Hormone-refractory prostate cancer: a primer for the primary care physician.
Bibliographic record
Abstract
OBJECTIVE: To provide a current and evidence-based clinical review of practical value to primary care physicians encountering men with hormone-refractory prostate cancer (HRPC) in their practice. METHODS: Evidence-based narrative review by two expert clinicians incorporating results of systematic reviews and randomized trials whenever available. RESULTS: HRPC represents the final common pathway to death from prostate adenocarcinoma, the single most prevalent cancer in Canadian men. However, primary care physicians will not encounter these patients with a frequency adequate to develop confidence in their care. HRPC is defined by progressive disease despite castration, and biologically is a characterized by androgen hypersensitivity. It is important to understand that HRPC is a disease spectrum ranging from asymptomatic patients with only a rising prostatic-specific antigen (PSA) level and a prognosis measured in years to extremely symptomatic patients with widespread metastases requiring end-of-life care. Numerous effective management options are now available for HRPC and are selected based on the phase of the disease natural history, and patient comorbidities and preferences. CONCLUSIONS: Men with HRPC have therapeutic options that can improve and maintain both the quality and quantity of their lives. A co-management approach including a medical oncologist and the patient's urologist and primary care physician is preferred.
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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 | 0.018 | 0.053 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.013 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.009 | 0.009 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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".