Adherence to Treatment Guidelines in Breast Cancer Care – a Retrospective Analysis of the ‘Organgruppe Mamma der Arbeitsgemeinschaft Gynaekologische Onkologie’
Bibliographic record
Abstract
BACKGROUND: The Organgruppe Mamma of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) performed a nationwide 3-phase analysis of the structure of care and standard of therapy given to patients with breast cancer from 2002 (4th quarter) to 2004 (4th quarter). The extent to which national and international treatment recommendations are implemented in routine clinical practice had so far not been evaluated in an interdisciplinary approach. No reliable data on the pattern of care of these patients have been published in Germany before. PATIENTS AND METHODS: The project included early breast cancer in the adjuvant and neoadjuvant setting as well as metastatic disease. We present the results of phase III of the AGO analysis, which are based on a survey conducted by the Organkommission Mamma in the 4th quarter of 2004. RESULTS: Evaluation of the data reveals that treatment based on the guidelines is now being implemented very reliably in certain sectors. This is of particular relevance to the pattern of adjuvant treatment in early breast cancer. In contrast, in metastatic breast cancer (MBC), the complexity of the interdisciplinary treatment approach is complicating this kind of straightforward analysis. CONCLUSION: The present analysis conducted by the AGO was the first attempt to analyse the treatment provided in patients presenting with MBC in a systematic fashion. The fundamental problem remains, irrespective of the stage of the tumour, that too few patients are treated in randomised clinical trials. The mission set by the AGO-Organkommission Mamma is the longitudinal observation of the therapy practices for breast cancer on the basis of the observations discussed here, which should ultimately benefit the optimisation of therapy quality in Germany.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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 source (direct Gemma or distilled Codex), 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".