Correlating symptoms and their changes with survival in patients with brain metastases
Bibliographic record
Abstract
OBJECTIVE: Having a clear prognosis for patients with brain metastases allows health care practitioners (HCPs) to determine appropriate palliative management and assist patients when making informed treatment decisions. The objective of this study was to determine the prognostic significance of commonly experienced symptoms as well as their changes. METHODS: Overall survival (OS) was calculated from the date of consultation for palliative radiotherapy to date of death or censored at last follow-up date. Symptom changes at follow up were defined as worsened, improved, or no change. Univariate and multivariate cox proportional hazard (PH) model of OS was conducted on 14 symptoms at baseline and on changes in those symptoms at 1-, 2-, and 3-month follow-ups. RESULTS: From 1999 to 2013, 1,660 patients were included for baseline symptom analysis. Through univariate analysis, fatigue, nausea, appetite loss, coordination, concentration, balance and depression were significantly related to OS. Upon multivariate analysis, fatigue and appetite loss were most predictive of short survival. For symptom change, 201 patients were included. The actuarial median OS was 5.0 months [95% confidence interval (CI): 4.3-7.0], 7.1 months (95% CI: 5.2-9.5) and 8.8 months (95% CI: 5.8-11.5) for patients with month 1, 2, and 3 follow-ups, respectively. The most common symptom changes following whole brain radiotherapy (WBRT) were: worsened fatigue, appetite loss, and weakness. Worsened difficulty concentrating, fatigue, nausea and headaches were most predictive of a poorer survival outcome. CONCLUSIONS: HCPs should be aware of the shorter prognosis associated with patients exhibiting one or more of these symptoms and tailor care accordingly to maximize patients' remaining quality of life (QOL).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 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) | 0.000 | 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 teacher head, 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".