Feasibility of neurocognitove and psychological assessments in allogeneic stem cell transplantation: A pilot study.
Bibliographic record
Abstract
9572 Background: Neurocognitive and psychological measures may provide insightful and even prognostic information, yet are not routinely incorporated into pre-allogeneic hematopoietic stem cell transplant (HSCT) assessments. We conducted a longitudinal pilot study to assess the feasibility of using neurocognitive and psychological tools in the HSCT setting. Methods: Patients age 27-72 with diagnoses of hematologic malignancies underwent neurocognitive/psychological assessments within 4 weeks prior to HSCT, at day +100 and day +180. The Montreal Cognitive Assessment (MOCA) Version 7 assessed neurocognitive impairment. Center for Epidemiological Studies Depression Scale (CES-D), State-Trait Anxiety Inventory (STAI), and Neuropsychiatric Inventory(NPI), evaluated depression, anxiety, and caregiver interpretation of patient distress, respectively. Evaluations were performed by a clinical psychologist. Results: 21 successive patients scheduled for HSCT were evaluated for feasibility of conducting the above evaluations. One patient declined to participate in the full initial evaluation. The evaluation was scheduled during a pre-existing psychosocial intake and required an additional 30 minutes of clinician and patient time. The MOCA required 10 minutes. The CES-D, STAI, and EORTC QLQ–C30 required 5 minutes each. Scoring required 10 minutes. Neurocognitive impairment was frequent at baseline and worsened post-HCST. Pre-HSCT anxiety/depression was very severe (expected incidence <10%), and persisted in 6-month survivers. Most patients had sub-clinical levels of anxiety/depression which may impact function. Conclusions: Longitudinal neurocognitive/psychological inventories in the HSCT setting are feasible and informative. An expanded, prospective study will be performed to correlate the measures with post transplant outcomes and QoL. Measure Pre-HSCT n=20 Day 100 n=12 6 month n=8 MOCA Normal Low normal Below normal 30% 50% 20% 16% 25% 59% 0 38% 62% Depression severe 25% 8% 33% Anxiety severe 20% 8% 50% Global QoL 80+ 60-79 <60 30% 40% 30% 17% 50% 33% 25% 38% 38% Overall survival 100% 75% 50%
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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 | 0.004 | 0.004 |
| 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 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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, 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".