Assessment of a dyspnea clinic for patients with thoracic malignancies.
Bibliographic record
Abstract
e20667 Background: Dyspnea is a common but undertreated symptom among patients with thoracic malignancies. To meet this need, a multidisciplinary dyspnea clinic was initiated at a tertiary cancer centre. Methods: Patients with a thoracic malignancy and an Edmonton Symptom Assessment Scale (ESAS) dyspnea score of 7 or higher (scale of 0-10) were invited to the clinic. Referrals were also accepted. Patients responded to quality of life questionnaires: ESAS, Cancer Dyspnea Scale (CDS, scores of 12 to 60), EORTC QLQ30, and a satisfaction survey (scales of 0-4). Spirometry, a 6-minute walk test, and chest imaging were performed. All patients received teaching in breathing strategies according to need. Data collection had ethics approval and statistical testing was by Wilcoxon signed rank test. Results of the first 44 patients are reported. Results: From October, 2010, to January, 2012, 44 patients were recruited, 23 with incurable disease. Twenty-five men and 19 women attended the clinic, median age 68.6 (range 48-84), median ESAS for dyspnea of 8 (range 6-10), and median palliative performance scale 80 (range 50-100). Diagnoses included non-small cell lung cancer (31), small cell lung cancer (8), mesothelioma (3), and other (2). At baseline visit, 30 patients used inhalers, 6 oral steroids, 22 narcotics, and 6 home oxygen. Eighteen patients met spirometric criteria for obstructive lung disease. Eight subjects had some degree of pleural effusion but none required drainage. After assessment, 18 patients were prescribed inhalers (9 for the first time), 6 oral corticosteroids, 9 narcotics, and 5 home oxygen. Among 26 patients with at least one follow-up visit, ESAS dyspnea scores improved (median 6.5 vs. 8, p=0.01) as did CDS score (median 29 vs. 32, p=0.03), but not global quality of life. In follow-up, 17 of 21 respondents felt they understood their dyspnea better and 18 would recommend the clinic to another patient. Conclusions: The dyspnea clinic was well-received by patients. An unexpected proportion of dyspneic patients were receiving curative treatment. Obstructive lung disease was a common finding, and both inhalers and palliative interventions were commonly employed. Improvements in ESAS and CDS scores were seen among patients undertaking follow-up.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.017 | 0.003 |
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".