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Access to Oncology Medicines in Canada: Consensus Forum for Recommendations for Improvement

2024· preprint· en· W4391820791 on OpenAlexafffundabout
Sandeep Sehdev, Nigel S. B. Rawson, Olexiy I. Aseyev, Catriona Buick, Marcus O. Butler, Scott Edwards, Sharlene Gill, Joanna Gotfrit, Cyrus C. Hsia, Rosalyn A. Juergens, Mita Manna, Joy McCarthy, Som D. Mukherjee, Stephanie Snow, Silvana Spadafora, David J. Stewart, Jason Wentzell, Ralph P.W Wong, Paweł Zalewski

Bibliographic record

VenuePreprints.org · 2024
Typepreprint
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsRegional Municipality of DurhamLakeridge HealthThunder Bay Regional Health Sciences CentreNOSM UniversityEssar Steel Algoma (Canada)Canadian Association of Nurses in OncologyMcMaster UniversityDr. H. Bliss Murphy Cancer CentreUniversity of ManitobaJuravinski Cancer CentreLondon Health Sciences CentreUniversity of British ColumbiaWilfrid Laurier UniversitySault Area HospitalMemorial University of NewfoundlandYork UniversitySunnybrook Health Science CentreSt. John’s Health Sciences CentreSaskatchewan Cancer AgencyNewfoundland and Labrador Centre for Applied Health ResearchOttawa HospitalHealth Sciences CentrePrincess Margaret Cancer CentreDalhousie UniversityArthur B. McDonald-Canadian Astroparticle Physics Research Institute
FundersAbbVie CanadaOttawa Hospital Research InstituteGilead SciencesAstraZenecaEli Lilly and Company
KeywordsTransparency (behavior)PharmacyMedicineAccountabilityGovernment (linguistics)Health careDelphi methodGuidelineBest practiceFamily medicineHealth technologyBusinessNursingPolitical science

Abstract

fetched live from OpenAlex

Patient access to new oncology drugs in Canada is only possible after navigating multiple sequential systemic checkpoints for national regulatory approval, health technology assessment (HTA) and collective government price negotiation. These steps delay access and prevent health care providers from being able to prescribe optimal therapy. Eighteen Canadian oncology clinicians from the medicine, nursing and pharmacy professions met to develop consensus recommendations for defining reasonable government performance standards around process and timeliness to improve Canadian cancer patients’ access to best care. A modified Delphi methodology was used to confirm strong consensus on 30 questions involving five themes: accountability, disparities, endpoints, timeliness, and cost-effectiveness. It was agreed that greater transparency is required across regulatory and HTA processes. Health professionals in oncology are frustrated for their patients because they are unable to deliver the modern guideline-supported therapies they want to provide due to delays in approval or funding. Canadian patients and their health care providers request improvements in timely access to life-saving therapeutics in line with other countries. Clinicians expect urgent improvements in our health systems to give our patients their best chance of survival.

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)0.149
metaresearch head score (Gemma)0.174
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.825
Threshold uncertainty score0.957

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.1490.174
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0020.004
Bibliometrics0.0100.011
Science and technology studies0.0140.006
Scholarly communication0.0130.007
Open science0.0100.011
Research integrity0.0160.015
Insufficient payload (model declined to judge)0.0100.002

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 head0.665
GPT teacher head0.541
Teacher spread0.124 · 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 designNot applicable
Domainnot available
GenreCommentary

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".

Quick stats

Citations2
Published2024
Admission routes3
Has abstractyes

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