Tiers of service: Outpatient medical oncology services for British Columbia, Canada.
Bibliographic record
Abstract
40 Background: The vision is for cancer care in British Columbia to be delivered in a coordinated, efficient manner, governed through effective partnerships between the Regional Health Authorities and BC Cancer. Systemic Therapy is delivered throughout BC by several providers, however service provision standards do not exist. BC Cancer and Fraser Health embarked on a process to develop a provincial Tiers of Service that outlines the responsibilities and requirements for the delivery of systemic therapy. Methods: From October 2017-April 2018, a working group drafted a Tiers of Service framework to be further approved by a Provincial Working Group. A scan of the literature and review of other jurisdiction's frameworks were evaluated. BC Cancer in partnership with the Regional Health Authorities have identified that the increased need for outpatient medical oncology services, combined with human resource and healthcare facility constraints requires a framework for organizing and delivering cancer care services in British Columbia. Therefore, a need to update the framework and shift nomenclature from the current “Levels of Service” to “Tiers of Service” was identified. Results: A survey of the working group was utilized to understand their level of confidence with regards to the development and utilization of the framework. Overall the working group increased their level of confidence from 33% to 100%. Conclusions: Tiers of Service: Outpatient Medical Oncology Services provides a practical framework which will be used to define and plan medical oncology services in British Columbia utilizing a common language and methodology. It describes the minimum responsibilities and requirements of each tier in providing a safe, sustainable and appropriate level of service. Tiers of Service will set standards and provide clarity for service provision, help build a capacity plan, plan where resources should be located, measure and monitor performance and improve the quality of the patient experience.
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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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.007 | 0.001 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.021 | 0.002 |
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".