Primary care physician willingness to provide follow-up care for adult cancer survivors
Bibliographic record
Abstract
6562 Background: Routine follow-up of adult cancer survivors is an important clinical and health service issue. Due to a lack of evidence suggesting advantages of long-term follow-up care in oncology clinics, there is increasing support for the locus of this care to be provided by primary care physicians (PCPs). However, views from PCPs on this issue remain to be studied. Methods: A mail survey of a random sample of community based PCPs in Canada, stratified by region and proximity to urban centres was conducted. Views on routine follow-up of adult cancer survivors and modalities to facilitate PCPs in providing this care were determined. Results: 330 PCPs responded (adjusted response rate 52%). PCPs are willing to assume exclusive responsibility for routine follow-up care approximately 2.5 (95 % Confidence Interval [CI], 2.3–2.7;) years after active treatment of colorectal and prostate cancers; 2.8 (95 % CI, 2.5–3.1) years for breast cancer and 3.2 years (95% CI, 2.9–3.5) years for lymphoma. Respondents ranked care shared between cancer specialists and PCPs as their preferred strategy of follow-up, followed equally by exclusive care by cancer specialists or by PCPs. PCPs considered the most useful modalities to assist them in assuming exclusive responsibility for follow-up care were: (1) a patient-specific letter from the specialist; (2) printed guidelines; (3) expedited routes of re-referral; and (4) expedited access to investigations for suspected recurrence. The least useful modalities were: (1) pamphlets; (2) more office staff; and (3) websites. The majority of PCPs recognized that specialist clinics are overcrowded (55.6 %) and that PCPs are better placed to provide psychosocial support (79.8 %). However, they believed that specialist follow-up is important so that patients remain in the cancer centre system (67.2 %) and that patients expect follow-up care by cancer specialists (71.7%). Variations in responses were observed according to current practices and proximity to urban centres. Conclusions: With appropriate information and support in place, PCPs are willing to assume exclusive responsibility for the follow-up care of prevalent adult cancer survivors. Insights gained from this survey may help guide strategies in providing optimal care to cancer survivors. 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 | 0.002 | 0.013 |
| 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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 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".