Conservative management for low-risk prostate cancer improves quality-adjusted life expectancy at lower cost compared with initial treatment
Bibliographic record
Abstract
Commentary on: Hayes JH, Ollendorf DA, Pearson SD, et al. Observation versus initial treatment for men with localized, low-risk prostate cancer: a cost-effectiveness analysis. Ann Intern Med 2013;158:853–60.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] What is the best treatment for localised prostate cancer? This simple question, for a common disease now affecting about one in six North American men, does not have a clear answer. This is not a ‘normal’ situation in medicine. For most common diseases, including most primary cancers, there is usually a consensus as to the best therapeutic approach. Not so for localised prostate cancer. Surgery contends with radiation of various types and conservative management, particularly active surveillance, which has made inroads against both of these for favourable risk disease. The lack of consensus reflects many factors, including difficulty in successfully completing randomised comparative trials (RCTs), long timelines to achieve robust endpoints and trade-offs between survival and quality of … [1]: {openurl}?query=rft.jtitle%253DAnn%2BIntern%2BMed%26rft.volume%253D158%26rft.spage%253D853%26rft_id%253Dinfo%253Adoi%252F10.7326%252F0003-4819-158-12-201306180-00002%26rft_id%253Dinfo%253Apmid%252F23778902%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.7326/0003-4819-158-12-201306180-00002&link_type=DOI [3]: /lookup/external-ref?access_num=23778902&link_type=MED&atom=%2Febmed%2F19%2F1%2F40.atom [4]: /lookup/external-ref?access_num=000320645000013&link_type=ISI
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Not applicable | low |
| gpt | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Not applicable | high |
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".