A gender-sensitive analysis of the feasibility and benefit of a psychological intervention for patients with advanced cancer
Bibliographic record
Abstract
Background: The role of gender in psychotherapy has been widely recognized but infrequently investigated in psychotherapy trials. We conducted a secondary analysis of data from a randomized controlled trial of Managing Cancer and Living Meaningfully (CALM), a supportive-expressive intervention for individuals with advanced cancer, to examine gender effects in the feasibility, acceptability, perceived benefit, and effectiveness of CALM. Methods: Trial participants, outpatients with advanced cancer (N = 305, 40% men and 60% women), completed measures at baseline, 3 months (t1), and 6 months (t2). We investigated gender differences in participation rates, attrition rates, number of CALM sessions received, and perceived benefit of CALM. Separate subgroup analyses of data and gender × treatment group moderator analyses from men and women were compared in examining treatment effects on depressive symptoms, end-of-life preparation, and death anxiety at each follow-up period. Results: No gender differences were observed in participation or attrition rates, number of CALM sessions received, or perceived benefit of CALM. In subgroup analyses at t2, men in CALM reported significantly lower depressive symptoms than men in usual care (UC; P = .017), women in CALM with moderate baseline death anxiety reported lower death anxiety than women in UC (P = .009), and both men (P = .022) and women (P = .016) in CALM reported greater end-of-life preparation than those in UC. There were no significant gender × treatment group interaction effects on any outcome. Conclusions: CALM therapy is feasible, acceptable, and beneficial on different outcomes for men and women. Further clinical trials with comprehensive measures of gender identity are needed to evaluate gender effects in psychotherapeutic interventions for patients with advanced disease.
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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 | 0.013 | 0.038 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".