Does prolonging the time to bladder cancer surgery affect long-term cancer control: a systematic review of the literature.
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Prolonged surgical wait times have significant effects on a patient's psychological well-being and a negative impact on quality of life but the effect on long-term cancer control is controversial. We conducted a systematic review of the bladder cancer literature to examine the best available evidence addressing the following key questions: What is the reported time interval for bladder cancer patients from the decision to operate until the day of bladder cancer surgery? Are there recommendations/guidelines in the urological cancer literature and, if so, how do the Canadian times compare? Is there a known association between duration of wait time beyond the recommended standard and clinical outcome (i.e., recurrence-free survival, overall survival)? METHODS: A structured literature search PubMed, Embase, the Cochrane Database and Google Scholar from January 1965 to January 2006 was conducted for published studies and international guidelines/consensus documents that evaluated surgical wait times for bladder cancer. Data extracted from eligible studies included median time to bladder cancer surgery from diagnosis and key patient outcomes, such as survival rate or adjusted hazard ratios (HR). RESULTS: Eighteen studies evaluating wait times for bladder cancer surgery were identified, ten of which measured the association between prolonged waiting time and overall survival or tumor grade. Differences in study data availability, method of analysis and wait time definitions precluded statistical pooling of the findings. Median wait times from various points of patient contact ranged from 29 days (urologist consultation to transurethral resection) to 164 days (general practitioner referral to surgery). In the lone Canadian epidemiological study, which focused on all types of urological cancer, median wait time was 64 days from referral to surgery. This was in contrast to national and international guidelines, which recommended a maximum wait time between 2 and 4 weeks for all cancer surgeries. The association between surgical delay and overall survival remained controversial with some studies reporting a reduced overall survival in patients with prolonged delays, while others failed to find such associations. However, the three studies that measured the association between a delay of (3) 3 months and tumor grade reported that patients in the prolonged delay groups had an overall poorer tumor grade. CONCLUSIONS: In Canada, it appears that current wait times for urological surgeries, such as for bladder cancer, are beyond the threshold recommended by national and international expert bodies. Even though the association between surgical delay and overall survival remains inconclusive, there is evidence to suggest that prolonged delays are associated with an overall poorer tumor grade. To provide the necessary guidance and recommendations on these issues to the federal and provincial governments, the surgical wait times (SWAT) initiative was developed. Through a partnership of the key stakeholders, it is the vision of SWAT to ultimately improve the care and quality of life of bladder cancer patients and their families.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it