Assessing the appropriateness of colorectal cancer screening in very elderly women: A cross-sectional analysis
Bibliographic record
Abstract
The Canadian Task Force on Preventive Health Care recommends against screening for colorectal cancer after age 75. This recommendation is based in part on lag time to mortality benefit and a reduced life expectancy in the very elderly. To explore the extent to which screening for colorectal cancer is appropriately ordered in primary care, we performed a cross sectional study in women aged 80-84 at an academic family medicine clinic in Montreal. Appropriateness was assessed using a validated life expectancy calculator, with a 10-year life expectancy of >50% serving as the threshold for appropriateness. Among women 80-84 years of age under the care of a physician in 2016 (N=144), 95 fecal immunochemical tests were ordered from 2016-2019. Of these, 41 were screening tests, and 16/41 (39%; 95% CI 24% to 54%) were deemed to be inappropriate. This finding suggests a need to improve screening decisions for elderly women followed in primary 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 | 0.004 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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".