Integrating Supportive and Palliative Care in the Trajectory of Cancer: Establishing Goals and Models of Care
Pourquoi ce travail est dans la base
Une base qui oublie comment elle a trouvé un travail ne peut pas être vérifiée. Voici les voies qui ont admis celui-ci.
Notice bibliographique
Résumé
Tom, a 50-year-old man with metastatic pancreatic cancer, was referred by his phase I physician to our supportive care center for symptom management. He was initially diagnosed with pancreatic cancer involving the liver approximately 6 months before this visit. He developed progressive disease despite three lines of systemic therapy, including four cycles of gemcitabine and cisplatin, three cycles of gemcitabine and vorinostat under phase I, and two cycles of fluorouracil, leucovorin, and oxaliplatin 6. His clinical course was complicated by recurrent venous thromboembolic events. Tom arrived at the supportive care clinic in a wheelchair and accompanied by his wife. He complained of right upper quadrant pain, particularly with inspiration, despite taking morphine continuous release 30 mg twice a day. He had also experienced severe fatigue, weakness, constipation, decreased appetite, and weight loss of 25 kg during the previous 5 months. Eastern Cooperative Oncology Group performance status was 4. Edmonton Symptom Assessment Scale (0 no symptom, 10 worst possible) revealed pain 8, fatigue 4, nausea 0, depression 0, anxiety 0, drowsiness 0, appetite 10, well-being 5, dyspnea 5, and sleep 5. On examination, he looked thin, was tachycardic and tachypneic, and had significant tenderness over the right upper quadrant. He was also experiencing severe weakness and had to use both hands to lift his legs to move around in bed. He lived with his wife and one son at home, but he had difficulty coping with the worsening symptoms. We adjusted his pain medications and laxatives, gave him a dose of methylnaltrexone in the clinic, recommended a home-safety evaluation, and provided supportive/expressive counseling. He expressed the desire not to receive any more cancer treatments, and we discussed the transition to hospice care so he could get more support at home. At the end of the visit, Tom said, “Oh, I wish I had seen you sooner. Why wasn’t I referred here earlier?” Tom went home with hospice care and died 10 days later.
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.
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 découle