Patients’ expectations of oncologists and primary care providers (PCPs) in addressing reproductive and sexual health.
Bibliographic record
Abstract
9584 Background: The risk of infertility and sexual dysfunction from cancer therapy is inadequately discussed at the time of cancer diagnosis (Wang et al, ASCO 2013) even though these issues can cause significant distress. Our aims were to survey young cancer patients to 1) ascertain their expectations of physicians in addressing these concerns and 2) characterize how patients’ expectations modify the likelihood of having discussions about reproductive and sexual health. Methods: Patients aged 20 to 39 diagnosed with solid tumors from 2006 - 2008, evaluated at any 1 of 5 regional cancer centers in British Columbia and alive at >/= 2 years after diagnosis were surveyed to determine their views about oncologists’ and PCPs’ responsibilities for reproductive and sexual health. Survey responses were paired with tumor and treatment characteristics from patients’ medical records. Using logistic regression, we explored for associations between expectations and whether or not patient-physician conversations had occurred. Results: A total of 453 patients (response rate 57%) were included: median age was 35 years, 29% were men, 88% had ECOG 0, and 78% reported being in a relationship. Tumor sites included breast (50%), testicular (27%), gynecological (17%) and colorectal (6%). Patients expected their PCPs to be more involved than their oncologists in addressing fertility and sexual function (82% vs. 76% and 73% vs. 49%, respectively). However, only 55% and 7% of individuals actually engaged in conversations about these issues with their physicians. In multivariate models, higher patient expectations of oncologists’ involvement in reproductive and sexual health did not correlate with greater likelihood of having a discussion (OR 1.22 p=0.49 and OR 0.99 p=0.98, respectively). Conversely, increased patient expectations of their PCPs correlated with receipt of a discussion about fertility (OR 2.44 p=0.01) but not about sexual function (OR 0.62 p=0.15). Conclusions: Patients prefer to address their reproductive and sexual health concerns with their PCPs. Whereas most discussions appear to be driven by physician factors, fertility conversations with PCPs can be facilitated by increased patient engagement.
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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 | 0.004 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".