Do we measure up? Is an objective measuring device necessary for the accurate assessment of oral cavity and oropharyngeal lesions?
Bibliographic record
Abstract
OBJECTIVES: The T stage of oral cavity and oropharyngeal squamous cell cancer lesions has a significant impact on patient treatment and overall outcome. Determining the presence and size of palpable lymph nodes also plays an important role in the complex staging of oral cancer. Oral cavity lesions and lymph nodes are often assessed by visual approximation and palpation. The focus of this study was to determine if the introduction of a measurement tool (a ruler) changes the T stage of oral cavity and oropharyngeal lesions and the N stage of lymph nodes. MATERIALS/METHODS: Various pieces of felt that represented oral cavity and oropharyngeal lesions were placed on the tongues of cadaver specimens. Several pieces of felt of different shapes were used to represent each T stage in the oral cavity and oropharyngeal tumour staging system (American Joint Committee on Cancer). Pieces of round clay, of differing sizes, were also placed in the neck of one of the cadavers once a subplatysmal flap was raised. These pieces of clay represented the various node sizes. The study participants were four head and neck surgeons, four senior residents, four junior residents, and five medical students. All subjects were asked to visually inspect the oral cavity and oropharynx of the cadaver and approximate, to the nearest 0.5 cm, the size of the lesion. The subjects were then asked to identify the lymph nodes in the same manner. Once the participants had recorded their answers, they were asked to repeat the process with the aid of a ruler and measure the same lesions and lymph node to the nearest 0.5 cm. RESULTS/CONCLUSIONS: In staging of oral cavity and oropharyngeal cancer, the use of a ruler is necessary to increase the accuracy of tumour staging. There was a statistically significant difference in the estimated size of tumours and nodes when using a ruler. The average absolute error using visual estimation of the tumour size was 5.6 mm. When using the ruler, the error was reduced to 1.7 mm. The node size showed the same trend, with average absolute error on visual estimation being reduced from 7.4 mm to 5.2 mm.
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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 | 0.077 | 0.220 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.009 |
| Scholarly communication | 0.006 | 0.015 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.007 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.005 |
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".