Background and purposeTelestroke has grown significantly since its implementation. Despite growing utilization, there is a paucity of data regarding the diagnostic accuracy of telestroke to distinguish between stroke and its mimics. We aimed to evaluate diagnostic accuracy of telestroke consultations and explore the characteristics of misdiagnosed patients with a focus on stroke mimics. MethodsWe conducted a retrospective study of all the consultations in our Ochsner Health's TeleStroke program seen between April 2015 and April 2016. Consultations were classified into one of three diagnostic categories: stroke/transient ischemic attack, mimic, and uncertain. Initial telestroke diagnosis was compared with the final diagnosis post review of all emergency department and hospital data. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-) for diagnosis of stroke/TIA versus mimic were calculated. Area under receiver-operating characteristic curve (AUC) analysis to predict true stroke was performed. Bivariate analysis based on the diagnostic categories examined association with sex, age, NIHSS, stroke risk factors, tPA given, bleeding after tPA, symptom onset to last known normal, symptom onset to consult, timing in the day, and consult duration. Logistic regression was performed as indicated by bivariate analysis. ResultsEight hundred and seventy-four telestroke evaluations were included in our analysis. Accurate diagnosis through teleneurological consultation was seen in 85% of which 532 were strokes (true positives) and 170 were mimics (true negatives). Sensitivity, specificity, PPV, NPV were 97.8, 82.5, 93.7 and 93.4%, respectively. LR+ and LR- were 5.6 and 0.03. AUC (95% CI) was 0.9016 (0.8749-0.9283). Stroke mimics were more common with younger age and female gender and in those with less vascular risk factors. LR revealed OR (95% CI) of misdiagnosis for female gender of 1.9 (1.3-2.9). Lower age and lower NIHSS score were other predictors of misdiagnosis. ConclusionWe report high diagnostic accuracy of the Ochsner Telestroke Program in discriminating stroke/TIA and stroke mimics, with slight tendency towards over diagnosis of stroke. Female gender, younger age and lower NIHSS score were associated with misdiagnosis.

The US National Plan for Alzheimer’s Disease prioritized the inclusion of health disparities groups in Alzheimer’s Disease and related dementia (ADRD) research in 2012, yet participation of American Indians and Alaska Natives (AI/AN) in ADRD research is significantly lower than the representation of other minorities. Among 47,165 participants in the US National Alzheimer’s Coordinating Center database, only 288 (0.6%) self-identified as AI/AN. Without the representation of AI/AN people in ADRD research, results from studies may not benefit Tribal communities. Using community-based participatory research methods, we conducted a qualitative study that included 6 in-person and 1 virtual focus groups with 64 urban and rural AI/AN elders. We examined barriers to and promoters of participation in clinical ADRD research. We applied inductive thematic analysis to unpack the meanings of the qualitative data through systematic coding and identification of themes. The primary factors linked to increasing willingness to participate in ADRD research were awareness of the impact of ADRD in their community; having a family history of ADRD; having research conducted that benefits the community and future generations; and having a positive relationship to allopathic medicine and research. Challenges to research included mistrust of researchers and allopathic practitioners, concerns related to the invasiveness of the tests, cultural restrictions towards biospecimen donation, and lack of awareness and information about ADRD. Future research efforts seeking to recruit AI/AN participants should consider the need for raising ADRD awareness, community-based ADRD education, and building trust and long-term relationships with AI/AN communities.

Introduction: Screening for food insecurity in clinical settings is recommended, but implementation varies widely. This study evaluated the prevalence of screening for food insecurity and other social risks in telehealth versus in-person encounters during the COVID-19 pandemic and changes in screening before versus after widespread COVID-19 vaccine availability. Methods: These cross-sectional analyses used electronic health record and ancillary clinic data from a national network of 400+ community health centers with a shared electronic health record. Food insecurity screening was characterized in 2022 in a sample of 275,465 first encounters for routine primary care at any network clinic during March 11, 2020-December 31, 2021. An adjusted multivariate multilevel probit model estimated screening prevalence on the basis of encounter mode (in-person versus telehealth) and time period (initial pandemic versus after vaccine availability) in a random subsample of 11,000 encounters. Results: Encounter mode was related to food insecurity screening (p<0.0001), with an estimated 9.2% screening rate during in-person encounters, compared with 5.1% at telehealth encounters. There was an interaction between time period and encounter mode (p<0.0001), with higher screening prevalence at in-person versus telehealth encounters after COVID-19 vaccines were available (11.7% vs 4.9%) than before vaccines were available (7.8% vs 5.2%). Conclusions: Food insecurity screening in first primary care encounters is low overall, with lower rates during telehealth visits and the earlier phase of the COVID-19 pandemic. Future research should explore the methods for enhancing social risk screening in telehealth encounters.Am J Prev Med 2023;65(3):467-475. (C) 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/)

Purpose Surgery residency applications include variables that determine an individual’s rank on a program’s match list. We performed this study to determine which residency application variables are the most impactful in creating our program’s rank order list. Methods We completed a retrospective examination of all interviewed applicants for the 2019 match. We recorded United States Medical Licensing Examinations (USMLE) step I and II scores, class quartile rank from the Medical Student Performance Evaluation (MSPE), Alpha Omega Alpha (AOA) membership, geographic region, surgery clerkship grade, and grades on other clerkships. The MSPE and letters of recommendation were reviewed by two of the authors and assigned a score of 1 to 3, where 1 was weak and 3 was strong. The same two authors reviewed the assessments from each applicant’s interview and assigned a score from 1-5, where 1 was poor and 5 was excellent. Univariate analysis was performed, and the significant variables were used to construct an adjusted multivariate model with significance measured at P < .05. Results Univariate analysis for all 92 interviewed applicants demonstrated that USMLE step 2 scores ( P = .002), class quartile rank ( P = .004), AOA status ( P = .014), geographic location ( P < .001), letters of recommendation ( P < .001), and interview rating ( P < .001) were significant in predicting an applicant’s position on the rank list. On multivariate analysis only USMLE step 2 ( P = .018) and interview ( P < .001) remained significant. Conclusion USMLE step 2 and an excellent interview were the most important factors in constructing our rank order list. Applicants with a demonstrated strong clinical fund of knowledge that develop a rapport with our faculty and residents receive the highest level of consideration for our program.

Background: Tacrolimus, a calcineurin inhibitor, is the cornerstone of immunosuppressive strategies in transplantation. Other studies have concluded that hyperkalemia correlates with tacrolimus therapy, though the impact is poorly un-derstood. In 2 separate analyses, the aim of this study was to investigate if the presence and/or magnitude of exposure to tacrolimus increased potassium levels in heart or lung transplant recipients. Material/Methods: This retrospective study identified allograft recipients who underwent heart or lung transplantation from January 2013 to December 2019 at Ochsner Health in New Orleans, USA. The first analysis (A-1) comprised 103 lung transplant patients' assessed potassium levels and prevalence of hyperkalemia in the absence of tacrolimus before transplant versus 30 days after transplant on tacrolimus. The second analysis (A-2) included 187 heart or lung transplant recipients and compared potassium levels and prevalence of hyperkalemia at day 30 after transplant during higher tacrolimus exposure (High-TAC) vs day 300 during lower tacrolimus exposure (Low-TAC). Results: In A-1, patients on tacrolimus had higher median potassium (4.7 mmol/L vs 4.1 mmol/L, P<0.0001) and prev-alence of hyperkalemia (32.04% vs 5.83%, P<0.0001). In A-2, patients in the High-TAC group had higher me-dian potassium (4.6 mmol/L vs 4.4 mmol/L, P=0.0005) and prevalence of hyperkalemia (22.46% vs 12.30%, P=0.0056). Conclusions: Our findings support those from previous studies. Presence of and higher levels of tacrolimus were associated with hyperkalemia following heart and lung transplantation. These findings highlight the importance of long-term monitoring of potassium levels in patients treated with tacrolimus.

Hypertensive disorders of pregnancy are a major cause of severe maternal morbidity (SMM). To reduce the risk of complications in the postpartum (PP) period, women with a known hypertensive disorder of pregnancy should have a blood pressure (BP) evaluation within 7 days of hospital discharge. Connected Maternity Online Monitoring (MOM) is a telemedicine service that patients may opt-in to, established at our institution in 2017, to provide remote pregnancy monitoring. In this program, a digital BP cuff allows home monitoring with data sent to the patient's provider through the electronic health record (EHR). This is a retrospective cohort study. All women with a hypertensive disorder of pregnancy who delivered at our institution from January 2015 to January 2020 were identified from our EHR and included in this study. Our primary aim was to evaluate the utility of Connected MOM in improving adherence to the recommended PP BP evaluation. The secondary aim was to compare the SMM in women enrolled in Connected MOM to those receiving traditional obstetric care. Nominal outcomes were reported as frequencies (%) and continuous outcomes as median (IQR). Unadjusted odds ratios were calculated for primary and secondary outcomes. A total of 3,584 women were included; 422 patients were enrolled in Connected MOM and 3,162 were not. There was no difference in age between the two groups of patients (median age and IQR 34 (31, 37) and 33 (29, 37) for enrolled and unenrolled patients, respectively). Patients enrolled in Connected MOM were more likely to adhere to PP BP evaluation and had a lower likelihood of pooled SMM outcomes (OR = 0.4 (95% CI 0.2-0.8, p value 0.008)) (Table 1). Women enrolled in Connected MOM were more likely to receive a PP BP evaluation within 7 days of hospital discharge. These findings suggest that telemedicine may have a role in improving compliance with BP evaluation in the PP period and may be associated with a reduction in SMM related to hypertensive disorders of pregnancy.

OBJECTIVES:The growing body of evidence suggesting that lifestyle changes and aggressive medical management reduce the risk of strokes in patients with carotid stenosis has fostered interest in noninvasive screening. The objective of this study was to develop recommendations for follow-up carotid ultrasound surveillance of patients with <60% carotid stenosis. METHODS:This retrospective observational cohort study includes 2956 patients seen between August 1998 and March 2015 in 4440 visits. Data analysis was restricted to 7710 carotid ultrasounds. Primary outcome was progression of carotid stenosis as defined by the "bulb" method: baseline stenosis of 0%-39% progressed to 40%-59% on subsequent examination, baseline stenosis of 0%-39% progressed to ≥60%, or baseline of 40%-59% progressed to ≥60%. Progression was estimated using Cox proportional hazard ratios and the Kaplan-Meier method. RESULTS:More than 10% of patients progressed in the 40%-59% baseline group within 12 months compared to 78 months for the 0%-39% baseline group. Patients who progressed had a higher proportion of peripheral vascular disease, and current/former smoking compared to those who did not. While there were statistically significant correlations between medication classes and comorbidities, none of the medications studied appeared to slow carotid stenosis progression. CONCLUSIONS:In our experience, for patients with a 0%-39% carotid stenosis, follow-up examination should be performed at 6-year intervals. For patients with 40%-59% carotid stenosis, follow-up should be obtained annually to identify those who progress to a level requiring intervention. Future studies should examine whether study findings can be replicated using other approaches for determining carotid stenosis.

Introduction: Sodium Glucose Cotransporter-2 inhibitors (SGLT2i) and Glucose-Like Peptide-1 receptor agonists (GLP-1ra) showed significant reduction in cardiovascular (CV) events in type 2 diabetes (T2DM) patients (pts). The ADA and ACC recommend using SGLT2i/GLP-1ra in CV patients with T2DM (T2DM-CV). This study evaluated prescribing patterns in T2DM-CV to distinguish characteristics between those pts receiving SGLT2i/GLP-1ra from those not receiving SGLT2i/GLP-1ra. Hypothesis: SGLT2i/GLP-1ra are underutilized in T2DM-CV pts. Methods: Ochsner Health’s EPIC database was queried for T2DM-CV pts treated between Jan 2016 - Dec 2018. Baseline demographics and clinical characteristics were compared using ANOVA for numerical covariates, χ-square test for categorical covariates and multivariate logistic regression. Results: A total of 4,741 T2DM-CV pts were identified with approved indication for SGLT2i/GLP-1ra. Only 686 received a prescription for one of the approved SGLT2i/GLP-1ra with CV indication at the time of the study (empagliflozin, canagliflozin, liraglutide). Pts receiving SGLT2i/GLP1-ra were younger, had higher BMI, A1c, hypertension, hypercholesteremia, and/or commercial insurance or self-pay. Pts with CAD, atrial fibrillation, prior TIA or stroke, or heart failure were less likely to receive these drugs. (Table) Cardiologists rarely prescribed SGLT2i/GLP-1ra (2.2%) compared with primary care physicians (PCP) (45.6%) or endocrinologists (44.6%) (p<0.001). Conclusions: T2DM-CV pts rarely received guideline directed SGLT2i/GLP-1ra, and cardiologists rarely prescribed them. Younger pts with higher A1c, CV risk factors, and commercial insurance were more likely to be prescribed SGLT2i/GLP-1ra than pts with CV disease, despite reduction in CV events in randomized trials and societal guidelines. Cardiologists need to work with endocrinologists and PCPs to drive use of these medications to improve outcomes in T2DM-CV pts.

Abstract Background Poorly controlled acute pain after surgery is associated with a varity of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Neuroaxial block is used for postoperative pain management and decrease analgesic use. Wrist arthroscopy is a very common surgery and performed as a day case surgery and need good postoperative analgesia. Many adjuvant drugs are added to bupivacaine to prolong the duration of sensory block like opioids and dexamethasone. Objective The aim of this thesis was to study the effect of adding both perineural & systemic dexamethasone as an adjuvant to bupivacaine in supraclavicualr nerve block. The comparison included the the effect on hemodynamics, postoperative pain & postoperative analgesic requirement. Methods In our study, 40 patients were randomly divided into two equal groups: Group #1 (20 patients): Block with 18 ml Bupivacaine 0.5% (+ 2 ml Dexamethasone ‘8 mg’) & 2 ml normal saline was injected IV. Group #2 (20 patients): Block with 18 ml Bupivacaine 0.5% (+ 2 ml normal saline) & 2 ml Dexamethasone ‘8 mg’ was injected IV. Results Our study showed that addition of 8 mg dexamethasone to bupivacaine in supraclavicular nerve block whether perineural or intravenous prolonged postoperative analgesia with negligible side effects however, slight better outcome for the perineural route. Conclusion Dexamethasone was seen to be a potent adjunct to local anaesthetic to prolong post operative analgesia with negligible side effects with slightly better outcome to the perineural route.

We sought to prospectively determine the efficacy of a noninvasive hemoglobin measurement system compared to a traditional blood draw in patients undergoing total joint arthroplasty. One hundred consecutive patients had their hemoglobin level measured by blood draw and the noninvasive device, simultaneously. Results were analyzed for the entire group and further stratified based on race and perfusion index measured by the device. The financial implications and patient satisfaction were compared. Hemoglobin measurements in the entire group and the two sub-groups were similar between the noninvasive device and the traditional blood draw. The noninvasive system was preferred by 100% of patients. Additionally, cost savings per patient using the noninvasive system was $16.50. This correlated to an 86% savings per case over the standard blood draw. The noninvasive hemoglobin monitoring system offers comparable measurements to a standard blood draw, while improving patient satisfaction and lowering costs. (Journal of Surgical Orthopaedic Advances 29(2):94-98, 2020).

Background: Diabetic patients are at an increased risk of prosthetic joint infection (PJI) after total joint arthroplasty (TJA). The relationship between insulin-dependence and PJI has not been investigated. We aimed at evaluating whether insulin-dependent diabetes mellitus (IDDM) patients were more susceptible to postoperative hyperglycemia and PJI than their non-insulin-dependent diabetes mellitus (NIDDM) counterparts. Methods: A retrospective review was conducted of diabetic patients undergoing TJA (hip or knee) from January 2011 to December 2016. Preoperative hemoglobin A1c (A1c) and postoperative glucose measurements were observed. Patients were stratified as IDDM or NIDDM. The A1c values that predicted hyperglycemia >200 mg/dL for each group were calculated. Primary end point was postoperative hyperglycemia >200 mg/dL and secondary end point was PJI. Results: There were 773 patients meeting inclusion criteria. The IDDM cohort had a higher preoperative A1c (6.97% vs 6.28%, P < .0001) and postoperative glucose (235.2 vs 163.5, P < .0001). IDDM patients were more likely to have postoperative hyperglycemia (63.84% vs 20.83%, P < .0001; odds ratio, 5.2; 95% confidence interval, 3.66-7.4). Overall, an A1c of >7.45% predicted postoperative hyperglycemia >200 mg/mL (odds ratio, 6.94; 95% confidence interval, 4.32-11.45). When separating our 2 cohorts, an A1c of >6.59% in IDDM, and >6.60% in NIDDM, was associated with an increased risk of postoperative hyperglycemia (P < .0001). PJI was similar between the 2 cohorts (2.52% vs 2.38%, P = .9034). Conclusion: IDDM patients undergoing TJA are 5.2 times more likely to have postoperative hyperglycemia >200 mg/dL than their NIDDM counterparts, although increased risk of PJI was not found in this study. Despite the higher A1c and postoperative hyperglycemia in IDDM patients, there was found to be no clinical difference between A1c cutoff values for postoperative hyperglycemia between IDDM and NIDDM patients. (C) 2020 Elsevier Inc. All rights reserved.

Abstract Background during critical illness, changes in circulating hormonal levels are a common phenomenon. These alterations are correlated with the severity and outcome of patients in intensive care unit (ICU). Thyroid hormone stays a key role in the maintenance of the body growth. Modulating metabolism and the immune system. Aim of the Work is to access the relation between thyroid dysfunction and mortality in critically ill patients and to access the strength of thyroid dysfunction as a predictor of mortality against APACHE II score and CRP, also to assess the additive effect of low FT3 and high APACHE II score as a predictor of mortality. Patients and Methods the study population (n = 40) included 21 males (52.2%) and 19 females (47.5). their age range from (21 years) to (91 years) were selected from critically ill patients admitted to El Demerdash hospital general ICU in the period from March 2017 to March 2018. Patients were divided into 2 groups according to 7th day thyroid profile: Group 1 Normal thyroid function group (24 patients). Group 2 thyroid dysfunction group (16 patients). Results the most significant abnormality between the 2 groups was TT3 and FT3. The patients in thyroid dysfunction group showed significantly higher APACHE II score and CRP but lower GCS. They also needed more mechanical ventilation with longer duration. There was no significant difference between the 2 study groups as regard cardiovascular complication. Conclusion our study also showed highly significant correlation between thyroid dysfunction and mortality. FT3 appeared to be better predictor of mortality among critically ill patients with AUC 83% and p value < 0.001 with sensitivity 99% and specificity 61%. The predictive value of FT3 for mortality increased by the addition of APACHE II score > 25.

Objective: To examine the use of intramuscular corticosteroid (IMCS) injections for treatment of acute upper respiratory infections (URI) and the influence on healthcare utilization. Methods: This retrospective cohort study used patient encounter data from a large multicenter regional health care system between 2013 and 2017. Adult patients diagnosed with acute URI (acute pharyngitis, acute sinusitis, acute otitis media, and URI not otherwise specified) during ambulatory encounters were included. Follow-up encounters for a diagnosis of acute URI within 60 days were identified and patient characteristics, encounter details, and procedure codes were retrieved. Frequency data was used to calculate IMCS injection administration prevalence, utilization trends, and associations with covariates. Follow-up data for return encounters within 60 days for the same diagnosis was examined. Results: Of the 153 848 initial encounters, 34 600 (22.5%) patients received IMCS injection for acute URI. Injection rates varied from 0.85% to 49.1% depending on specialty and practitioner type. Internal medicine, family medicine, urgent care, and otorhinolaryngology clinics most commonly administered IMCS. 3788 patients returned for a second encounter of which 751 (19.8%) received an injection. IMCS injection during the first encounter was associated with increased odds of repeat visit within 60 days (OR: 1.74; 95% CI: 1.61–1.88). Conclusion: IMCS use in the treatment of acute URI is highly prevalent despite lack of evidence for impact and safety. Prevalence is variable across multiple medical and surgical specialties including otorhinolaryngology. Administration of IMCS injection may contribute to the likelihood of a subsequent healthcare visit for the same indication.

IntroductionThe injection interval for onabotulinumtoxinA (BoNTA) in the management of chronic migraine (CM) is 12 weeks (78‐84 days). The aim of this study was to review patient‐reported wearing off effect (WOE) of the therapeutic benefit of BoNTA near the end of the treatment cycle. We intended to describe the demographics of patients at baseline and compare groups of patients with multiple episodes of WOE.MethodsWe conducted a retrospective review of patients with CM who received uninterrupted BoNTA therapy from January 2014 to March 2018. The data from patient‐reported WOE (worsening headache variables and neck pain) that occurred during the 4 weeks (28 days) prior to the scheduled re‐injection of BoNTA for treatment cycles with injection interval ≤13 weeks and without obvious confounding factors were reviewed.ResultsWe identified 98 eligible patients and analyzed 471 treatment cycles. Forty‐three unique patients reported at least 1 occurrence of WOE. About 24/43 patients reported 1 WOE event and 19/43 patients reported ≥2 WOE events. Between the 2 groups, anxiety disorder and opioid use for headache were statistically significantly different. In the former group, the median interquartile range (IQR) dose of BoNTA was 165 (155, 175) units and the median IQR duration of the antinociceptive effect of BoNTA was 66.5 (63, 71.5) days. In the latter group, the median IQR dose of BoNTA was 167 (155, 173.3) units and the median IQR duration of the antinociceptive effect of BoNTA was 65.3 (62.5, 68.8) days. Up to 32% of these patients reported an increase in the use of abortive therapies to manage the symptoms of WOE.DiscussionThe primary goal of BoNTA in the treatment of CM is to mitigate the development of central sensitization. Since the 12‐week injection paradigm may not provide sustained antinociceptive effect in all patients, it may account for the failure of response to BoNTA. Repeated occurrences of the WOE can potentially lead to medication overuse and impact quality of life.

Neuroendocrine tumors (NETs) are a heterogeneous group of malignancies with limited systemic treatment options. Preclinical evidence has shown that the PI3K/AKT/mTOR signaling pathway plays a central role in the pathogenesis and progression of NETs. Clinical studies with the mTOR inhibitor, everolimus, demonstrated its safety and efficacy in the treatment of NET, however, patients will ultimately progress. A novel mTOR inhibitor, ABI-009 (albumin-bound rapamycin nanoparticles, nab-rapamycin), has a favorable safety profile and evidence of efficacy in patients with solid tumors and offers promise for NETs. A preclinical study showed significantly greater antitumor activity and prolonged survival with ABI-009 compared with equal weekly dosing of oral rapamycin and oral everolimus. This preclinical study demonstrated superior efficacy of ABI-009 to oral mTOR inhibitors and suggest that ABI-009 may result in disease control after everolimus failure. The goal of this phase II pilot study is to evaluate the utility of ABI-009 in NETs to warrant a full phase II clinical study. This pilot phase II trial is a prospective, open-label, single arm, single center trial evaluating the efficacy and safety of ABI-009 in patients with gastroenteropancreatic or lung NETs who have undergone prior treatment with everolimus. Patients with unresectable, metastatic grade 1 and 2 NETs of the gastroenteropancreatic system or lung who have progressed or have been intolerant to everolimus will be eligible for inclusion in this study. The study will enroll 10 patients with Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. ABI-009 will be administered intravenously at 100 mg/m2 on days 1 and 8 of a 21-day cycle. Patients will be treated until disease progression. Tumor response will be assessed by computerized tomography scan at baseline then every 9 weeks for 1 year, then every 12 weeks thereafter until progression. The primary endpoint is disease control rate at 6 months measured by RECIST 1.1. Currently, 3 of the planned 10 patients have been enrolled. ClinicalTrials.gov Identifier: NCT03670030. Section not applicable Section not applicable

Immunotherapy blocks immunoinhibitory pathways and allows for reversal of immunosuppression caused by malignant tumors. Immunotherapy can cause immune-related adverse events (IrAE) including rash, pneumonitis, colitis endocrinopathy, nephritis, adrenal insufficiency, hepatitis, and uveitis. Limited data exist to predict which patients will have the greatest response to therapy and if there is a correlation between IrAE and immunotherapy effectiveness. The aim of this study was to determine the relationship between IrAE and immunotherapy efficacy. A retrospective medical records review was collected of patients with metastatic cancer who received immunotherapy. Data included demographics, Eastern Cooperative Oncology Group Performance Status, imaging, time on treatment, best response, disease progression, and presence or absence of IrAE while on treatment. Treatment response was analyzed using the Response Evaluation Criteria in Solid Tumors guideline, version 1.1. Overall survival probabilities were calculated by the Kaplan-Meier survival method. 456 patients were included for analysis, 175 (38.4%) had an IrAE while on immunotherapy. The development of IrAE correlated with response rate for complete response, partial response, and overall response rate. A significant increase in overall survival was also seen. The presence of IrAE may be a potential predictive indicator for treatment response to immune checkpoint inhibitors.