Evaluation of a Symptom Diary Card for Tailoring Antiemetic Therapy for Children with Cancer
Bibliographic record
Abstract
ABSTRACT Objective: The Alberta Children's Hospital lacks definitive antiemetic guidelines for oncology outpatients. In addition, under the current system, clinicians often have difficulty in monitoring delayed chemotherapy-induced nausea and vomiting in outpatients. The objective of this study was to evaluate the feasibility of using a symptom diary card to monitor the outcome of antiemetic therapy in outpatients. Methods: Using a 4-point scale, outpatients and their parents recorded episodes of nausea or vomiting, activity levels, and diet on symptom diary cards after a course of chemotherapy. On their return to the clinic, the patients or their parents completed a questionnaire to evaluate the symptom diary card. Health-care staff evaluated the symptom diary cards at the end of the study period. Results: Twenty oncology patients (ranging in age from 1 to 18 years) were enrolled in the study over a 2-month period. Seventeen (85%) of the 20 symptom diary cards were returned. In all patients nausea and vomiting were controlled, but nausea was still distressing for most patients. Older children experienced higher frequencies of nausea and vomiting. Patients receiving 5-day treatments experienced higher frequencies of nausea and vomiting than did patients receiving shorter courses of treatment. Fourteen (70%) of the 20 participants felt that the format of the symptom diary card needed improvement, but most patients and parents were interested in using the cards again. Conclusion: With a few modifications, symptom diary cards would be a feasible way to monitor response to antiemetic therapy at the Alberta Children's hospital. The card would be a useful monitoring tool for selected patients who experience severe nausea and vomiting and for formal clinical trials. Furthermore, the symptom diary card will be useful for evaluating the effectiveness of the current antiemetic regimen for outpatients. RESUME Objectif : Le Alberta Children's Hospital ne dispose d’aucunes lignes directrices officielles sur les traitements antiemetiques destines aux patients externes en oncologie. De plus, dans le systeme actuel, les cliniciens ont souvent des difficultes a faire le suivi des episodes de nausees et de vomissements retard causes par la chimiotherapie chez ces patients. L'objectif de la presente etude etait d'evaluer la faisabilite d'utiliser une fiche quotidienne des symptomes pour faire le suivi des resultats des traitements antiemetiques chez les patients traites en externe. Methodes : A l'aide d'une echelle de quatre points, les patients en externe et leurs parents ont consigne les episodes de nausees et de vomissements, le niveau d’energie, et le regime alimentaire suivi sur des fiches quotidiennes des symptomes suite a une seance de chimiotherapie. Lors de leur visite suivante a la clinique, les patients et leurs parents ont rempli un questionnaire pour evaluer la fiche quotidienne des symptomes, Le personnel soignant a evalue les fiches quotidiennes des symptomes a la fin de la periode d'etude. Resultats : Vingt patients en oncologie (dont l'âge variait entre 1 an et 18 ans) ont ete admis a l'etude qui s'est deroulee sur une periode de deux mois. Dix-sept (85%) des 20 fiches quotidiennes des symptomes ont ete retournees. Chez tous les patients, les episodes de nausees et de vomissements ont ete maitrises, mais les episodes de nausees etaient toujours penibles pour la plupart des patients. Les enfants plus vieux avaient des episodes de nausees et de vomissements plus frequents. Les patients qui ont recu des traitements sur une periode de cinq jours avaient des nausees et des vomissements de facon plus frequente que ceux qui avaient recu des traitements sur une periode plus courte. Quatorze des 20 participants ont juge que le format des fiches quotidiennes des symptomes pouvait etre ameliore, mais la plupart des patients et des parents etaient interesses a utiliser a nouveau ces fiches. Conclusion : En y apportant quelques modifications, ces fiches quotidiennes des symptomes pourraient etre un moyen de faire le suivi des reactions a un traitement antiemetique au Alberta Children's Hospital. Cette fiche representerait un outil de suivi interessant pour une population de patients choisis qui souffrent de nausees et de vomissements graves et dans le cadre d'essais cliniques officiels. En outre, la fiche quotidienne des symptomes serait utile dans l'evaluation de l'efficacite des traitements antiemetiques actuels chez les patients externes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".