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Comprehensive Oncologic Emergencies Research Network (CONCERN)

Overview

The Comprehensive Oncologic Emergencies Research Network (CONCERN) was established in March 2015 with the goal to accelerate knowledge generation, synthesis, and translation of oncologic emergency medicine research through multi-center collaborations. CONCERN is an open scientific forum for researchers working across oncology and emergency medicine interested in collaborative approaches to improve outcomes during unscheduled cancer-related medical care. Research is needed to better inform appropriate utilization, prevention, management, and coordination of unscheduled cancer-related care, implement cancer prevention services, and develop evidence-based management strategies within urgent and emergency care settings.

Objectives

  1. To identify knowledge gaps impacting the prevention, management, and coordination of cancer-related urgent and emergent care issues.
  2. Accelerate knowledge generation and translation through multi-centre research collaborations across oncology and emergency medicine.
  3. Identify and test oncologic emergency prevention measures in oncology care settings.
  4. Identify and test care management strategies for oncologic emergencies presenting to urgent and emergency medicine settings.
  5. Translate research findings into national guidelines and implement in academic and community emergency care settings.
  6. Support collaborative educational efforts in the area of cancer and emergency medicine.
  7. Mentor new and established investigators working in the area of cancer and emergency medicine.

Organizational Structure

CONCERN's co-chairs are:

  • Christopher Coyne, MD, MPH, University of California San Diego Health
  • Caroline A. Thompson, PhD, MPH, University of North Carolina

Membership

CONCERN membership includes more than 20 medical centers and is open to new members interested in collaborative research in cancer and emergency medicine. There are no membership requirements. For membership questions, please contact Claire Critchley, MS at claire.critchley@unc.edu.

Sign Up for CONCERN Membership

Publications

  • Rico JF, Caterino JM, Stephens JA, Abar B, Adler A, Bastani A, Bernstein SL, Bischof JJ, Coyne CJ, Grudzen CR, Henning DJ, Hudson MF, Klotz AD, Lyman GH, Madsen TE, Reyes CC, Ryan RJ, Shapiro NI, Swor R, Thomas CR, Venkat A, Yeung SCJ, Yilmaz S, Baugh CW. Variables associated with admission rates among cancer patients presenting to emergency departments: a CONCERN group study. Emerg Cancer Care 2, 7 (2023). https://doi.org/10.1186/s44201-023-00022-z
  • Lash RS, Hong AS, Bell JF, Reed SC, Pettit N. Recognizing the emergency department's role in oncologic care: a review of the literature on unplanned acute care. Emerg Cancer Care. 2022;1(1):6. doi: 10.1186/s44201-022-00007-4. Epub 2022 Jun 16. PMID: 35844666; PMCID: PMC9200439. https://pubmed.ncbi.nlm.nih.gov/35844666/
  • Yilmaz S, Grudzen CR, Durham DD, McNaughton C, Marcelin I, Abar B, Adler D, Bastani A, Baugh CW, Bernstein SL, Bischof JJ, Coyne CJ, Henning DJ, Hudson MF, Klotz A, Lyman GH, Madsen TE, Pallin DJ, Reyes-Gibby C, Rico JF, Ryan RJ, Shapiro NI, Swor R, Thomas CR, Venkat A, Wilson J, Yeung SJ, Caterino JM. Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department. J Palliat Med. 2022 Jul;25(7):1115-1121. doi: 10.1089/jpm.2021.0567. Epub 2022 May 13. PMID: 35559758; PMCID: PMC9467631. https://pubmed.ncbi.nlm.nih.gov/35559758/
  • Bischof JJ, Elsaid MI, Bridges JFP, Rosko AE, Presley CJ, Abar B, Adler D, Bastani A, Baugh CW, Bernstein SL, Coyne CJ, Durham DD, Grudzen CR, Henning DJ, Hudson MF, Klotz A, Lyman GH, Madsen TE, Reyes-Gibby CC, Rico JF, Ryan RJ, Shapiro NI, Swor R, Thomas CR, Venkat A, Wilson J, Yeung SJ, Yilmaz S, Caterino JM. Characterization of older adults with cancer seeking acute emergency department care: A prospective observational study. J Geriatr Oncol. 2022 Sep;13(7):943-951. doi: 10.1016/j.jgo.2022.06.003. Epub 2022 Jun 17. PMID: 35718667; PMCID: PMC11137847. https://pubmed.ncbi.nlm.nih.gov/35718667/
  • Shelburne N, Simonds NI, Jensen RE, Brown J. Cancer-related emergency and urgent care: expanding the research agenda. Emerg Cancer Care. 2022;1(1):4. doi: 10.1186/s44201-022-00005-6. Epub 2022 Jun 14. PMID: 35844668; PMCID: PMC9194780. https://pubmed.ncbi.nlm.nih.gov/35844668/
  • Klotz AD, Caterino JM, Durham D, Felipe Rico J, Pallin DJ, Grudzen CR, McNaughton C, Marcelin I, Abar B, Adler D, Bastani A, Bernstein SL, Bischof JJ, Coyne CJ, Henning DJ, Hudson MF, Lyman GH, Madsen TE, Reyes-Gibby CC, Ryan RJ, Shapiro NI, Swor R, Thomas CR Jr, Venkat A, Wilson J, Jim Yeung SC, Yilmaz S, Stutman R, Baugh CW. Observation unit use among patients with cancer following emergency department visits: Results of a multicenter prospective cohort from CONCERN. Acad Emerg Med. 2022 Feb;29(2):174-183. doi: 10.1111/acem.14392. Epub 2021 Dec 4. PMID: 34811858; PMCID: PMC10359998. https://pubmed.ncbi.nlm.nih.gov/34811858/
  • Hudson MF, Strassels SA, Durham DD, Siddique S, Adler D, Yeung SJ, Bernstein SL, Baugh CW, Coyne CJ, Grudzen CR, Henning DJ, Klotz A, Madsen TE, Pallin DJ, Rico JF, Ryan RJ, Shapiro NI, Swor R, Venkat A, Wilson J, Thomas CR, Bischof JJ, Lyman GH, Caterino JM. Examining pain among non-Hispanic Black and non-Hispanic White patients with cancer visiting emergency departments: CONCERN (Comprehensive Oncologic Emergencies Research Network). Acad Emerg Med. 2022 Mar;29(3):364-368. doi: 10.1111/acem.14395. Epub 2021 Oct 23. PMID: 34606137. https://pubmed.ncbi.nlm.nih.gov/34606137/
  • Coyne CJ, Reyes-Gibby CC, Durham DD, Abar B, Adler D, Bastani A, Bernstein SL, Baugh CW, Bischof JJ, Grudzen CR, Henning DJ, Hudson MF, Klotz A, Lyman GH, Madsen TE, Pallin DJ, Rico JF, Ryan RJ, Shapiro NI, Swor R, Thomas CR Jr, Venkat A, Wilson J, Yeung SJ, Caterino JM. Cancer pain management in the emergency department: a multicenter prospective observational trial of the Comprehensive Oncologic Emergencies Research Network (CONCERN). Support Care Cancer. 2021 Aug;29(8):4543-4553. doi: 10.1007/s00520-021-05987-3. Epub 2021 Jan 22. PMID: 33483789. https://pubmed.ncbi.nlm.nih.gov/33483789/
  • Pettit, Nicholas & Al-Hader, Ahmad & Thompson, Caroline. (2021). Emergency Department Associated Lung Cancer Diagnosis: Case Series Demonstrating Poor Outcomes and Opportunities to Improve Cancer Care. Current Problems in Cancer: Case Reports. 3. 100059. 10.1016/j.cpccr.2021.100059.
  • Adler D, Abar B, Durham DD, Bastani A, Bernstein SL, Baugh CW, Bischof JJ, Coyne CJ, Grudzen CR, Henning DJ, Hudson MF, Klotz A, Lyman GH, Madsen TE, Pallin DJ, Reyes-Gibby CC, Rico JF, Ryan RJ, Shapiro NI, Swor R, Thomas CR Jr, Venkat A, Wilson J, Yeung SJ, Caterino JM. Validation of the Emergency Severity Index (Version 4) for the Triage of Adult Emergency Department Patients With Active Cancer. J Emerg Med. 2019 Sep;57(3):354-361. doi: 10.1016/j.jemermed.2019.05.023. Epub 2019 Jul 26. PMID: 31353265; PMCID: PMC7478143. https://pubmed.ncbi.nlm.nih.gov/31353265/
  • Caterino JM, Adler D, Durham DD, Yeung SJ, Hudson MF, Bastani A, Bernstein SL, Baugh CW, Coyne CJ, Grudzen CR, Henning DJ, Klotz A, Madsen TE, Pallin DJ, Reyes-Gibby CC, Rico JF, Ryan RJ, Shapiro NI, Swor R, Venkat A, Wilson J, Thomas CR Jr, Bischof JJ, Lyman GH. Analysis of Diagnoses, Symptoms, Medications, and Admissions Among Patients With Cancer Presenting to Emergency Departments. JAMA Netw Open. 2019 Mar 1;2(3):e190979. doi: 10.1001/jamanetworkopen.2019.0979. PMID: 30901049; PMCID: PMC6583275. https://pubmed.ncbi.nlm.nih.gov/30901049/
  • Brown J, Grudzen C, Kyriacou DN, Obermeyer Z, Quest T, Rivera D, Stone S, Wright J, Shelburne N. The Emergency Care of Patients With Cancer: Setting the Research Agenda. Ann Emerg Med. 2016 Dec;68(6):706-711. doi: 10.1016/j.annemergmed.2016.01.021. Epub 2016 Feb 26. PMID: 26921969; PMCID: PMC5001927. https://pubmed.ncbi.nlm.nih.gov/26921969/
Additional Publications

 

Grants & Awards

  • UNC Lineberger Pilot Awardees (1-year, $50K) “Planning CONCERN's Program Project: Emergency Department Care Across the Cancer Continuum”
    • Caroline Thompson (PI), UNC; Beau Abar (Co-I), David Adler (Co-I), University of Rochester; Jason Bischof (Co-I), Ohio State University; Christopher Coyne (Co-I),  University of California San Diego; Jessica Denomme (Co-I), University of Virginia Health; Arthur Hong (Co-I), University of Texas Southwestern Medical Center; Cielito Reyes-Gibby (Co-I), University of Texas MD Anderson Cancer Center
    • Starting February 2026, this pilot will develop a competitive National Cancer Institute Healthcare Delivery Research Program Project (P01) application to extend the CONCERN network’s research goals by developing a program focused on emergency department (ED) cancer care, with emphasis on defining and addressing gaps in the current system while positioning the ED as a critical, but neglected, point in the cancer care continuum.
  • Lung Cancer Research Foundation ($150K) “Increasing Lung Cancer Screening Uptake Among Emergency Department Patients”
    • David Adler (PI), Beau Abar (Co-I) and Patricia Rivera (Co-I), University of Rochester
    • This project leverages the universal access setting of the ED to identify individuals at greatest risk for lung cancer and get them screened. A scalable ED-based intervention that increases LCS uptake would save lives.
  • American Cancer Society Discovery Boost Grant (2-years, $300K)
    • ​“Investigating Safety-Net Financial Account Data for Cancer Health Services Research”​
      • Arthur Hong (PI), UT Southwestern ​
      • Starting in September 2025. 'We are investigating the impact of delays while applying for coverage programs for the uninsured (eg Medicaid) on clinical cancer outcomes.’​
    • 'Advancing Cervical Cancer Screening Through Emergency Department-based Self-Sampling’. ​
      • Beau Abar (PI), Dave Adler (Co-I), University of Rochester​
      • The study, starting in November 2025, seeks to evaluate the utility of an ED-based intervention to identify cervical cancer screening needs and provide the opportunity for onsite hrHPV self-sampling. We have already been piloting our distribution and follow-up protocols this summer, with very positive preliminary findings to date. 
Additional Grants

Meetings

 

Contacts

NIH Contacts

Roxanne Jensen, PhD
Outcomes Research Branch
Healthcare Delivery Research Program
Division of Cancer Control and Population Sciences
National Cancer Institute
roxanne.jensen@nih.gov

Jeremy Brown, MD
Office of Emergency Care Research
National Institute of Neurological Disorders and Stroke
Jeremy.brown@nih.gov

Network Executive Committee

  • Beau Abar, PhD

    Beau Abar, PhD

    University of Rochester
    beau_abar@urmc.rochester.edu

    Beau Abar, PhD, MS is a Professor of Emergency Medicine, Psychiatry, and Public Health Sciences at the University of Rochester Medical Center, Rochester, NY where he also serves as Assistant Director of Emergency Medicine Research. He completed his PhD in Human Development and Family Studies, with concentrations in prevention science and quantitative methods, at Penn State, and his postdoctoral fellowship was in Emergency Medicine and Quantitative Health Sciences at the University of Massachusetts Medical School. He received a Masters of Medical Management through the Simon Business School at the University of Rochester.

    Dr. Abar’s research focuses on using the wait time inherent in Emergency Department visits as an opportunity for public health interventions. The majority of his recent work has been on developing, implementing, and evaluating cancer screening interventions through the Emergency Department, including studies on cervical, colorectal, and lung cancer screening.

     
  • Jason Bischof, MD

    Jason Bischof, MD

    The Ohio State University
    jason.bischof@osumc.edu

     

    As an emergency medicine physician, I care for patients during some of their most vulnerable moments. I aim to provide the best possible treatment and help patients navigate challenging decisions when the unexpected happens.

    In addition, I serve as the assistant director of clinical trials for the Department of Emergency Medicine within The Ohio State University College of Medicine. I am passionate about research because it allows us to improve patient care through the development of new treatments, diagnostic tools and enhanced clinical care delivery pathways. Through ongoing collaborations at The Ohio State University Wexner Medical Center and nationally, I am excited about advancing our expertise through clinical research that addresses topics ranging from cardiac arrest to acute cancer care.

     
  • Christopher Coyne, MD, MPH

    Christopher Coyne, MD, MPH

    CONCERN co-chair, emergency medicine
    University of California San Diego Health
    cjcoyne@health.ucsd.edu

    Since 2018, I have served as the Director of Clinical Research for the Department of Emergency Medicine at UC San Diego. In this capacity I oversee clinical trials, while assisting faculty and trainees with project design, analysis and content production. Additionally, I oversee trainees as the Clinical Research Fellowship Director.  I currently serve as the Hub-PI for the Strategies to Innovate Emergency Care Clinical Trials Network (SIREN) and Co-Chair of the NCI supported Comprehensive Oncologic Emergencies Research Network (CONCERN). 
  • Arthur Hong, MD

    Arthur Hong, MD

    UT Southwestern Medical Center
    arthur.hong@utsouthwestern.edu

    Arthur S. Hong, M.D., M.P.H., is an Associate Professor in the Department of Internal Medicine, the O’Donnell School of Public Health, and the Harold C Simmons Comprehensive Cancer Center (SCCC) at the University of Texas Southwestern Medical Center. 

    His medical degree is from the University of Michigan, with residency in internal medicine at the Mayo Clinic. He completed a research fellowship at Harvard Medical School, including a Master of Public Health degree from the Harvard School of Public Health. He serves as a Population Science and Cancer Control Research Program lead at SCCC, Associate Chief of Population Science for the Parkland Cancer Program, Director of the Research and Scholarship Section for the Division of General Internal Medicine.

    Dr. Hong’s research spans quality measurement in cancer care delivery, as well as improving the value and quality of care and evaluating program and policy changes.
  • Matthew Hudson, PhD, MPH

    Matthew Hudson, PhD, MPH

    Prisma Health
    Matt.Hudson@prismahealth.org

    Matthew F. Hudson, Ph.D., M.P.H. is the Director of Cancer Care Delivery Research (CCDR) at Prisma Health (Greenville, South Carolina). Dr. Hudson is also Professor of Medicine at the University of South Carolina School of Medicine Greenville and holds additional faculty appointments at the University of South Carolina, Clemson University, and Wake Forest’s Department of Implementation Science.  He completed his Ph.D. in Evaluative Clinical Science supplementing his Master of Public Health, with a Behavioral Science focus.

    Dr. Hudson conducts and oversees research on interventions mediating patient, clinician, and organizational factors influencing cancer care outcomes and patient well-being. Dr. Hudson’s scholarship interfaces cancer care delivery, emergency medicine and, more broadly, examines how to position learning health systems for continuous improvement and innovation. Complimenting his CONCERN Executive Committee service, Dr. Hudson is Deputy Editor in Chief of JNCI-Cancer Spectrum and a member of the Editorial Board for the journal, Learning Health Systems.  
  • Nicholas Pettit, DO, PhD, MPH

    Nicholas Pettit, DO, PhD, MPH

    Indiana University School of Medicine
    nrpettit@iu.edu

    Dr. Pettit is an emergency medicine resident physician and Associate Professor of Emergency Medicine, Department of Medicine, Division of Hematology/Oncology, IU School of Medicine. He earned his DO from Ohio University Heritage College of Osteopathic Medicine and his Ph.D. from The Ohio State University. His professional interests are in research, critical care, and hematology/oncology in the ED. His research interests are in cancer screening and prevention in the emergency department.
  • Cielito Reyes-Gibby, DrPH

    Cielito Reyes-Gibby, DrPH

    MD Anderson Cancer Center
    creyes@mdanderson.org

    Dr. Reyes-Gibby is a Professor with Tenure in the Department of Emergency Medicine at MD Anderson Cancer Center. She has a dual appointment in the Department of Biostatistics. The focus of her research is on the application of classical and molecular epidemiology approaches to understanding the complex interaction among clinical, epidemiological and biological/genetic factors on the occurrence and persistence of cancer-related symptoms and toxicities of cancer treatment. Since 2004, she has been awarded several grants as Principal Investigator by the National Institutes of Health (NIH). She is on the editorial boards of her specialty journals and a chartered member of the Interdisciplinary Clinical Care in Specialty Care Settings Study Section at the NIH. She is the 2016 recipient of the Provost Distinguished Faculty Mentor Award at MD Anderson.
  • Caroline A. Thompson, PhD, MPH

    Caroline A. Thompson, PhD, MPH

    CONCERN co-chair, oncology
    University of North Carolina
    caroline.thompson@unc.edu

    I am a tenured Associate Professor of Epidemiology at the University of North Carolina (UNC) Gillings School of Global Public Health, Full Member of the UNC Lineberger Comprehensive Cancer Center, and Research Fellow at the Carolina Population Center. I earned my PhD with a focus in cancer epidemiology and epidemiologic methodology from the University of California San Diego and obtained postdoctoral training in healthcare delivery science as an AcademyHealth Delivery Systems Science Fellow (DSSF).

    My research program focuses on three interconnected areas: 1) the epidemiology of cancer healthcare outcomes, with emphasis on understanding how healthcare delivery patterns—including emergency department utilization—affect cancer diagnosis and outcomes; 2) cancer health disparities, identifying drivers of inequities in cancer burden and outcomes across groups defined by race, ethnicity, income, and geography, particularly in rural and underserved populations; and 3) methodological approaches for analyzing large registry and administrative datasets (claims, EHR) to assess diagnostic healthcare utilization patterns and their impact on cancer outcomes.
  • Monica Wattana, MD, FAAEM

    Monica Wattana, MD, FAAEM

    MD Anderson Cancer Center 
    mwattana@mdanderson.org 

    Monica K. Wattana, an Emergency Medicine physician, was the first to complete an Oncologic Emergency Medicine fellowship at UT MD Anderson Cancer Center. She is currently an Associate Professor, the Director of Education for the Department of Emergency Medicine, and the Program Director for the Oncologic Emergency Medicine fellowship at MD Anderson Cancer Center. Monica is regarded as a content expert in oncologic emergencies and has lectured nationally and internationally on multiple topics within oncologic emergency medicine. Her research focuses on medical education and the side effects of novel therapeutics and ED interventions. She has authored the book "Pocket Guide to Oncologic Emergencies." She is also the co-editor of the book "Oncologic Emergency Medicine: Clinical Cases illustrating Key Concepts," both published by Cambridge University Press.