A feasibility trial of geriatric assessment and integrated care plan for older cancer patients.
Bibliographic record
Abstract
TPS9634 Background: The majority of persons diagnosed with cancer are older adults. A comprehensive geriatric assessment (CGA) can identify current health care issues, start interventions to prevent/postpone adverse outcomes and maintain/improve the functional status and well-being of older adults. However, there is limited and conflicting evidence to support the effectiveness of CGA in oncology settings. Here, we explore the impact of a CGA and integrated care plan in optimizing outcomes in older patients with advanced breast (BC), gastrointestinal (GI) or genitourinary (GU) cancer Methods: A two-group parallel single-blind phase II RCT is enrolling 60 patients aged 70 years and over, diagnosed with GI, GU or BC, referred for first line chemotherapy or having received < 2cycles ( < 6weeks) of chemotherapy at Princess Margaret Cancer Centre. Patients need to be fluent in English, have a life expectancy > 6 months, ECOG PS 0-2 and able to provide informed consent. Randomization to intervention and control group is 1:1 and stratified by treatment intent (adjuvant vs. palliative). The intervention includes a full CGA by a multidisciplinary geriatric team followed by an integrated care plan to address the issues identified. Based on the CGA and discussion with the patient, tailored evidence-based interventions will be carried out by the team using a standardized intervention protocol. Participants in the intervention group are seen by the intervention team at baseline for the CGA and development of the integrated care plan; and at 3 and 6 months to assess intervention fidelity and measure outcomes. The co-primary outcomes are: 1) Maintaining/improving quality of life (EORTC QLQ-C30); 2) Modification of the cancer treatment plan. The secondary outcomes are: 1) Functional status (OARS Instrumental Activities of Daily Living); and 2) Feasibility of the study by tumor site. 15 of 60 planned patients have been enrolled to date. This will be one of the first RCTs of CGA in geriatric oncology to show feasibility and provide estimates of impact on relevant outcomes to inform the design of a phase 3 trial. Clinical trial information: NCT02222259.
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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 | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.018 | 0.001 |
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".