High-intensity focused ultrasound for prostate cancer: a practice guideline
Bibliographic record
Abstract
Objective: The aim of this practice guideline was to developevidence-based recommendations for clinicians on the use ofhigh-intensity focused ultrasound (HIFU) in patients with localizedprostate cancer.Methods: The guideline was developed using the methods ofCancer Care Ontario’s Program in Evidence-Based Care (PEBC).The core methodology of the PEBC’s guideline development processis systematic review. A comprehensive literature search wasundertaken to identify high-quality studies, reviews and other practiceguidelines on the use of HIFU in prostate cancer. The evidenceformed the basis of the recommendations, which were reviewedand amended where necessary, by clinical experts in medical andradiation oncology and urology.Results: The literature review yielded limited evidence. No randomizedcontrolled trials or meta-analyses comparing HIFU withcurrently accepted management approaches were identified. Thebody of evidence is primarily based on data from case series.Internal feedback was provided by the PEBC Genitourinary DiseaseSite Group membership and the Report Approval Panel. Externalpeer review included targeted review by clinical experts specificallyrequested to comment on the guideline, and professionalconsultation through an online survey of health care professionals.Conclusion: HIFU is currently not recommended as an alternative toaccepted curative treatment approaches for localized prostate cancer.Objectif : Le but de ce guide de pratique était d’élaborer des recommandationsfactuelles pour les cliniciens concernant l’emploid’ultrasons ciblés de haute intensité (HIFU) dans le traitement ducancer de la prostate localisé.Méthodologie : Le guide de pratique a été élaboré à l’aide dela méthodologie préconisée par Action Cancer Ontario dans sonProgramme de soins fondés sur la recherche (PSFR). La métho–dologie centrale pour l’élaboration de lignes directrices selon ceprogramme repose sur un examen systématique. Des recherchesexhaustives ont été effectuées dans les publications afin de cernerdes études de haute qualité, des articles de synthèse et d’autreslignes directrices de pratique sur l’emploi de la technique HIFUdans le traitement du cancer de la prostate. Les données dégagéesont formé la base des recommandations, qui ont ensuite été examinéeset modifiées, si nécessaire, par des cliniciens experts en oncologiemédicale, en radio-oncologie et en urologie.Résultats : La revue de la littérature n’a permis de dégager quedes données limitées. Aucun essai clinique avec randomisationni aucune méta-analyse comparant la technique HIFU à des techniquesde traitement actuellement acceptées n’ont été cernés.L’ensemble des données est fondé surtout sur des séries de cas. Descommentaires internes provenaient des membres du groupe sur lesmaladies génito-urinaires du PSFR et du Comité d’approbation durapport. L’examen externe par des pairs incluait un examen ciblépar des cliniciens experts à qui on avait demandé spécifiquementde commenter le guide de pratique, et par des professionnels dela santé par le biais de consultations professionnelles en ligne.Conclusion : La technique HIFU n’est actuellement pas recommandéecomme traitement de rechange aux techniques actuellementacceptées pour le traitement du cancer de la prostate localisé.
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How this classification was reachedexpand
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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".