A retrospective analysis of integrative medicine consultations at a major cancer center: Reasons for consultation, symptom burden, quality of life, and satisfaction.
Bibliographic record
Abstract
e17630 Background: Many cancer patients use complementary and alternative medicine, but limited data exists regarding the reasons for an integrative medicine consultation and the patient’s symptom burden, quality of life, and satisfaction. Methods: Beginning in September of 2009, all patients receiving an integrative oncology consultation were asked to complete a modified Measure Yourself Concerns and Wellbeing (MYCaW), a modified Edmonton Symptom Assessment Scale (ESAS, 0-10 scale), and a satisfaction rating (0-10 scale). Starting in January of 2013, quality of life was measured by the Patient Reported Outcomes Measurement Information System Global Health (PROMIS-10). Results: A total of 2,564 new patient integrative oncology consultations were conducted from 9/2009 to 12/2013, representing 63% of all consultative visits, with most patients (97.5%, n=2501) completing at least one assessment. About one-quarter of patients (26.0%) had at least one follow-up visit (average 3.1±1.7). The most common reasons for consultation as reported by the MYCaW were integrative approach (32.3%), herbs/supplements (31.9%), nutrition (20.4%), overall health (13.0%), and pain (12.6%). When ranking the importance of the reason for the consultation, 47% marked 10 on a 0-10 points scale for their first reason. Overall satisfaction was rated ≥8 by 94.6% of patients. The highest rated symptoms on the ESAS included poor sleep (mean=4.2), fatigue (4.0), poor memory (3.2), distress (3), and poor appetite (2.8). For the PROMIS-10 (n=711), the standardized T-scores were 43.6 for physical health and 45.8 for mental health (a score of 50 representing healthy population levels). The most common services utilized after the initial consultation were acupuncture (n=1,028) and massage (n = 636). Conclusions: Patients at a major cancer center commonly seek an integrative oncology consultation to address issues of integrative approaches, herbs/supplements and nutrition. Patients had a high satisfaction with the clinical service and reported mild-moderate symptom burden and clinically significant physical health problems.
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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 | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| 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".