Trending similarly, patient volume has increased. The previous report showed a total patient census of 42 since the start---a span of approximately two years. [10] Since that published report, the clinic has seen a marked increase in patient volume (n=101), a 140.5% increase. The increase could be attributed to several factors. Our analysis identified that the current MDC model favors an improved practice pattern that’s patient-centric. The simultaneous provider visits increase efficiency in the workup and management for newly diagnosed CNS disease, fostering faster collaborative decision-making, thus avoiding potential treatment delays and additional referrals to another specialist. Both radiation oncologist and neurosurgeon prior to the new patient visit, review the workup, imaging, and labs and engage dynamically, interdependently, and adaptively towards a common goal. Dialogue between the two specialists are structured to adhere to standard clinical practice guidelines---an integral component for a successful MDC. [16]
Our data also shows that patients come from a vast array of provider referrals and varying degrees of systemic disease status. Primary care physicians and medical oncologists may refer patients into RADIANS for further workup with associated neurologic focal signs and preliminary work-up with imaging and labs, whether benign or malignant CNS disease. Patient referrals that come from emergency room consults are the direct result from patients requiring immediate neurosurgical intervention and are then referred to RADIANS for post-op workup, or from patients presenting with stable disease requiring further management and workup. Patients are then given treatment recommendations offering various radiation therapy planning or neurosurgical intervention based on standard of care guidelines whether for curative or palliative intent. All of which are openly discussed with the patients and their caregivers---a dynamic that patients showed high appreciation for based on the administered surveys.
We acknowledge, however, limitations to the current clinic model and our three-year experience. Patient scheduling and clinic flexibility can be challenging as the clinic is dependent upon provider availability. As the clinic continues to expand and grow, flexibility could be achieved by the addition of more clinic days or providers for broader coverage. Another area that should be pursued is the impact and effect the MDC clinic model may have on the caregivers involved. Their role in the overall quality of cancer care should be considered. Finally, another area of consideration and not often studied, as pointed out by Fennel et al., [17] is how external regulatory influences (especially reimbursement incentives) play a role in the sustainability of MDCs in the community hospital setting. Despite these limitations, the model has proven to be highly effective in the community hospital setting for CNS disease.
CONCLUSIONS
To date, we are the first to report on an outpatient community hospital-based multidisciplinary CNS clinic model where patients with benign or malignant CNS disease are evaluated jointly and simultaneously by the radiation oncologist and neurosurgeon. Our three-year data demonstrates that the patient-centric, clinic model optimizes both patient and physician time and patient approval remains high at extended follow-up. The clinic model proves to be a reliable, regional referral center that contributes substantially to improving the care of cancer patients, while providing access to ongoing clinical trials.
RADIANS give patients the option to be evaluated and treated in the community hospital-based setting, rather than at large tertiary centers. Patients are offered evidence-based treatment modalities, where outcomes have shown to have low rates of post-radiation therapy side effects and good local control. Despite being in a community hospital setting, the clinical model could serve beneficial in larger urban medical centers.
Data collection and treatment analysis will continue as we investigate the potential cost-benefit, clinical long-term outcomes, morbidity and mortality rates, impact on caregiver outcomes, and possible mechanisms for early detection by means of vigilant follow-up and imaging surveillance.
CONFLICT OF INTEREST: Dr. Mitin receives research funding and consulting fees from Novocure, Inc., and personal consulting fees from Janssen. Dr. Ciporen is a consultant for spiWAY, but does not receive consulting fees. No other authors have any conflicts of interest to report.
FUNDING: No funding source was provided to conduct this study.
ACKNOWLEDGEMENTS: The authors are grateful for the entire Tuality/OHSU Cancer Center and the Tuality Community Hospital Neurosurgery Clinic for their outstanding patient care and coordination.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
