Chemotherapy safe handling and safe labeling guideline concordance evaluation: A Canadian experience.
Bibliographic record
Abstract
179 Background: The safe delivery of chemotherapy is of utmost importance to patients, health care providers and systems administrators. Cancer Care Ontario and the Program for Evidence-Based Care published two guidelines addressing issues of chemotherapy safety: Safe Handling of Parenteral Cytotoxics (Safe Handling) in 2007 and Key Components of Chemotherapy Labeling (Safe Labeling) in 2009. Concordance with the two documents was evaluated across systemic treatment hospitals in Ontario in order to direct quality improvement initiatives. Methods: Since 2009, concordance with Safe Handling has been assessed annually by self-reported questionnaire as part of the regular provincial performance review process. In 2011, concordance with Safe Labeling was assessed by submission and scoring of five standardized chemotherapy labels demonstrating core and additional criteria. Core criteria included patient and drug information, administration information, as well as adherence to other guidelines related to abbreviations and units of measurement. Individualized regional scorecards were compiled highlighting areas of discordance and then used to develop improvement plans. Results: As of October 2011, 98% of Ontario hospitals providing chemotherapy had updated policies and procedures in place for the safe handling of cytotoxics, significantly improved compared to a baseline of 77% in 2009. Baseline evaluation of Safe Labeling performed in 2011 showed a provincial average of 64% concordance for core criteria and 63% for additional criteria. Regionally, concordance scores ranged from 55% to 80% for core criteria and 38% to 75% for additional criteria. Conclusions: Concordance with safety practice guidelines has the potential to improve significantly with continued measurement and performance management. A baseline assessment serves to identify areas for quality and process improvements. Continued evaluation of guideline concordance is necessary in order to achieve the desired target rate for the province.
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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 | 0.043 | 0.061 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.009 |
| Science and technology studies | 0.009 | 0.003 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| 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".