The International Endorsement of US Distress Screening and Psychosocial Guidelines in Oncology: A Model for Dissemination
Bibliographic record
Abstract
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Distress Management have, since 1997, called for routine screening of distress in patients with cancer. Following the example of pain as the fifth vital sign, the case for using the concept of distress as the sixth vital sign was made by leading psycho-oncologists in 2007. Cancer care organizations in Canada and the International Psycho-Oncology Society have adopted the NCCN Guidelines for Distress Management and have named distress screening as the sixth vital sign, thereby encouraging cancer care clinicians to think of screening for distress when they screen for pain and other vital signs. Using the evidence integration triangle, this article explores the dissemination of the notion of distress as the sixth vital sign in an international context. This exploration shows that NCCN and similar organizations can adopt the evidence integration triangle in its next phase of moving toward full implementation of the NCCN Guidelines for Distress Management.
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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 | 0.447 | 0.679 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.012 | 0.014 |
| Science and technology studies | 0.007 | 0.029 |
| Scholarly communication | 0.024 | 0.026 |
| Open science | 0.006 | 0.033 |
| Research integrity | 0.030 | 0.027 |
| Insufficient payload (model declined to judge) | 0.015 | 0.006 |
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".