Improving bone health in men with prostate cancer on ADT: Results of a randomized phase II trial.
Bibliographic record
Abstract
10099 Background: Androgen deprivation therapy (ADT) is widely used to treat men with PC but is associated with accelerated bone loss and fragility fractures. Although guidelines have recommended several strategies to optimize bone health care for these men, multiple studies have shown important gaps in the quality of bone health care and there are no proven interventions to address these gaps. We conducted a phase II randomized controlled trial (RCT) of two educational interventions to see if either could improve bone health care. Methods: Men with PC starting or continuing on ADT for at least 6 months were randomized 1:1:1 to either (a) a customized bone health pamphlet for the patient and a one-page summary of bone health recommendations for their family physician (BHP+FP); (b) a BHP for the patient and support from a bone health coordinator (BHP+BHC); or (c) usual care (UC). The primary outcome was receipt of a bone mineral density (BMD) test within 6 months. Secondary outcomes included guideline-appropriate use of calcium and vitamin D, lifestyle changes, and bisphosphonate prescriptions for men at high risk of fracture. Analyses used chi-square and logistic regression. The trial is registered at clinicaltrials.gov (NCT02043236). Results: 115 men were recruited (40 men in the BHP+FP arm, 37 men in the BHP+BHC arm, and 38 men in the UC arm). Baseline characteristics were well balanced across groups. The BHP+BHC strategy (78% versus 36%, odds ratio (OR 6.19, 95% confidence interval (CI) 2.19-17.5)) but not the BHP+FP strategy (58%, OR 2.39, 95% CI 0.95-6.04) was associated with an increased odds of BMD ordering compared to UC. Both strategies were associated with numerically higher rates of calcium and vitamin D use but neither intervention was statistically significant (p > 0.20). Too few men were smoking or consuming excess alcohol to allow meaningful between-group comparisons. The BHP+BHC strategy was associated with a greater rate of exercise uptake (p = 0.028) than UC. None of the 5 men at high fracture risk received a bisphosphonate. Conclusions: BHP+BHC is associated with a greater rate of BMD ordering and exercise uptake than UC in men on ADT, but other aspects of bone health do not appear to be improved by either intervention. Clinical trial information: NCT02043236.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Randomized trial | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Randomized trial | high |
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 | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
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, unvalidatedLabeled directly by 2 models reading the full record.
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".