PALLIATIVE CARE IN RESIDENTIAL CARE HOMES: IMPLEMENTATION CHALLENGES AND EARLY FINDINGS IN THREE CLINICAL TRIALS
Bibliographic record
Abstract
Abstract This symposium will describe, compare and contrast three active clinical trials implementing palliative care models for people with dementia in residential care facilities and nursing homes. SPA-LTC is a pragmatic clinical trial in three Canadian provinces, providing training to palliative care teams and a process for triggered palliative care conferences. EMBED-Care, based in the United Kingdom, is testing a digital clinical support tool to improve integrated palliative care for people with dementia using holistic assessment and promoting shared decision-making. UPLIFT-AD is a multi-state U.S. based clinical trial, providing training for in-facility Palliative Care Leads and facilitating specialty palliative care clinician consults for people with moderate to advanced dementia. This symposium provides an opportunity to compare methodologic choices in study design, including intervention design, use of internal (care facility) based resources vs. external supports, and outcome assessment. Presenters will describe implications of these design choices for the implementation of the trial and for longer term sustainability. Implementation experience, including barriers and facilitators to palliative care programs for people with dementia, will be described.
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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 | 0.515 | 0.548 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.009 | 0.007 |
| Open science | 0.004 | 0.006 |
| Research integrity | 0.005 | 0.006 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".