Abstract 4136: Comparison of overall survival of Chronic Lymphocytic Leukemia (CLL) patients referred or not referred to a specialized CLL clinic: A Canadian population-based study
Notice bibliographique
Résumé
Abstract Chronic Lymphocytic Leukemia (CLL) patients in Manitoba are either referred to the CancerCare Manitoba (CCMB) CLL clinic or receive care from other hematologists/general practitioners. However, it is unknown whether referral to the CLL-specialized clinic alters patients' outcome. All CLL/SLL diagnoses in Manitoba 2007-2011 were obtained from the Manitoba Cancer Registry to create an immunophenotipically confirmed population-based cohort. Referred patients to the CLL-specialized clinic were identified from the CCMB charts. Association between age and treatment was measured by chi-squared test. Hazard ratio (HR) was determined using Cox Proportional Hazard Regression model. Of 555 CLL/SLL diagnoses, 281 (51%) were referred to the CLL-specialized clinic. For referred and non-referred patients the median age was 68y (39-99) and 72y (45-96), treated patients were 77 (27%) and 31 (11%), time to first treatment was 5m (0-5.5y) and 3m (0-2.5y), respectively. M:F was 1.7:1 for both groups. CLL was the primary cause of death in both referred and non-referred patients (57% and 35%, respectively). Comorbidities such as cardiovascular diseases had equal contributions to mortality in both populations (7% and 9.5% in referred and non-referred patients, respectively). When patients older than 70 years were investigated, elderly patients that were referred to the clinic were more likely to receive treatment (p = 0.0002). When adjusted for age (≥80y HR 10.79, p: >0.0001; 71-79y HR 5.44, p: 0.0007; 62-70y HR 4.07, p: 0.0051; <62 HR 1.00), gender (male HR 1.61, p: 0.0414), pre-CLL cancer (HR 1.85, p: 0.0187) and post-CLL Cancer (HR 2.31 p: 0.0208), patients seen by CLL-specialists had a >2-fold increased OS compared to non-referred patients (HR 2.39, p: 0.0003) in the Manitoba population. In the non-referred population, there was a striking correlation between advancing age and decreasing OS. This correlation was almost eliminated in the referred population. Thus, patients seen in a specialized clinic have an improved survival compared to non-referred patients and this appears to be primarily related to improved OS in the elderly. Whether this observation is related to improved therapy/supportive care in the specialized clinic or to referral bias is under investigation. Citation Format: Sara Beiggi, Versha Banerji, Angela Deneka, Jane Griffith, Spencer Gibson, James Johnston. Comparison of overall survival of Chronic Lymphocytic Leukemia (CLL) patients referred or not referred to a specialized CLL clinic: A Canadian population-based study. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4136. doi:10.1158/1538-7445.AM2014-4136
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».