Phase-specific costs of care in diffuse large B-cell lymphoma in Ontario, Canada.
Notice bibliographique
Résumé
e18840 Background: This Canadian study analyzes real-world data to estimate phase-specific costs and health care resource utilization for patients with diffuse large B-cell lymphoma (DLBCL). Methods: A cohort of adult patients diagnosed with DLBCL were identified between 2003-2014 from the Ontario Cancer Registry (OCR) and linked to treatment data from Cancer Care Ontario and other provincial administrative health care databases. Health system costs and resource utilization were determined for four defined phases of care in which index date was defined as the OCR diagnosis date, including: pre-diagnosis (90 days prior to index date), initial treatment (index date to 6 months), follow-up (end of treatment phase to beginning of end-of-life or completion of cohort follow-up) and end-of-life (last 6 months of life for patients who died). Costs (Canadian dollars in 2014) and resource utilization were normalized to 30-days. Results: There were 5,392 individuals (53% males; median age 64 years (IQR 53-74)) diagnosed with DLBCL. The median follow-up was 1,903 days (IQR 1,194-2,882) from index date. At follow-up completion, 4,015 (74.5%) individuals were alive. Total mean 30-day cost was $1,175 (±2,267) in pre-diagnosis, $9,166 (±5,581) during initial treatment, $1,462 (±2,757) during follow-up, and $7,965 (±7,104) during end-of-life. The total 30-day cost for inpatient care was $3,864 (±5,013) during treatment (n = 3,362 hospitalized during treatment) and $5,045 (±5,908) for end-of-life (n = 1,367 hospitalized during end-of-life). For home care, the mean 30-day costs were $528 (±512) during initial treatment (n = 3,508, 65% of cohort) and $725 (±884) during end-of-life (n = 1,211, 23% of cohort). Mean 30-day cost of cancer medication was $80 (±455) in pre-diagnosis, $3,115 (±1,236) during initial treatment, $232 (±712) during follow-up, and $305 (±694) during end-of-life. A subset of 239 individuals had autologous stem cell transplantation (ASCT) for relapsed/refractory DLBCL. For the ASCT subgroup, the mean total 30-day cost was $11,653 (±4632) in pre-ASCT phase, $1,542 (±2961) in post-ASCT phase, and $14,094 (±12,845) in end-of-life phase for those that subsequently died (n = 118). A further subset of 52 individuals had relapsed and proceeded to third-line therapy. The total mean total 30-day cost was $8,288 (±8,943) in the first 6-month follow-up, $2,584 (±4,000) in the post 6-month follow-up, and $14,999 (±9,443) in end-of-life phase for those that died (n = 29). Conclusions: Total mean 30-day cost was highest in initial treatment phase and end-of-life phases following a U-shaped pattern. Inpatient care was the cost driver across all phases. Individuals who required ASCT had significantly increased costs. Home care was less frequently accessed during end-of-life phase compared to initial treatment phase (23% vs. 65%). These findings can help allocate appropriate resources throughout the different phases of cancer care.
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 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,003 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 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 ».