Cost analysis of post-nephrectomy follow-up schedules from three North American clinical practice guidelines for localized renal cell carcinoma (RCC).
Bibliographic record
Abstract
657 Background: Several guidelines have been developed for follow up of patients after nephrectomy for RCC. The direct financial cost of following recommendations in three North American guidelines were estimated in this analysis. Methods: Recommendations from the American Urological Association (AUA), Canadian Urological Association (CUA), and National Comprehensive Cancer Network (NCCN) for post-radical nephrectomy care were compiled. Data regarding costs of testing and physician visits were obtained from the Ontario Health Insurance Plan Schedule of Benefits. Both the cost per patient completing five years of surveillance (scenario A), and the estimated cost adjusted for attrition from predicted recurrences (scenario B) were calculated. A sensitivity analysis was performed and will be presented. Results: For five years of follow up of a single patient in both scenarios, the costs are summarized in the table. For scenario A, follow up costs ranged from $515-1112 for T1N0, $1639-2746 for T2N0, $1856-2746 for T3/4 and $1918-2746 TxN+. For scenario B, costs were $497-1051 for T1N0, $1259-2198 for T2N0, $1008-1595 for T3/4N0 and $1043-1595 for TxN+. Conclusions: The AUA, CUA, and NCCN guidelines showed considerable differences in their associated costs, particularly when expected recurrences were accounted for. The NCCN recommendations are predicted to be the costliest to implement, irrespective of stage.[Table: see text]
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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 | 0.009 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.004 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".