Symposia — Conferences — Oral Communications
Bibliographic record
Abstract
Background: A growing number of older people reside in long-term care (LTC) homes. As they near the end-of-life, it is vital that LTC residents express their healthcare wishes though Advance Care Planning (ACP). Yet, ACP remains suboptimal and LTC residents often experience unmet needs and unnecessary hospital transfers. Objectives: We applied the Knowledge-To-Action framework to 1) identify shared barriers and solutions to improve the process of ACP and end-of-life care for LTC residents; 2) develop a standardized, scalable, and person-centered approach to ACP, and 3) evaluate this approach in a multicentre cluster randomized trial. Methods: We began in September 2017 with a 1-day workshop for 44 LTC stakeholders, including residents and families, from Manitoba, Alberta, and Ontario. Sessions were recorded and thematic analysis performed. An environmental scan was conducted to assess ACP practices in 38 LTC homes in participating provinces. Over the following 11 months, we developed the intervention to address weak links in ACP. From August 2018 to August 2020, we conducted an unblinded, cluster-randomized, mixed-methods trial in 29 LTC homes (15 intervention, 14 control) in these provinces to assess the impact of the intervention on ACP comprehensiveness and care and interventions at the end-of-life (ClinicalTrials.gov NCT03649191). Results:
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".