Access to care and patient satisfaction for surgically-treated breast cancer
Bibliographic record
Abstract
17010 Background: Although recent studies have described timeliness of breast cancer (BC) care and its impact on outcomes, there is little data on patient perception of timeliness. This study examined the association between clinicodemographic factors, timeliness and patient satisfaction for surgically-treated BC patients across defined intervals of diagnosis (Dx) and treatment. Methods: All patients undergoing surgery for primary BC within a single Health District over 24 months were enrolled in a prospective consecutive cohort study. A comprehensive, standardized method of ascertaining specific time intervals, including a patient interview, was used to quantify the timeliness of presentation, Dx and treatment. A validated satisfaction questionnaire was applied to patients 2 weeks after surgery, and following chemotherapy. Multiple linear regression, using the natural logarithm of the time interval as the dependant variable, was performed to examine the association of factors and satisfaction with specific time intervals. Results: Among the 519 patients in the study, 317 (61%) were screen-detected and 202 (39%) presented symptomatically. Complete satisfaction questionnaire responses were obtained in 348 (67%). The median time intervals in days (interquartile range) were: abnormal screen to Dx - 33 (21–48); symptoms to Dx 44 (23–97); Dx to surgery - 31 (22–43); surgery to adjuvant chemotherapy 63 (49–73). On multivariate analysis, the interval from presentation (either abnormal mammogram or symptoms) to Dx was 33% longer for screen-detected patients (p<0.0001) and 38% longer for patients where more than one diagnostic test was performed (p=0.009). Moderate correlation was identified between patient satisfaction and both the intervals from presentation to Dx (r2=0.212;p<0.0001) and from Dx to surgery (r2=0.262;p<0.0001). Controlling for the length of these intervals, younger women (p=0.01) and those with a Dx made via screening (p=0.004) had significantly lower satisfaction scores. Conclusions: The timeliness of care for BC involves several defined components; variations in the relatively short interval from Dx to surgery appeared to have most impact on patient satisfaction. Younger women and those diagnosed via screening were less satisfied with their access to timely care. No significant financial relationships to disclose.
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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 | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 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".