Patient-reported psychosocial needs and psychological distress: the influence on survival in geriatric oncology patients.
Bibliographic record
Abstract
10033 Background: Little is known about how psychosocial factors and distress affect geriatric oncology patients and their survival. The study goals were: review patient-reported needs from all cancer types; identify factors associated with increased risk for psychological distress, defined as moderate to severe anxiety (ANX) and depression (DEP); and determine whether ANX and DEP are independent prognostic variables for patients ≥65 years. Methods: All patients ≥65 years, referred to BC Cancer from 2011 – 2016 who completed the Psychosocial Screen for Cancer (PSSCAN-R) and the Canadian Problem Checklist (CPC) within 6 m of cancer diagnosis were included in the study. Baseline demographics and disease characteristics were collected retrospectively. Univariate analysis using the X2 test were used to compare patient groups. OS was calculated using the Kaplan Meier method and compared using the log rank test. MVA conducted using Cox-regression analysis. Results: 26, 323 patients were included in the analysis. Baseline characteristics: female 50%; age 65-69 29%, 70-79 46%, ≥80 27%; GI 20%, Breast 18%, GU 16%, Lung 16%, Other 29%; M0 66%, M1 19%, MX 15%. Patients presenting with ANX and DEP were more likely to be female, be aged 65 to 69, have lung cancer and metastatic disease (p-values < 0.001). Patients reporting emotional, informational, physical, and social/family problems or needs were more likely to present with ANX and DEP (p < 0.001). Median OS ANX 34 m vs no symptoms 43 m (p < 0.001) and DEP 31m vs no symptoms 43m (p < 0.001). MVA including age, sex, M status, ANX, DEP showed all variables were statistically significant; increasing age HR 1.05, male vs female HR 1.11, M1 vs M0 HR 3.62, ANX vs no symptoms HR 1.30, DEP vs no symptoms HR 1.50. Conclusions: Geriatric oncology patients who are female, are aged 65-69, have metastatic disease or lung cancer are at risk for distress. ANX and DEP are independent prognostic variables, negatively impacting survival. This vulnerable cohort of geriatric oncology patients should receive psychological support and follow up to better improve survival.
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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 | 0.003 |
| 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 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".