Edmonton Symptom Assessment Scale (ESAS): Time duration of self-completion versus assisted-completion in palliative care patients—A randomized controlled trial.
Bibliographic record
Abstract
67 Background: ESAS is a multidimensional assessment tool for self-reporting of symptom intensity. Unfortunately, ESAS is not used often in clinical care due to the perception that it may be time consuming. Our aim was to compare the time duration of self-completion (SC) of ESAS for the first time by patients with advanced cancer vs. assisted-completion (AC) with a health care professional (HCP). Methods: In this randomized controlled trial, patients with advanced cancer who have never completed the ESAS at MD Anderson were allocated (1:1) with a web-based system to either to self-completion of the ESAS form vs assisted completion by the research assistant. Time of completion was measured by the research assistant using a stop watch. Patients completed the Rapid Estimate of Adult Literacy in Medicine (REALM) test prior to administration of the ESAS. In the self-completion group, the nurse reviewed the responses to verify that the reported ESAS scores were correct (nurse review). Results: 127 patients were enrolled (69 patients to AC and 58 to SC). The median age was 60 years old, and median REALM score was 65. The median (IQR) time of SC alone was significantly less than AC (1.2 minutes (.7, 1.5) vs 1.82 minutes (1.3, 2.3), p = .000). With nurse review time included, the SC time increased to 1.92 minutes (p (vs. AC) = .28). Lower literacy (REALM) score was significantly associated with increased completion time (p = .007). Other demographical and clinical variables were not significantly associated with completion time. 73/127 (58%) patients reported they did not mind completing the ESAS alone or with the help of the nurse. Conclusions: The ESAS can be completed in less than 2 minutes with or without assistance by a HCP. When nurse review time was included, there was no difference in time of completion as compared to assisted completion. Our results support that regular clinical use of ESAS will have minimal impact on clinical time.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 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".