Do cancer centers designated by the National Cancer Institute have better surgical outcomes?
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: The National Cancer Institute (NCI) designates cancer centers as regional centers of excellence in research and patient care. Although these centers often advertise their superior outcomes, their relative performance has not been examined empirically. In the current study, the authors assessed whether patients at NCI cancer centers compared with patients at control hospitals had lower mortality rates after major cancer surgery. METHODS: Using the national Medicare database (1994-1999), the authors assessed surgical mortality and late survival rates for 63,860 elderly patients undergoing resection for lung, esophageal, gastric, pancreatic, bladder, or colon carcinoma. For assessing performance, patients treated at the 51 NCI cancer centers were compared with patients from 51 control hospitals with the highest volumes for each procedure. Mortality rates (surgical and 5-year rates) were adjusted for patient characteristics and residual differences in procedure volume. RESULTS: NCI cancer centers had lower adjusted surgical mortality rates than control hospitals for 4 of the 6 procedures, including colectomy (5.4% vs. 6.7%; P = 0.026), pulmonary resection (6.3% vs. 7.9%; P = 0.010), gastrectomy (8.0% vs. 12.2%; P < 0.001), and esophagectomy (7.9% vs. 10.9%; P = 0.027). Nonsignificant trends toward lower adjusted operative mortality rates at NCI cancer centers were also observed for cystectomy and pancreatic resection. Among patients surviving surgery, however, there were no important differences in subsequent 5-year mortality rates between NCI cancer centers and control hospitals for any of the procedures. CONCLUSIONS: For many cancer procedures, patients undergoing surgery at NCI-designated cancer centers had lower surgical mortality rates than those treated at comparably high-volume hospitals, but similar long-term survival rates.
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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 | 0.000 | 0.000 |
| 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) | 0.002 | 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