Quality-of-care provided to prostate cancer (PC) patients for prevention and treatment of osteoporosis-induced by androgen deprivation therapy (ADT): Results of a chart audit.
Bibliographic record
Abstract
e20622 Background: Men with PC on ADT are at risk of developing decreased bone mineral density (BMD) and osteoporosis, frequently associated with increased risk of fractures and related consequences. Guidelines recommend referral to specialized clinics for bone health care, but the quality of care in osteoporosis clinics and benefits to patients has never been reported. Methods: Charts for 67 consecutive men (mean age 74.2 y) on ADT referred to the osteoporosis clinic at the Toronto General Hospital, Toronto, Canada, between 2010 and 2011, were reviewed by a single reviewer using a structured data abstraction sheet. The following quality of care issues were examined: (a) bone health services provided to PC patients receiving ADT, i.e. screening, preventing, and treating osteoporosis; (b) use of Canadian guidelines and fracture risk assessment during ADT for targeting the appropriate therapy. Results: 56 (83.6%) were receiving continuous ADT and 11 (16.4%) intermittent for a mean duration of 27.4±30.7 months at the time of baseline visit. 19.4% had their first BMD before starting ADT and 50.7% during the first year. At initial consultation, 55.2% were taking <1000 mg calcium daily from all sources, while 26.9% were taking more than 1200 mg; 22.4% were taking Vitamin D ≥ 3 months, 81.8% of them had a blood level of Vitamin D ≥ 75 nmol/L. Based on a validated fracture risk assessment tool (CAROC), the 10-year fracture risk was moderate in 28 (41.8%) and high in 9 (13.4%). 71.4% of the patients with a sedentary lifestyle were advised to increase exercise or were referred to a formal exercise program. Of the 39 (70%) and 24 (39.2%) of patients who were not taking appropriate amounts of calcium and vitamin D, respectively, 100% were recommended to adjust their intake to guideline levels. All the patients with high fracture risk were recommended to take bisphosphonates. Conclusions: The osteoporosis clinic performed a comprehensive assessment and recommended guideline-based bone health care for the vast majority of men on ADT, suggesting a systematic approach to assessing bone health is associated with high rates of guideline-adherent care.
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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 | 0.007 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".