A randomized trial of computer and pamphlet-based versions of the Decision Board (DB)
Bibliographic record
Abstract
6508 Background: Many women with breast cancer want to be involved in treatment decision making. The DB is a visual aid poster board which sequentially presents written and graphical information from clinical trials regarding treatment options for early breast cancer. The physician presents the DB to the patient during the consultation. Randomized trials have demonstrated that the standard version of the DB improves patient comprehension, satisfaction and comfort with decision making. The standard DB is cumbersome to use and hard to update. Computer based instruments are attractive as they provide more flexibility in presenting information, and can be easily updated and accessed via the Internet. On the other hand pamphlet based versions may be easier to use. We developed computer versions of the DB for breast cancer surgery and adjuvant chemotherapy options using a Windows type format. Pamphlet versions were also developed. The objective of this study was to compare the computer and pamphlet versions of the DB to the proven standard version. Methods: 309 women were randomized to the physician consultation plus the standard (105), computer (103) or pamphlet (101) versions of the DB. Patients were stratified according to type of decision: surgical treatment or adjuvant chemotherapy. Patients were evaluated following the consultation for their knowledge about the breast cancer treatments offered, decisional conflict, and satisfaction with preparation for decision making using established validated instruments. Usefulness of the instrument for the patient and physician was also assessed. Results: Study outcomes were similar between the three versions of the DB ( Table ). Usefulness of the instrument for the patient and physician was also similar for the different versions. Conclusions: The different versions of the DB appeared equally effective in facilitating shared decision making. Physicians and patients now have the option of choosing which instrument best suits their needs. Such versatility may encourage wider use of the DB. No significant financial relationships to disclose. [Table: see text]
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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 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.014 | 0.001 |
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".