Setting a Research Agenda for Ductal Carcinoma In Situ That Meets the Current Need for Change
Bibliographic record
Abstract
Editorials1 April 2014Setting a Research Agenda for Ductal Carcinoma In Situ That Meets the Current Need for ChangeLaura Esserman, MD, MBA and Michael Alvarado, MDLaura Esserman, MD, MBAFrom University of California, San Francisco, San Francisco, California. and Michael Alvarado, MDFrom University of California, San Francisco, San Francisco, California.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-0435 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Patient-Centered Outcomes Research Institute (PCORI) was established in 2010 by the Patient Protection and Affordable Care Act. The PCORI mission is to generate evidence-based information guided by patients, caregivers, and the broader health care community. An external advisory panel identified the management of ductal carcinoma in situ (DCIS) as a prime target for research because of uncertainty about the best options for care. The PCORI commissioned the Duke University Evidence Synthesis Group to bring stakeholders together to identify the most critical research questions related to DCIS, and the results of this effort appear in this issue (1).Why did ...References1. Gierisch JM, Myers ER, Schmit KM, Crowley MJ, McCrory DC, Chatterjee R, et al. Prioritization of research addressing management strategies for ductal carcinoma in situ. Ann Intern Med. 2014;160:484-91. LinkGoogle Scholar2. Wells CJ, O'Donoghue C, Ojeda-Fournier H, Retallack HE, Esserman LJ. Evolving paradigm for imaging, diagnosis, and management of DCIS. J Am Coll Radiol. 2013;10:918-23. [PMID: 24295941] CrossrefMedlineGoogle Scholar3. Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014;348:g366. [PMID: 24519768] CrossrefMedlineGoogle Scholar4. Esserman LJ, Shieh Y, Rutgers EJ, Knauer M, Retèl VP, Mook S, et al. Impact of mammographic screening on the detection of good and poor prognosis breast cancers. Breast Cancer Res Treat. 2011;130:725-34. [PMID: 21892702] CrossrefMedlineGoogle Scholar5. Esserman LJ, Thompson IM, Reid B. Overdiagnosis and overtreatment in cancer: an opportunity for improvement. JAMA. 2013;310:797-8. [PMID: 23896967] CrossrefMedlineGoogle Scholar6. Li CI, Daling JR, Malone KE. Age-specific incidence rates of in situ breast carcinomas by histologic type, 1980 to 2001. Cancer Epidemiol Biomarkers Prev. 2005;14:1008-11. [PMID: 15824180] CrossrefMedlineGoogle Scholar7. Ozanne EM, Shieh Y, Barnes J, Bouzan C, Hwang ES, Esserman LJ. Characterizing the impact of 25 years of DCIS treatment. Breast Cancer Res Treat. 2011;129:165-73. [PMID: 21390494] CrossrefMedlineGoogle Scholar8. Moyer VA; U.S. Preventive Services Task Force. Medications to decrease the risk for breast cancer in women: recommendations from the U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159:698-708. [PMID: 24061412] AbstractGoogle Scholar9. Fisher B, Costantino J, Redmond C, Fisher E, Margolese R, Dimitrov N, et al. Lumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer. N Engl J Med. 1993;328:1581-6. [PMID: 8292119] CrossrefMedlineGoogle Scholar10. Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med. 2013;368:987-98. [PMID: 23484825] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Laura Esserman, MD, MBA; Michael Alvarado, MDAffiliations: From University of California, San Francisco, San Francisco, California.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0435.Corresponding Author: Laura Esserman, MD, MBA, Carol Franc Buck Breast Care Center, 1600 Divisadero Street, Box 1710, University of California, San Francisco, San Francisco, CA 94115; e-mail, Laura.Esserman@ucsfmedctr.org.Current Author Addresses: Drs. Esserman and Alvarado: Carol Franc Buck Breast Care Center, 1600 Divisadero Street, Box 1710, University of California, San Francisco, San Francisco, CA 94115.This article was published online first at www.annals.org on 25 February 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrioritization of Research Addressing Management Strategies for Ductal Carcinoma In Situ Jennifer M. Gierisch , Evan R. Myers , Kristine M. Schmit , Matthew J. Crowley , Douglas C. McCrory , Ranee Chatterjee , Remy R. Coeytaux , Amy Kendrick , and Gillian D. Sanders Metrics Cited byWhat quality-of-life issues do women with ductal carcinoma in situ (DCIS) consider important when making treatment decisions?MRI ductography of contrast agent distribution and leakage in normal mouse mammary ducts and ducts with in situ cancerPatient-reported outcomes in ductal carcinoma in situ: A systematic reviewNot all ductal carcinoma in situ is created equal: can we avoid surgery for low‐risk ductal carcinoma in situ ?Do LORIS Trial Eligibility Criteria Identify a Ductal Carcinoma In Situ Patient Population at Low Risk of Upgrade to Invasive Carcinoma?Molecular biology: Marked progressScreening Is Only Part of the Answer to Breast CancerRussell Harris, MD, MPH 1 April 2014Volume 160, Issue 7 Page: 511-512 Keywords Breast cancer Cancer prevention Cancer treatment Death rates Ductal carcinoma in situ Forecasting Lesions Lumpectomy Patient advocacy Research reporting guidelines ePublished: 1 April 2014 Issue Published: 1 April 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. 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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 | 0.049 | 0.182 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.006 | 0.002 |
| Science and technology studies | 0.004 | 0.006 |
| Scholarly communication | 0.013 | 0.010 |
| Open science | 0.005 | 0.004 |
| Research integrity | 0.017 | 0.023 |
| Insufficient payload (model declined to judge) | 0.017 | 0.008 |
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".