Stronger together: Implementing patient-reported symptom tool in routine cancer care in diverse Asia—A multi-national pilot feasibility study (PROMiSE-Pilot).
Notice bibliographique
Résumé
TPS180 Background: Patients diagnosed with cancer often experience disease or treatment-related symptoms, which can be under-elicited and under-appreciated by clinicians during time-poor consultations. This is particularly challenging in Asia where structural disparities in healthcare access mean oncology services are often under-resourced. Five oncologists from Thailand, India, Singapore, Philippines and Australia formed a working group as part of ASCO Asia-Pacific Leadership Development Program (LDP-AP). Systematic symptom monitoring using patient-reported outcomes measures (PROM) was identified as a potential solution to improve care in diverse Asian settings. PROM has demonstrated improved outcomes in Western settings but its utility in resource limited Asian contexts is less well established. A study was developed to evaluate the feasibility of implementing PROM in routine outpatient care across diverse cultural contexts in Asia. Methods: PROMiSE-Pilot is a prospective, multi-centre, feasibility study of integrating PROM in routine outpatient care across Asia. The Edmonton Symptom Assessment Scale questionnaire (ESAS-r) was selected as the PROM tool. Clinicians in 4 hospitals in Singapore, Manila, Bangkok and Hyderabad will be invited to participate, and their patients will be invited to complete the ESAS-r on paper before each visit. The primary aim is to evaluate if proportion of patients who complete ≥5 of 10 items on ESAS-r is ≥85% (Clopper Pearson). Secondary aims include assessing proportion who complete ≥8 and all 10 items and perceived utility of ESAS-r evaluated through surveys adapted to measure patient and clinician satisfaction. Site-specific patient, clinician, administrative barriers and facilitators will be studied. A pragmatic approach to context-specific implementation was adopted with each site developing its own process map for delivering the pilot and adapting to local patient demographics (e.g. low literacy), cultural contexts and resources. Translated versions of ESAS-r were acquired where necessary. Recruitment commenced in March 2024 following ethics approval at 2 sites. 87 patient encounters have been captured from 5 participating clinicians in Singapore. 5 clinicians have agreed to participate in Bangkok. Target recruitment is 200 encounters per site. Multi-centre data will be presented at the Breakthrough congress. Clinicians from ASCO LDP-AP identified PROM as a low-cost but potentially high-value approach to improving quality of care in resource limited settings in Asia. Understanding the feasibility of such a tool is vital prior to consideration of wider scale adoption by stakeholders. This co-developed multi-national pilot additionally demonstrates the value of collaboration, our strength in diversity and a pragmatic model for investigator-initiated studies in Asia.
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 | 0,020 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,002 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
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 ».