Health utility scores (HUS) and health-related quality of life (HRQoL) in stage 4 lung cancer (S4LC) patients with brain metastases (BM).
Bibliographic record
Abstract
24 Background: Novel therapies have improved the survival of S4LC patients, particularly those with EGFR or ALK alterations. As BM are common among such patients, determining whether HUS appropriately capture BM-specific HRQoL is crucial in economic analyses. We evaluated the relationship between the FACT-Brain (Br) HRQoL, presence of BM, and HUS. Methods: This cross-sectional study of S4LC outpatients at a comprehensive cancer centre assessed FACT-Br and EQ-5D-3L-derived HUS. Correlational analyses, stratified by BM status, were performed between HUS and each of FACT-Br and its subscales: FACT-General (G), physical well-being (PWB), social well-being (SWB), emotional well-being (EWB), functional well-being (FWB), and brain cancer (BrC). Linear regression interaction models assessed whether BM modified the associations between FACT-Br or its subscales and HUS. Results: The 65 BM and 42 non-BM patients had similar demographics: median age (range) was 62 (30-83) years, 61% were female, 55% were Caucasian, and 54% were EGFR/ ALK+. Mean± standard error of the mean (SEM) values of HUS were similar between BM and non-BM groups (0.77±0.02 vs. 0.78±0.02; p=0.49). However, 40 BM patients with stable brain disease had higher HUS than the 14 with progressive disease (0.81 vs. 0.69; p=0.007). Mean±SEM values for FACT-Br, FACT-G, and BrC were 148±2.6, 79±1.5, and 69±1.3, respectively, with no differences between BM and non-BM groups. With the exception of SWB, FACT-Br and its subscales were each individually correlated with HUS (all p<0.001 unless specified), including between HUS and PWB (all patients: r=0.58; BM only: r=0.60; non-BM only: r=0.54), FACT-Br (all: r=0.55; BM: r=0.55; non-BM: r=0.54), FACT-G (all: r=0.51; BM: r=0.49; non-BM: r=0.55), and BrC (all: r=0.49; BM: r=0.51; non-BM: r=0.44, p=0.003). Having BM did not modify these relationships (each interaction, p>0.35). Conclusions: The FACT-Br HRQoL measures and the majority of its subcomponents moderately correlate with HUS but are not specific to patients with BM. Progression of CNS disease greatly alters HUS. EQ-5D-3L-derived HUS are a useful index of HRQoL in S4LC.
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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 | 0.004 |
| 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 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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 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".