Curating clinical trials: Helping patients find hope by exploring clinical trial opportunities.
Bibliographic record
Abstract
6521 Background: Clinical trials are essential to the advancement of clinical therapies. However, only 5% of cancer patients enroll in clinical trials (CTs) due to limited accessibility. Given that greater participation in CTs is associated with better patient outcomes, patients from smaller centres are at a disadvantage. The Clinical Trials Navigators (CTN) program was established by Hamm (2022) to help patients in smaller communities navigate and enrol in CTs, resulting in clinical trial enrolment of 7% of patients. This study will provide updated results on the impact of the CTN program as it has expanded. Methods: Between March 2019 to September 2022, 241 patients were enrolled in the CTN program. Five Clinical Trials Navigators (CTNs) receive referrals from various sources: physicians, patients, and patient support groups. CTNs review medical information submitted and search five CT registries. Eligibility criteria is scrutinized. A second review of the CT list is conducted by two physicians to ensure accuracy. The number of potential trials is recorded at each step of review. Data collected includes: patient disease, stage, and number of prior therapies, time from referral to death, number of potential trials, number of trials that were phase I or phase II / III / IV, number of outgoing referrals, locations of the identified trials, and successful enrolment onto CTs. Patient information and results were inputted and analysed using REDCap. REB Category A approval has been granted on August 31, 2022. REB approval number is 22-439. Results: 41 Canadian cancer patients used the CTN program. The updated study found that 75.9% of patients were in stage IV of their disease, and 51% had at least two prior lines of therapy. 61.4% of patients deceased at last follow up, with a range of 0.3-37.5 months from CTN program referral to death, and a median of 5.9 months. CTNs identified a range of zero to 26 trials for each patient with a median of three trials: a range of zero to 10 phase I trials were found, and a range of one to eight phase II / III / IV trials were found. 25.5% of patients referred to a CT enrolled onto the recommended trial. The expanded CTN program resulted in CT enrolment of 8.5% of patients that follow-up information is available for. Conclusions: One quarter of patients referred to a CT by the CTN program were successfully enrolled, highlighting the CTN program as a successful tool to identify CTs for cancer patients and improve CT accrual. 8.5% of all patients with available follow-up information that participated in the CTN program were enrolled onto clinical trials. Further investigation into reasoning for early high mortality rates should be assessed. New initiatives to improve uptake of the CTN program are ongoing.
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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 | 0.130 | 0.386 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.019 | 0.013 |
| Open science | 0.004 | 0.010 |
| Research integrity | 0.009 | 0.011 |
| Insufficient payload (model declined to judge) | 0.142 | 0.091 |
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".