Proceedings of the WFNS Neuro-Oncology Committee Workshop Rome 2015
Bibliographic record
Abstract
Vestibular schwannoma: Radiosurgery, surgery or wait and scan?Quality of life, symptoms and resultsThe optimal treatment of small vestibular schwannomas (VS) remains a matter of controversy, and a significant volume of literature has been published on the outcome of various management approaches.Before the factors that predict outcome can be determined, however, the question of what outcome is sought must first be answered.Many endpoints have been measured for VS, and modern techniques achieve high levels of facial nerve function and tumor control, however, recent studies indicate that symptoms such as vertigo and tinnitus may be extremely troublesome to patients and are relatively underemphasized.Health-related quality of life (HRQOL) considerations emphasize overall level of function and the pursuit of valued life goals, and data on the impact of VS management on QOL is now emerging.A prospective, observational study of 193 patients evaluating the effect of conservative management on tumor growth, symptoms, and QOL found that 41% required treatment within 5 years, and that vertigo significantly reduced QOL.In a comparison of 113 patients given Gamma Knife radiosurgery (RS), with 124 patients allotted to conservative management, tumor size and growth rate were significantly reduced and the rate of new treatment was lower in the RS group, whereas hearing loss, symptoms, and QOL were not different.These studies used the Short Form-36 (SF-36) QOL instrument, which may be limited by lack of specificity for fluctuations attributable to symptoms.Comparison of 82 patients receiving microsurgery or RS found more facial nerve and hearing preservation in the RS group, as well as better scores on the Health Status Questionnaire (HSQ) and Dizziness Handicap Inventory (DHI).Another prospective series of 91 patients comparing microsurgery and RS found no difference in SF-36 scores and significantly better Glasgow Benefit Inventory (GBI) scores for the RS group.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.055 | 0.021 |
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".