Current state content analysis of patient-reported outcome measures and clinical needs assessment tools utilized throughout the cancer care continuum at an academic medical center.
Bibliographic record
Abstract
238 Background: The Cancer Survivorship Care Quality Framework (CSCQ-F) is an evidence-based framework that outlines domains and indicators pertinent to the provision of quality cancer survivorship care. Many indicators from the CSCQ-F can be assessed by clinical interview or patient-reported outcome measures (PROMs) to gauge whether patients are receiving quality survivorship care. We conducted a current-state analysis of the PROMs and needs assessment tools (NATs) utilized throughout our academic medical center and assessed the extent to which constructs covered on our assessments align with relevant domains and indicators from the CSCQ-F. Methods: Healthcare leaders identified assessments currently available for use throughout oncology clinics at our institution. We included assessments directly completed by patients (i.e., PROMs) and assessments completed by clinicians based on patient feedback gathered through clinical interview or oncology nurse navigation (i.e., NATs). We excluded assessments not currently in use. We coded each assessment item by construct (e.g., depression, neuropathy, substance use, referral) and time of administration (e.g., new patient visits, treatment change, unknown). Then, we mapped items/constructs to the CSCQ-F domains. Afterward, we compared items/constructs mapped to the CSCQ-F domains with CSCQ-F indicators to identify gaps in assessment. Results: We identified two PROMs (Lucet and The Edmonton Symptom Assessment Scale (ESAS)) and two NATs (Epic Wheel and an internally developed cancer navigation assessment). Constructs covered by these assessments aligned with all domains of the CSCQ-F, except for “Patient/Caregiver Experience.” Gaps in assessment based on the CSCQ-F depend on which assessments patients receive. All new patients are administered Lucet (an electronic distress screening tool) and referred for cancer navigation assessment. However, ESAS is administered through Palliative Care, and it is unclear whether and when all providers administer Epic Wheel (a social determinants of health NAT). The CSCQ-F indicates reassessment of symptoms and/or conditions should occur at defined intervals throughout the cancer continuum, but there is no clear reassessment protocol at our institution. Conclusions: To our knowledge, this is the first content-analysis of PROMs and NATs mapped to the CSCQ-F. Our results signify a need to (1) address gaps in assessment, (2) determine a protocol for symptom reassessment, and (3) standardize enterprise-wide administration procedures for PROMs and NATs throughout the cancer continuum. Future work should also identify who is responsible for following up on patients’ identified concerns and determine whether adequate resources are available to address patients’ symptoms and needs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".