Quantifying the psychosocial needs of cancer patients and associated provider workload to build PSO services into the funding model for systemic treatment in Ontario.
Bibliographic record
Abstract
18 Background: As part of a broader set of provincial health funding reforms, Cancer Care Ontario (CCO) developed a new funding model for systemic treatment. A decision was made to build dedicated funding for psychosocial oncology (PSO) services into the model. The objective of this work was to estimate the psychosocial needs of cancer patients and the associated PSO provider workload to inform the incorporation of these services into the model. Methods: PSO clinicians formed advisory groups for six disciplines: social work, psychology, nutrition, physiotherapy, occupational therapy, and speech language pathology. For each cancer type, treatment intent, and phase of the cancer journey, advisors were asked to estimate: 1) proportion of patients who need services, 2) length of an average visit, and 3) average number of visits needed to address patient needs. Groups utilized online surveys to generate estimates to serve as a starting point for discussion. Evidence was used to inform the advisory groups’ consensus when available. Results: Each group produced recommendations based on estimated patient needs and associated workload. For example, the dietitian group recommended that prior to beginning systemic treatment, 50% of lung cancer patients receive a first consult visit (~75 minutes), followed by 1-2 follow up visits (~30 minutes each). Direct activities for these visits included nutrition assessment, weight loss management, and managing symptoms such as dysphagia. Indirect activities included documentation, chart review, and making referrals. Conclusions: This was an initial attempt to measure PSO workload based on patient needs, and the consensus process used could be leveraged by other jurisdictions. This work allowed the identification of specific funding for PSO services for patients who undergo systemic treatment in Ontario. Limitations included a lack of rigorous evidence and the complex nature of the funding model. Further efforts are underway to refine the recommendations and to leverage this work for quality improvement purposes.
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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 | 0.004 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".