NCOG-03. COGNITIVE CONCERNS AND PERFORMANCE IN PATIENTS WITH METASTATIC NON-SMALL CELL LUNG CANCER (mNSCLC)
Bibliographic record
Abstract
Abstract INTRODUCTION Cognitive concerns and objective cognitive impairment are both common in cancer patients, although the relationship between these variables is uncertain. Brain metastases have the potential to affect both outcomes. We examined the relationships between cognitive concerns, cognitive performance, and psychological disturbance in mNSCLC patients with and without brain metastases. METHODS mNSCLC patients completed standardized neuropsychological tests (HVLT-R, TMTA/B, COWA) and questionnaires measuring cognitive and neurobehavioral concerns, depression, demoralization, self-esteem, illness intrusiveness, and physical symptoms. Perceived cognitive impairment was defined as FACT-Cog scores ≤1.5 SD below the normative mean. Impaired cognitive performance was defined as ≥2 test scores ≤1.5 SD or one test score ≤2.0 SD below normative means. Multivariate analyses used the mean composite of neuropsychological test z-scores (COG-comp). Progressive disease (extra- and/or intracranial) was defined as radiological progression or clinical deterioration within one month before the study. RESULTS 74 patients participated (53% female; median age 62 (37–82); 30% EGFR mutated). Time since mNSCLC diagnosis was 11 months (median; 0–89). 50% had brain metastases, 21 of whom received cranial radiation (11 SRS, 10 WBRT±SRS). 27% reported cognitive concerns and 42% were impaired on objective testing (HVLT-R:34%, TMT:27%, COWA:16%). Neither was more common in patients with brain metastases. COG-comp (mean±SD: –0.39±0.91) was unrelated to cognitive concerns. In multivariate analyses, less depression (p< 0.01) and illness intrusiveness (p=0.03), and absence of disease progression (p=0.03) were related to better perceived cognitive function. No significant associations were found between cognitive performance and demographic, disease, or psychological variables. CONCLUSION Cognitive impairment is common in mNSCLC patients with or without brain metastases, but is independent of cognitive concerns. Cognitive concerns which are linked to depression, illness intrusiveness and disease progression, may be more likely to reflect the impact of cognitive changes in daily life. Both merit further clinical and research attention.
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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 | 0.002 |
| 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) | 0.003 | 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".