The expanding role of patients in integrated cancer network governance.
Bibliographic record
Abstract
106 Background: The expanding role of patients (including family) at all levels of healthcare systems is increasingly recognized to favour changes in cancer services delivery. The province of Quebec (Canada) is no exception and promotes patients involvement in governance activities such as the implementation of the National cancer program, local integrated cancer networks, practice guidelines, and patient information material. Generally speaking, network governance refers to the steering process carried out to ensure goals’ achievement. However, we lack sufficient understanding of how patients contribute to this process, at local and national levels. This presentation seeks to report on patients involvement in governance activities within integrated cancer networks. Methods: Design: Qualitative data comprising semi‐structured interviews, focus groups and review of documents. Setting: Four Integrated Local Cancer Networks (ILCN) in Quebec purposively selected to provide variation in size, geographic location and time since implementation of the ILCN. Participants: Key stakeholders including policy-makers (n = 8), managers (n = 56), clinicians (n = 39), patients and their family members (n = 28). Analysis: Content analysis using open-ended coding. Results: This study shows the added value of the formalization of patients involvement in the governance committees at local and national levels of the cancer network. It illustrates the operationalization of the political will to translate the Quebec cancer program ideas into concrete patient-centred practice. Enlightening patients experience through discussion leads to shared decision making, building a “community of patients”, the diffusion of supportive tools, and the development, use and interpretation of performance indicators. Conclusions: Patients involvement is a major, but manageable, change in the integration of care across the cancer continuum. Formalizing the expending role of patients in local and national levels governance committees narrows the macro (hierarchical) and micro (relational) governance divide, which in turn contributes to patient-centred and integrated cancer care.
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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 | 0.015 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.008 | 0.009 |
| Scholarly communication | 0.008 | 0.004 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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".