The influence of institution accrual on patient survival in Canadian cancer clinical trials
Bibliographic record
Abstract
Purpose: To determine whether participating centre annual accrual and centre-size corrected (“proportional”) accrual are associated with overall survival in Canadian Cancer Trials Group (CCTG) clinical trials. Methods: The association between centre annual accrual and overall survival was analyzed for all Canadian participants enrolled by 88 member sites onto 52 phase III clinical trials led by CCTG between 1975 and 2013. Centre annual accrual rate per year was used as a continuous variable. 30 member centres in the Province of Ontario with available referral/treatment data were used to determine the association of centre-size corrected accrual with overall survival, where centre size is estimated by the number of treated cases seen at the centre, and centre-size corrected accrual is defined as the proportion of patients treated at a single centre accrued to clinical trials. The association of accrual measures with overall survival was estimated by a hierarchical mixed effects Cox-proportional hazards models. Results: Median CCTG annual accrual at 88 member centres was 2.47 patients per year (IQR 1.54 – 3.89). Analysis included 20 353 Canadian participants, and 10 338 Ontario participants enrolled onto 52 phase III trials. Centres with higher annual accrual (per 1 patient / year) had longer patient overall survival (HR 0.98, 95% CI 0.96 – 0.99, p = 0.006) after adjustment for covariates. The median centre-size corrected accrual (i.e. as proportion of total incident cases) of Ontario cancer patients that were recruited into CCTG trials, from member centres, was 0.13% (IQR 0.09% – 0.31%). Centre-size corrected accrual (per 0.10% increase in percent of patients accrued to clinical trials) was marginally significantly associated with patient overall survival (HR 0.95, 95% CI 0.89 – 1.02, p = 0.057). Conclusions: Overall survival is longer for cancer patients on CCTG trials treated by high-accruing centres. When centre-size corrected (“proportional”) accrual is modelled, the association with patient overall survival is marginally significant.
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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 | 0.222 | 0.500 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.007 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| 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; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
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".