Bibliographic record
Abstract
Introduction and Objectives: Abiraterone acetate (Abi) therapy showed survival benefits in the treatment of castration-resistant prostate cancer (CRPC) in phase III trials.In Quebec, Abi reimbursement was approved for docetaxel (Doc) naïve and refractory patients in 2014 and 2012, respectively.This study evaluated the cost-effectiveness and survival impact of Abi in the management of CRPC post-docetaxel.Methods: The study cohort was selected from the: Régie de l'Assurance Maladie du Québec (RAMQ) and Med-Echo databases.It consisted of patients with CRPC starting chemotherapy or abiraterone treatments in between 2009-2010 (Doc), defined as pre-Abi era, and 2012-2013 (Doc+Abi), and defined as Abi era.Survival was evaluated by Kaplan-Meier and the difference in survival between pre-Abi and Abi eras by log-rank test.Association between Abi exposure and survival was evaluated by cox proportional hazards model adjusted for co-variables.The incremental costeffectiveness ratio (ICER) was obtained by dividing changes in costs (Doc alone, Doc+Abi) and survival in the two periods.Results: Survival was significantly increased by the addition of Abi to CRPC management.Mean survival was 11.47 (±0.6;N=115) vs. 15.26(± 0.85; N= 67) months in the pre-Abi vs. Abi era (p<0.001).Mean treatment duration for Abi was 163 days (±108.7)and for chemotherapy during Abi period was 4.4 cycles (±3.1) and 4.6 cycles in the pre-Abi era (±4.2).The adjusted hazard ratio when comparing pre-Abi vs. Abi era was 1.32 (95%CI 0.98-1.78).The primary therapy cost per patient for Doc group was $3,680 and for Doc+Abi group was C$49,650.As expected, the addition of Abi resulted in a cost increment estimated at C$45,970/patient.The ICER was C$145,569 per life-year gained.Conclusions: Our real-life study indicates that patients receiving Abi plus Doc had a survival benefit when compared to the group receiving chemotherapy alone.Addition of Abi was associated with an important ICER.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.509 | 0.264 |
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".