Costs of treatments for local/regional prostate cancer
Bibliographic record
Abstract
6527 Background: Men with prostate cancer have a variety of treatment options, including surgery, radiation, hormonal therapy, combinations thereof, or active surveillance. Treatment choice may have important cost implications. Methods: Using the SEER-Medicare database, we examined the Inpatient, Outpatient, Emergency, and Other costs of men diagnosed with local/regional prostate cancer in the year 2000 who were 66+ years old and enrolled in the fee-for-service Medicare program. Based on the treatments received in the first 9 months from diagnosis, men were assigned to these treatment groups: active surveillance, radiation, hormonal, hormonal+radiation, surgery (might also include radiation and hormonal therapy). We matched the prostate cancer cases to noncancer controls on age, race, sex, SEER region, comorbidity, and survival. We estimated the costs of prostate cancer care from 1 month pre- to 12 months post-diagnosis by calculating the incremental costs of care for cases vs. controls. Costs of care were estimated using Medicare payments. Results: 13,769 prostate cancer cases were matched with 13,769 controls and allocated to these treatment groups: active surveillance (n=2,805), radiation (n=2,582), hormonal (n=2,190), hormonal+radiation (n=3,992), and surgery (n=2,200). The most expensive treatment group was hormonal+radiation, with cases having a total average incremental cost of $17,795 vs. controls, followed by surgery ($15,467), radiation ($12,326), and hormonal therapy ($10,804). Active surveillance was the least expensive ($4,152). Outpatient costs were the major driver of increased costs for the hormonal+radiation group. Increased costs for surgery patients were driven by both Outpatient and Inpatient costs. Emergency Department and Other costs were generally similar between prostate cancer cases and controls. Conclusions: The treatment choice of men with local/regional prostate cancer has important implications for cost in the year following diagnosis. Additional analyses exploring long-term costs are needed. [Table: see text] 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 | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".