Abstract P5-14-11: Retrospective analysis of VES13 questionnaire prior oncology consultation in the Senior Women’s Breast Cancer Clinic at tertiary care center, what have we learned?
Bibliographic record
Abstract
Abstract Purpose/Objectives: - Breast cancer mortality is the highest among older women due to co morbidities, increased frailty. Geriatric assessment with focus on frailty is important and several validated tools available to assist this. The Vulnerable Elders Survey 13 (VES-13) screening tool validated in community populations aged 70 and older is a self-reported tool developed to identify older patients at risk of further health decline, showed 4.2 time risk of functional decline over two year in high scorer. We introduced VES-13 screening tool in Senior Women’s Breast Cancer Clinic (SWBCC), prior patient’s visits with medical, radiation or surgical oncology consultations. The aim was to identify feasibility of using VES 13 as a screening tool and its impact on clinical decisions and treatment recommendations. Materials/Methods: - this is descriptive retrospective study, we reviewed VES-13 questionnaires collected SWBCC in patients above the age of 70. We reviewed electronic medical records, variables included ECOG, disease stage, number of comorbidities, and referral to geriatrician or other supportive services, presence of basic social supports, modifications in oncology treatment. We also investigated if the oncologists in the breast centre reviewed VES-13 scores and requested additional services or referral the patients to a geriatrician or other allied health services in the patients who scored higher on the VES-13 instrument. Descriptive statistics were used analyze the data. Results: - 701 patients completed VES-13 questionnaires in the SWBCC between October 2019 and January 2020. 235(33.5%) patient had a documented VES-13 score of 3 or greater. Analysis was focused on patients with a VES13 score of 3 or greater. Mean VES13 score was 6 ± 3.86 with a mean ECOG score of 1.09 ± 1.19.There was no statistically significant association between referrals for geriatric assessment and VES13 score (p=0.20) or ECOG (p=0.33. However, while referral to additional allied health services was not significantly associated with VES13 score (0.6114), it was significantly associated with patient ECOG status (p<0.0001). Higher VES13 scores, increased patient age and higher ECOG scores were significantly associated with modification of oncological treatment and recommendations (p<0.0001). Conclusions: - Our study demonstrates that clinicians do not frequently use the VES13 in their clinical assessment, as opposed to the patients’ ECOG status, which results in missed opportunities for referral of frail patients for additional supportive services. Lack of review by oncologists of the VES13 questionnaires due to time constrain in a busy oncology clinic, further complicate it. Proper Utilizing of VES-13 screening can help in more optimal assessment of older breast cancer patients, individualize treatment approaches and reduce the possibility of frailty related adverse treatment outcomes in older population. Proper infrastructure of introducing VES-13 screening and collection of the VES-13 instrument in a busy academic Breast Cancer Centre is recommended Citation Format: Benazir Mir Khan, Arman Zereshkian, Xingshan Cao, Rajin Mehta, Bonnie Bristow, Maureen Trudeau, Nayanee Henry-Noel, Matthew Neve, Mireille Norris, Mark Pasetka, Katie Rice, Fiona McCullock, Frances Wright, Ines Menjak, Ewa Szumacher. Retrospective analysis of VES13 questionnaire prior oncology consultation in the Senior Women’s Breast Cancer Clinic at tertiary care center, what have we learned? [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-14-11.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 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".