Operationalizing a prioritized COVID-19testing strategy at a Canadian tertiary care cancer center
Notice bibliographique
Résumé
Background: Available data suggest that cancer patients who contract COVID-19 may have worse outcomes, including a higher mortality compared to noncancer patients In an effort to inform and guide our clinicians in theongoing management of cancer patients during the COVID-19 pandemic, CancerControl Alberta (CCA)implemented targeted fast-track testing for symptomatic, immunocompromised cancer patients in the ambulatorysetting We report the results of the first 7 weeks of testing at the Tom Baker Cancer Centre (TBCC), acomprehensive tertiary cancer center serving southern Alberta (population approximately 2 million) Methods: Referral for prioritized COVID-19 testing (results within 24 hours) was intended for ambulatory cancerpatients who were identified to have symptoms consistent with an influenza-like illness and confirmed to meet atleast one of the following criteria: stem cell transplant recipient, hematologic malignancy, cancer diagnosis receiving>0 5 mg/kg/day of prednisone or equivalent, patients on immunotherapy treatment, patients on active chemotherapy within the last 3 weeks, neutropenia (ANC <500), lung cancer, chronic lung disease (e g , COPD), or patientsreceiving curative radiation Testing occurred on site at the TBCC at a designated drive-through testing area wherestaff, using PPE, tested patients who remained in their cars The assay for COVID-19 was nucleic acid-based test, and patients were also tested for a standard respiratory virus panel Patients received either a nasopharyngeal orthroat swab, for hematologic and solid tumors diagnoses, respectively Descriptive analyses were performed Results: Between April 15th and June 1st, 2020, 80 patients received prioritized testing at the Tom Baker CancerCentre Patients who were tested for COVID-19 had the following characteristics: median age of 60 5 years (range19, 85) and 31% were male The majority of tested patients (80%) met the criteria as outlined to prioritize testing Patients with the following tumor types comprised over 80% of those tested: breast (n=22), hematologic (n=16), lung(n=9), gynecologic (n=9), and GI (n=9) The average time from screening to testing was 26 5 hours, and theaverage time from test to result was 12 8 hours At the time of reporting, only one breast cancer patient, who justfinished chemotherapy, tested positive via the fast-track testing process;this patient received repeat clearancetesting, undergoing a total of 6 tests over one month before achieving 2 negative tests Conclusions: Our experience demonstrates that prioritized testing for COVID-19 among those who are potentiallythe most susceptible, namely immunocompromised cancer patients, is feasible Very few (1%) positive cases ofCOVID-19 were identified, among 80 patients tested in the first 47 days of operationalizing the fast-track testingprocess Expedited testing should be considered as an ongoing strategy to provide guidance to clinicians inmanaging cancer patients during the COVID-19 pandemic
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 | 0,004 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,006 | 0,001 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,003 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 ».