22 / FROM HEALTHY TO VULNERABLE: OLDER MEN’S EXPERIENCES WITH PROSTATE CANCER AND CANCER CARE
Bibliographic record
Abstract
Background: Advanced cancer patients(AdCa) experience physical, psychological, existential/spiritual distress and financial distress(FD) associated with the disease or treatment. Regular assessments of these issues in the outpatient-setting are limited. Methods: We reviewed 289 consults of AdCa evaluated by our Supportive Care Outpatient-Center between October-2012 and January-2013. We used Edmonton Symptom Assessment Scale adding two items following the same scale(0 to 10) to evaluate: Spiritual Pain and FD, (ESAS-FS). We determined the frequency, intensity and correlates of self-reported FD (Distress/Suffering experienced secondary to financial issues) among these AdCa. Results: Mean age(range): 60.1 years(22-92). 53% were male. 189(65%) were White, 45(15%) African American, and 34(12%) were Hispanic. Type of cancer: head and neck 62(21%), gastrointestinal 57(20%), breast 40(14%), lung 32(11%), urological 32(11%), and others 45(16%). 187/289(65%) AdCa had FD: mean(95% Confidence-Interval) 4(3.5-4.4). AdCa with FD had worse Pain [mean(95%CI) 5.12(4.7, 5.6) vs. 4.3(3.6, 4.9)](p=0.028), depression [3.8(3.3, 4.2) vs. 1.5(1.1, 2.1), p<0.0001], anxiety [4.1(3.6, 4.6 vs. 1.6(1.1, 2.1), p<0.0001], Well-Being [5.2 (4.9, 5.6) vs. 4.3 (3.7, 4.9), p=0.006], and Spiritual Pain[2.4(2.0, 2.9) vs. 0.5(0, 1.0), p<0.0001]. FD correlated (Spearman) with Pain r=0.25, p<0.0001; Sleep r=0.29, p<0.0001; Depression r=0.41, p<0.0001; Anxiety r=0.45, p<0.0001; Drowsiness r=0.26, p<0.0001, Well-being r=0.25, p<0.0001; and Spiritual Pain r=0.44, p<0.0001. Logistic regression multivariate analysis showed association with Spiritual Pain[OR (95% Wald CI) 1.575(1.284-1.932), p<0.0001] and Anxiety [1.261 (1.083-1.488), p<0.0001].Conclusion: FD was reported in more than 65% of AdCa. It correlates with physical and psychological, and spiritual distress. The use of ESAS-FS allows identifying AdCa with FD evaluated in a Supportive Care Outpatient Clinic. More research is needed.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| 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".