Bibliographic record
Abstract
In this issue of the CUAJ, Vigneault et al published their work validating a French-Canadian version of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire in a French-Canadian population.This represents an important step forward in the quest to incorporate patient-reported outcomes (PRO) into routine clinical practice.There is a multitude of evidence that we, as prostate cancer healthcare providers, underestimate the treatment-related symptom burden of our patients.1 Although, we may frequently minimize this symptom burden in the face of the almighty endpoint of oncological cure, the fact remains that impacts on health-related quality of life are significantly associated with satisfaction with care among both patients and their spouses.2 As such, assessment of a patient's treatment-related symptom burden using a validated questionnaire not only seems intuitive, but has been proposed as a quality indicator in the treatment of early-stage prostate cancer.3 These PROs are not unique to prostate cancer and recently there has been an explosion in the development of PROs for many benign and malignant disease processes within urology; 4 however, routine incorporation of these instruments into the clinic can be problematic.Studies evaluating integration of these instruments into clinical practice have noted that perceived interruptions in clinic efficiency may represent a barrier to widespread adoption.5 Nonetheless, there is objective evidence that systems which maximize the potential of PROs can improve care.Basch et al randomized patients receiving chemotherapy for metastatic cancer to standard of care symptom monitoring or a novel web-based PRO questionnaire platform.If a participant in the PRO group reported a severe or worsening symptom, the clinical nurse responsible for the patient was sent an automated email alert.When compared to the standard of care group, patients in the PRO intervention experienced improved overall survival, improved quality of life, fewer emergency room visits, and a longer time on chemotherapy.6,7 Cancer Care Ontario endorses the use of PROs with the measurable target of having 70% of patients complete these questionnaires."Your Symptoms Matter" kiosks are available at 14 regional cancer centres and 28 partner hospitals across Ontario.A web-based application is also available for patients to use via their home computers (https://isaac.cancercare.on.ca/).Currently, more than 27 000 cancer patients are screened for changes in symptom burden each month through the system.The program originally began using the Edmonton Symptom Assessment Scale (ESAS) to track patient health-related quality of life.Realizing that the ESAS
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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 | 0.106 | 0.242 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.010 |
| Science and technology studies | 0.002 | 0.005 |
| Scholarly communication | 0.009 | 0.007 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.003 | 0.008 |
| Insufficient payload (model declined to judge) | 0.003 | 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".