Integrated Palliative Care Outcome Scale (iPOS) as a Tool to Identify Complex Palliative Care Needs - First Results of iPOS-assessment in a Palliative Care Team
Bibliographic record
Abstract
Background. Demoralization is a state of existential distress in patients with advanced illness, typically with coping difficulties, feelings of loss of sense and purpose in life and despair, among other things. DS-II is an evaluation tool for this syndrome, which has recently been reformulated.Aim. To obtain a Spanish version of DS-II and check its psychometric properties in advanced cancer patients in Spain and some Latin-American countries.Methods. Following a translation-back translation process, a pilot test was carried out to verify its validity. A validation study was then undertaken, including advanced cancer patients attended by five palliative care teams in Spain, Argentina, Chile and El Salvador. Patients completed DS-II(es), Hospital Anxiety and Depression Scale (HADS) and Edmonton Symptom Assessment System-revised (ESAS-r). Reliability was studied according to internal consistency; construct validity and concurrent validity with HADS and ESAS-r; discriminant validity using The Karnofsky Performance Status scale; feasibility, with response ratio and time required. Cut off points were established, and sensitivity and specificity were studied.Results. The Spanish version of DS-II was obtained. 150 patients completed the validation study. Cronbach's Alpha for DS-II was 0.88, for the sense and purpose subscale it was 0.83 and for coping ability, 0.79. A confirmatory analysis using structural equation models with their corresponding latent constructs showed that all the items correlated positively on their subscales and on the overall scale. DS-II (es) correlated significatively with HADS (rho=0.73, p<0.001). Cut-off points at scores 10 and 20 out of 32 were stablished. The scale showed high sensitivity (81.97%) and specificity (80.90%). The prevalence of demoralization was 33% in our sample. Conclusion. The Spanish version of the new Kissane DS-II demoralization scale has been shown to be valid, reliable and feasible with adequate psychometric properties when tested on advanced cancer patients.Founding: Project funded by the Spanish Ministerio de Sanidad y Consumo (Fondo de Investigaciu00f3n Sanitaria), project PI18/01703.
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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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| 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".