Aurash Naser-Tavakolian, MD, and Anthony Nguyen, MD, PhD, have won the 2022 Cedars-Sinai Rubenstein Award for Excellence in Resident Research for their cancer research.

The annual award, which includes a $3,000 cash prize, honors Paul Rubenstein, MD, Cedars-Sinai's first director of Medical Education. It aims to foster clinical and translational research, enrich knowledge and encourage the development of residents across Cedars-Sinai as investigators.

Naser-Tavakolian, a urology resident at Cedars-Sinai, was recognized for his contributions to research that found physician biases can affect decision-making for prostate cancer patients.

Shared decision-making is the standard of care for low- and intermediate-risk prostate cancers. This means that instead of the physician making a recommendation of a certain treatment plan based on the patient's medical record and clinical data, the physician presents all the treatment options and allows the patient to help guide the process of choosing a treatment based on the patient's values.

"Some patients may want to pursue aggressive treatments at all costs, while others opt for less-aggressive treatments that may help them maintain a higher quality of life during treatment," Naser-Tavakolian said.

Naser-Tavakolian's team performed a qualitative analysis of physician interactions with 40 men who had low- to intermediate-risk prostate cancer. Investigators created transcripts of physician conversations with these patients and isolated quotes from the physicians. They asked coders who had not heard or seen full transcripts of the conversations to look at a single isolated quote from each conversation and predict what treatment the physician ultimately would recommend.

When coders looked at the isolated quotes—which should, in theory, be conveying objective information—they were able to predict with 91% accuracy what the physician ultimately recommended.

"The question you have to take a step back and ask is: Do we need to be convincing the patient as opposed to finding out what's important to the patient and then meeting them halfway, laying out the options for them and helping jointly decide what the best option would be?" Naser-Tavakolian said. "We're not saying what's right or wrong, but we feel our work is important to share, because we've actually found that the words you choose to use matter. The words that we choose have an impact on how our patients interpret data and gauge what level of risk is acceptable to them."

Naser-Tavakolian said he hopes this research will help physicians become more aware of their own biases and work toward using more objective language when treatment options are likely to have similar outcomes.

Nguyen, a radiation oncology resident at Cedars-Sinai, was selected for his research on the use of lymph nodes for determining a prognosis for cancer patients.

The team found that number of positive lymph nodes is a universal and dominant prognostic biomarker for patients with solid cancers, irrespective of the tumor type.

Nguyen's team used clustering analysis to generate highly discriminate nodal staging systems for 16 different solid cancers.

"Our proposed prognosis systems, despite being based on a single factor, were more accurate compared to currently used systems in all cancer sites that we tested," Nguyen said.

This work demonstrates a fundamental and powerful association between number of positive lymph nodes and mortality across solid cancers. The team has proposed that number of positive lymph nodes should serve as a foundation for nodal staging across solid tumors.

"It was an honor to share our work with the broader Cedars-Sinai community with a hybrid in-person and virtual symposium this year," Nguyen said. "I am proud to be part of an institution that is dedicated to resident research, and I am thankful for the support I received from the Burns and Allen Research Institute and Clinical and Translational Science Institute at Cedars-Sinai."