Early change in fatigue, insomnia, and cognitive impairment and symptom severity at 3-years post-treatment in breast cancer survivors
Bibliographic record
Abstract
Abstract Purpose Breast cancer is the most common form of cancer among Canadian women. Survivorship challenges include fatigue, sleep disturbance, and cognitive impairment. This study examined: 1) symptom trajectory from diagnosis to three years; 2) whether symptom change in the first four months was associated with prolonged difficulties after three years; and 3) which factors were associated with deterioration in symptoms during the first four months. Methods This prospective observational cohort study examined 53 women (Mage = 58.6, 96.2% White, 67.9% Stage I) with newly diagnosed breast cancer over three years. Women completed assessments before starting treatment, four months, and three years after diagnosis. Three-way repeated-measures ANOVAs evaluated symptom trajectories. A repeated-measures mediation analysis was performed to determine if change from pre-treatment to four months accounted for change from pre-treatment to three years. A series of between-subjects ANOVAs were used to determine what variables significantly differed by deterioration status. Results Perceived cognitive impairment and fatigue increased linearly from diagnosis to three years. Change in fatigue in the first four months fully accounted for its change over three years. Insomnia severity and sleep quality deteriorated from diagnosis to four months, but returned to pre-treatment levels at three years. Those whose fatigue and cognitive ability deteriorated during the first four months were younger. Conclusion Efforts to identify those who are at risk of experiencing fatigue, sleep disturbance, and cognitive impairment; monitor patients early after receiving a diagnosis; and provide targeted interventions may prevent long-term deterioration and improve well-being.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".