EVALUATING PNEUMOCYSTIS JIROVECII PNEUMONIA (PCP) PROPHYLAXIS IN PATIENTS WITH GLIOMA RECEIVING CONCURRENT TEMOZOLOMIDE AND RADIATION – A PATIENT AND PHYSICIAN SURVEY
Bibliographic record
Abstract
Abstract Temozolomide (TMZ) given concurrently with radiation (TMZ-RT) is essential in glioma therapy. Pneumocystis jirovecii pneumonia (PCP) prophylaxis is required by provincial and national drug monographs based on two incidents of PCP in a pilot study. There is otherwise limited evidence to inform the need for PCP prophylaxis in this population. METHODS: We conducted a single-centre survey of patients and national survey of physicians on the role of PCP prophylaxis in patients with glioma receiving concurrent TMZ-RT. RESULTS: Fifteen percent (31/212) of physicians and 60% (44/73) of patients completed a survey. The median age of patients was 42 (20-77); 85% (34/40) had completed adjuvant TMZ, and 59% (24/41) were not offered PCP prophylaxis. After reviewing the hypothetical risks of PCP, 13.2% (5/38) of patients were concerned about PCP infection, whereas 26% (10/38) were concerned about potential side effects from prophylactic antibiotics. Physician participants included medical (29%, 9/31) radiation (29%, 9/31), and neuro-oncologists (32%, 10/31). Most physicians (77%, 17/22) felt the evidence informing PCP prophylaxis in this population was weak; 58% (11/19) were not routinely prescribing prophylaxis, and 73% (16/22) felt that PCP prophylaxis should be limited to patients with additional risk factors. Sixty-three percent (22/35) of patients and 57% (12/21) of physicians were interested in a clinical trial to assess the risk of PCP infection in this setting. CONCLUSION: Clinical equipoise exists on the role of PCP prophylaxis during and after TMZ-RT amongst patients and physicians. Rigorous prospective studies need to be conducted to inform and standardize best practices.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".