Wait Times in Diagnostic Evaluation and Treatment for Patients With Stage III Non-Small Cell Lung Cancer in British Columbia
Bibliographic record
Abstract
OBJECTIVE: Non-small cell lung cancer (NSCLC) is associated with poor prognosis. Although this is mostly due to the aggressive natural history of the disease, the effect of treatment delays on patient outcomes is unclear. This study examines various time intervals in the diagnostic evaluation, staging, and treatment of patients with unresectable stage III NSCLC. METHODS: A case-control study of patients with stage III NSCLC in British Columbia was carried out. One hundred nineteen patients treated radically with chemoradiotherapy were matched with 238 patients treated palliatively. Multivariate analysis was used to compare treatment delays and prognostic factors in the 2 groups. RESULTS: Compared with radically treated cases, patients treated palliatively had shorter median times from first symptom to first abnormal test (32 vs. 58 d) and from first symptom to pathologically confirmed diagnosis (67 vs. 90 d). More radically treated patients (61% vs. 50%) were first assessed by a thoracic surgeon, whereas more palliatively treated patients (73% vs. 50%) were initially assessed by a respirologist. The median time from diagnosis to referral to a cancer center was similar between the 2 groups, but palliative cases were 5 times more likely to have a delay of >55 days between diagnosis and referral. This delay was observed in 24% of palliatively treated and 7% of radically treated cases. CONCLUSIONS: The wait time from first symptom to referral to a regional cancer center in British Columbia for stage III NSCLC was approximately 3 to 4 months. Efforts to reduce wait times are warranted to reduce patient distress and possibly disease progression.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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, 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".