The Esophageal Online Patient Reported Outcomes (EsO-PRO) Questionnaire: Formal implementation and assessment of a combined clinical and research data collection tool.
Bibliographic record
Abstract
37 Background: Systematic symptom monitoring improves quality of life, and possibly overall survival in cancer outpatients receiving chemotherapy. To reduce patient, staff, and resource burden, combining research surveys with electronic PRO assessments in a multidisciplinary academic esophageal cancer clinic may allow dual clinical-research goals to be met. Methods: EsO-PRO is a data collection tool directed at esophageal cancer outpatients created through expert feedback. Using the Canadian Institutes of Health research (CIHR) Knowledge-to-Action (KTA) framework, clinic flow and stakeholder maps were constructed. Facilitators and barriers were then identified, and responses were generated to address implementation barriers. Multiple iterations of the questionnaire were implemented; patient and clinic staff feedback was collected through key informant interviews, and major themes were described. Results: Creation of EsO-PRO included multiple validated tools: the FACT-E, modified Cancer Research UK esophageal cancer risk questionnaire, EQ5D-5L, PRO-CTCAE for common esophageal symptoms, and baseline clinico-demographic data. Four iterations of the KTA cycle for pilot implementation identified specific key facilitators (clinician champions, staff engagement, resource-integration, and clinician-researcher synergy) and barriers (familiarity with technology, survey length, and communication barriers). Qualitative assessment also identified perceived importance of questions as key to patient completion, and role delegation, staff burden, clinic flow interruption as critical issues to address. Splitting EsO-PRO into two separate visits for completion, allowing completion at home, and changing fill-in-the-blanks to check-off boxes were identified as potential solutions. Conclusions: The CIHR-KTA framework identified concrete methods for improved integration of a combined clinical-research survey tool for routine use in a multidisciplinary esophageal cancer outpatient clinic. Our process serves as an effective model for integration of innovations in multidisciplinary esophageal cancer clinics.
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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 | 0.093 | 0.088 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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".