Practitioner feedback on clinical practice guidelines developed by Cancer Care Ontario's Lung Disease Site Group: Extending the circle of involvement
Bibliographic record
Abstract
6031 Background: Clinical practice guidelines (CPGs) are developed in Ontario through the disease site groups of Cancer Care Ontario's Program in Evidence-based Care. The Lung DSG consists of medical, radiation and surgical oncologists, methodologists, nurses and two consumer representatives. Guideline topics are selected by the DSG members and researched by specially trained research coordinators, who collate the evidence from the medical literature for review by the DSG. Since 1995, 10 CPGs have been published and 4 others have been completed in draft form. Methods: Completed CPGs are sent to practitioners for their feedback (PF) as part of the CPG development cycle. The CPG is accompanied by a survey instrument that asks about the acceptability and usefulness of the CPG to the practitioner. Results: 1198 questionnaires have been sent with the 14 CPGs to medical oncologists (52.3% of total questionnaires), radiation oncologists (16.3%), surgeons (15.9%), respirologists (13.7%) and other specialists (1.8%). The majority of questionnaires went to community-based practitioners (60%) and most practitioners surveyed were not members of the DSG (83.1%). Surveys were completed by 62.8% of those surveyed and 80% of those responding indicated that the CPG was relevant to their practice. Respondents indicated that they agreed or strongly agreed with the need for the CPG topic in 86.9% of cases, with the acceptability of the evidence summary (91.9%) and with the guideline recommendation as stated (86.1%). Overall, 77.1% indicated that they were likely to use the CPG in their practice. Practitioners frequently commented on issues of guideline clarity and adoption, or suggested wording edits. Explicit responses to these comments are included in the final CPG. Conclusions: PF enables a greater number of practitioners to participate in CPG development and review, obtains important feedback on the quality of the CPG document and the feasibility of CPG use in practice. By self-report, the majority of practitioners indicate that they would adopt CPG recommendations from the provincial Lung DSG. 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 | 0.046 | 0.179 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.014 | 0.003 |
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".