A312 FACTORS ASSOCIATED WITH PHYSICAL SYMPTOM BURDEN AMONG PATIENTS WITH PANCREATIC CANCER
Bibliographic record
Abstract
Abstract Background Patients with pancreatic ductal adenocarcinoma (PDAC) experience substantial physical symptoms. Factors associated with symptom burden in PDAC are not well described. Aims To evaluate risk factors for symptoms assessed through the Edmonton Symptom Assessment Scales (ESAS) among patients with PDAC. Methods We included patients diagnosed with PDAC and associated ESAS forms at diagnosis between January 1 2007 to December 31 2020 in Ontario, Canada. The ESAS contains nine symptoms (pain, tiredness, nausea, depression, anxiety, drowsiness, loss of appetite, well being, and shortness of breath) on a scale from 0 to 10. Our outcomes were moderate to severe (ESAS scores 4 and above) physical symptoms (pain, tiredness, nausea, poor appetite, drowsiness, and dyspnea). We analyzed associations between baseline variables and outcomes using multivariable regression models. Covariates included age, sex, tumour location, cancer stage, index cancer-directed therapy (surgery, surgery and chemotherapy, chemotherapy alone, radiation, and no cancer-directed therapy), distance to cancer centre, comorbidities, and access to a family physician. Results We identified 4918 patients (mean age 68 years, 52% male) with one or more ESAS records. Most patients (61%) had stage III or IV disease at diagnosis. At diagnosis, 30%, 37%, 14%, 34%, 25%, and 15% reported moderate to severe pain, tiredness, nausea, poor appetite, drowsiness, and shortness of breath respectively. Six months after diagnosis, 42%, 59%, 25%, 51%, 41%, and 23% reported moderate to severe pain, tiredness, nausea, poor appetite, drowsiness, and dyspnea respectively. At 6 months, moderate to severe pain was associated with baseline dyspnea (p=0.003) and pain (pampersand:003C0.001), moderate to severe tiredness was associated with increasing age (p=0.04), female sex (p=0.02), pre-existing coronary disease (p=0.030), and baseline pain (p=0.010), and tiredness (pampersand:003C0.001), moderate to severe nausea was associated with female sex (pampersand:003C0.001), pre-existing osteoarthritis (p=0.010), and baseline depression (0.006), nausea (pampersand:003C0.001), and pain (pampersand:003C0.001), moderate to severe poor appetite was associated with female sex (pampersand:003C0.001), and baseline poor appetite (pampersand:003C0.001) and tiredness (p=0.490), moderate to severe drowsiness was associated with receipt of radiation therapy (p=0.003), pre-existing arrhythmia (p=0.026), and baseline depression (p=0.029), drowsiness (pampersand:003C0.001), and dyspnea (p=0.010), and moderate to severe dyspnea was associated with age (p=0.010), pre-existing COPD (pampersand:003C0.001), and baseline dyspnea (pampersand:003C0.001), and tiredness (p=0.023). Conclusions Patients with PDAC and physical symptoms at diagnosis are more likely to have corresponding moderate to severe symptoms later on. Universal physician symptom screening may enable improved symptom management. Funding Agencies CIHR
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".