The characteristics and correlates of dyspnea (D) in advanced cancer patients (ACP)
Bibliographic record
Abstract
8019 Background: D is a frequent and devastating symptom in advanced cancer. It results from pulmonary pathology, but other causes contribute to it. There has been a limited attempt to characterize this symptom clinically, especially breakthrough D(BTD). Methods: 74 ACP with D underwent assessment of D and other symptoms using Edmonton Symptom Assessment Scale (ESAS, 0–10), Oxygen-Cost Diagram(OCD)], Oxymetry, Pulmonary Function Tests [VC, FVC, FEV1, MIP,PFR], Hospital Anxiety and Depression [HADS], and a detailed clinical questionnaire of daily characteristics of dyspnea. Results: Two types of D were observed, constant D(CD) as well as a breakthrough D (BTD). 28/74 (37.8%) patients (pts) had continuous D(CD). 14/28 (50%) pts with CD also had episodes of BTD. BTD was the sole symptom in 46/74 (62.1%) pts. Overall BTD was found to occur in 60/74 (81%) of patients. 4/60 (6.6%) of pts had D of more than 15 minutes duration (minimal latency period of short acting opioids). 46/60 (76.6%) pts had BTD lasting less than 5 minutes. 8/60 (13.3%) patients had less than 2 BTD episodes/day, 9/60 (15%) had more than 6 BTD epiosdes/day, and 45/60 (75%) had 2–6 BTD episodes/day. In univariate analysis, D (ESAS) was associated significantly with fatigue (p<0.0001), sleep (p=0.002), anxiety(ESAS) (p=0.006), depression(ESAS) (p=0.01), feeling of well-being (p=0.03), OCD(p=0.001). D (OCD) was significantly associated with HADS depression (p=0.001), fatigue (p=0.01), and VC (p=0.04). In multivariate analysis, dyspnea was significantly associated with fatigue (p=0.001), FEV1 (p=0.004), pain (0.01), and depression (p=0.03); this model explained 34% of the variation.D (OCD) was significantly associated with depression (p=0.0006) and FEV1 (p=0.045) although the model explained only 21% of the variation (R-Square). Conclusions: D is a breakthrough symptom(BTD) of very short duration in most cancer patients, and need different treatment algorythm compared to CD. D is a multidimensional construct commonly occurring with a cluster of other symptoms, requiring a multi-modality approach. Traditional pharmacological approaches will be ineffective in most patients with BTD. This new characterization should be useful for clinical trials. No significant financial relationships to disclose.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".