Results of a multicenter randomized trial to evaluate a survivorship care plan for breast cancer survivors.
Bibliographic record
Abstract
9005 Background: Survivorship care plans (SCPs) are recommended for patients who have completed primary treatment and are transitioning to routine follow-up care. SCPs are considered to have face validity but have never been tested in a randomized trial. The objective of this study was to evaluative a SCP for breast cancer survivors transitioning to routine follow-up care with their own family physician (FP). Methods: 408 early -stage breast cancer patients who completed primary treatment at least 3 months previously and without recurrent or new primary cancer were enrolled through tertiary care cancer centers throughout Canada and stratified into 2 groups: <24 months (n=180) and ≥ 24 months (n=228) since diagnosis. All patients were transferred to their own FP for follow-up care. In the intervention group, 200 patients received a SCP consisting of: a treatment summary; a patient-version of follow-up guidelines; brochures and information about local relevant supportive care resources. These were compiled in a binder and reviewed with the patient in a 30-minute educational session with a nurse. FPs of intervention patients received a copy of all documents plus the full guideline and a reminder table of recommended follow-up visits and tests. In the control group, 208 patients received a discharge visit and FPs received a discharge letter, according to usual practice. The primary outcome was psychosocial adjustment (Impact of Events Scale; IES) at 12 months post-intervention. Secondary outcomes were continuity of care, health-related quality of life (SF-36), patient satisfaction, and adherence to guidelines. Results: There were no differences between groups on psychosocial adjustment, or on any of the secondary outcomes studied. There were no differences between groups on any outcomes when the two strata were analyzed separately. Conclusions: This SCP did not have an impact on patient outcomes or adherence to follow-up guidelines. IES Intervention n = 165 Control n = 180 Difference (95% CI) At 12 months* 16.4 (15.7) 17.5 (15.2) -1.2 (-4.4, 2.1) Change from baseline* -2.9 (12.5) -1.4 (12.8) -1.6 (-4.3, 1.1) * Mean (SD)
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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 | 0.005 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.013 | 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".