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Promoting prostate cancer screening equity: Findings from a quality improvement education initiative implemented in 3 sites.

2022· article· en· W4298147263 on OpenAlexaff
Ginny Jacobs, Kristen S. Hobbs, Keith Crawford, Waseem Hussain, Claire Jean-Simon, Roxanne Leiba Lawrence, Patrice Lazure, Laura Lee Hall, Pam McFadden

Bibliographic record

VenueJournal of Clinical Oncology · 2022
Typearticle
Languageen
FieldMedicine
TopicClinical practice guidelines implementation
Canadian institutionsAxdev Group (Canada)
FundersGenentech
KeywordsMedicineFamily medicineIntervention (counseling)Prostate cancer screeningHealth equityHealth careQuality managementNursingProstate cancerPublic healthCancerProstate-specific antigenInternal medicine

Abstract

fetched live from OpenAlex

112 Background: Prostate cancer (PC) screening guidelines differ in recommended age at screening and varying emphasis on risk factors (e.g., race, family history), leading to lack of clarity among healthcare providers (HCPs). Research has highlighted a higher risk for Black patients, and the importance for at-risk patients to undergo screening at an earlier age and receive appropriate follow-up. A system-based Quality Improvement Education (QIE) intervention was developed to increase screening and referrals for PC especially among higher risk subgroups. The QIE aimed to increase awareness of the burden and consequences of racial disparities while mobilizing a team-focused approach. Methods: QIE intervention was deployed at 3 practice sites that provide community-based primary care services to Black populations (72% Black patients). The sites differed in patient capacity, staff, challenges faced, and pre-intervention screening practices. Practice assessments were completed pre-intervention by site representatives (n = 3) and individual baseline surveys were filled out by HCPs (n = 24). The 12-week intervention included educational materials from Prostate Health Education Network (PHEN) and deployment of an updated screening protocol within each clinic to raise PC awareness to staff and patients. Post-intervention evaluation was based on qualitative interviews (n = 5) and feedback from the QIE coaches. Patient data from electronic health records (EHR) on PC screening and referrals was collected post-initiative and divided a posteriori into 3 sub-groups, pre, during and post-intervention (n = 6662). Results: QIE led to increased awareness of barriers to access faced by patients from diverse communities. The QIE also led to increased awareness among team members regarding the need for screening at-risk groups at an earlier age and the importance of follow-up with patients. Online education materials made available to HCPs raised patient awareness. Table highlights an increase in PC screening during the intervention, but limited sustainability post-intervention. Interviewees reported increases in patient education, referrals and follow-up action. Conclusions: Increase in percentage of patients screened during the intervention phase was potentially due to added attention during the initiative, while limited sustainability post-intervention might be due to the brief intervention period, reliance on retrospective data and inability to fully leverage EHR data. Based on this project’s learnings, similar initiatives should seek organizational support for data analytics and process documentation to ensure consistent data standards and overall success.[Table: see text]

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 imitation

Not 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.

metaresearch head score (Codex)0.020
metaresearch head score (Gemma)0.021
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.033
Threshold uncertainty score0.105

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0200.021
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0010.002
Science and technology studies0.0040.002
Scholarly communication0.0030.002
Open science0.0020.006
Research integrity0.0020.003
Insufficient payload (model declined to judge)0.0020.000

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.

Opus teacher head0.573
GPT teacher head0.660
Teacher spread0.088 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

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Citations1
Published2022
Admission routes1
Has abstractyes

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