Differences in uptake of postoperative adjuvant chemotherapy for lung cancer: Results from the Project for an Ontario Women's Health Evidence-Based Report Card (POWER) study
Bibliographic record
Abstract
6556 Background: The goal of the POWER study is to improve health and reduce inequities among women of Ontario using performance measurement. Indicators are selected to facilitate assessment of care by sex and neighbourhood income. Results pertaining to the uptake of postoperative adjuvant chemotherapy for non-small cell lung cancer (NSCLC) are presented. Methods: An expert panel process was used to identify performance measures feasible to be evaluated from administrative data. Recent evidence suggests that adjuvant chemotherapy after resection of NSCLC is associated with improved survival. This measure was selected the by the expert panel. Data from Ontario Cancer Registry, Registered Persons Database as well as provincial billing and hospital databases was used to evaluate this measure stratified by age, sex, income and region. All adult patients who underwent resection of NSCLC between April 2003 and May 2004 were included in the cohort. Claims indicating chemotherapy administration within 6 months of surgery were considered adjuvant chemotherapy. Results: Overall in Ontario, the use of postoperative chemotherapy in NSCLC was 17.6% (95% CI 15.3%-20.2%) in April 2003 increasing to 32.9% (95%CI 29.8%-36.3%) in May 2004. In May 2004. use of chemotherapy decreased with increasing age: 47% of patients <65 years received chemotherapy versus 27% of patients aged 65–79. There was significant variation by region: in those under 65 years the rate of chemotherapy use among 14 regions ranged between 24–70 percent; in those 65–79 years it ranged between 18–35 percent. There was no difference in chemotherapy use between men or women or by neighbourhood income quintile. Conclusions: Rates of chemotherapy use almost doubled from April 2003 to May 2004, suggesting uptake of the new evidence in the treating community. Age and region-related, rather than sex or income, differences exist in the uptake of this new evidence. Further work is necessary to determine how these differences in uptake affect outcomes. No significant financial relationships to disclose.
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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 | 0.007 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 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 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".