Cost-effectiveness of a survivorship care plan for breast cancer survivors.
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
6082 Background: Survivorship care plans (SCP) are recommended for patients who have completed primary treatment and are transitioning to routine follow-up care. However, SCPs may be costly and their effectiveness is unproven. The objective of this study was to assess the cost effectiveness of a SCP for breast cancer survivors transitioning to routine follow-up care with their own family physician (FP) using data from a recent randomized controlled trial (RCT). Methods: Analysis used resource use and utility data for 408 breast cancer patients enrolled in the RCT. In the intervention group, patients received a SCP consisting of: a 30-minute educational session with a nurse who reviewed a treatment summary, a patient-version of follow-up guidelines, brochures and information about local relevant supportive care resources; whilst 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. Analysis assessed the societal costs and quality adjusted life years (QALYs) for both groups over the two year follow up of the RCT. Health care resources including physician visits and laboratory tests were weighted by appropriate Canadian unit costs. Analysis also considered costs to patients including travel and lost productivity assessed by the friction cost method. QALYs were assessed using the EQ5D questionnaire. Uncertainty concerning cost effectiveness was assessed through non parametric bootstrapping and deterministic sensitivity analysis. Results: The SCP was estimated to cost $59.96 per patient or $1.32 million per year in Canada given breast cancer incidence. The control group dominated the intervention group: as total costs per patient were lower for the control group ($736 versus $789) and total QALYs were higher (1.42 versus 1.41). The probability that the SCP was cost effective was 27% at a threshold value of a QALY of $50,000. Sensitivity analyses adopting a health care system perspective, using the human capital approach and including the cost of recurrences did not change the conclusions of the analysis. Conclusions: Based on the findings of this trial, SCPs would be costly to introduce and would not be cost effective.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 it