(098) IMPACT OF PRE-TREATMENT COUNSELLING ON DECISIONAL REGRET OF PROSTATE CANCER SURVIVORS: CROSS-SECTIONAL ANALYSIS OF PATIENT REPORTED EXPERIENCE FOLLOWING DIAGNOSIS OR TREATMENT
Bibliographic record
Abstract
Abstract Introduction Prostate cancer (PCa) impacts patient lives beyond oncological concerns alone. PCa survivorship includes the mental, physical, sexual, emotional, and financial effects patients endure from time of diagnosis, through treatment, and beyond. For some, this includes decision regret (DR). We aim to determine survivor experiences and understanding from a functional perspective throughout survivorship. Objective Our objective was to describe the local experiences and perspectives of PCa survivors regarding their functional outcomes at both the pre and post treatment level. Additionally, we sought to investigate the relationship between patients’ understanding of sexual and urinary side effects of treatment as well as modality of care delivery (ie virtual or in person) and development of treatment DR. Methods This is a cross-sectional survey of survivors. Our survey was circulated to all members of the Manitoba Prostate Cancer Support Group. Topics included erectile dysfunction (ED), penile shortening, urinary incontinence, and patient understanding throughout their care. Survey items included binary and Likert scale questions regarding patient understanding and treatment impact, as well as an open answered question asking how survivorship care may be improved. Responses were used identify predictors of DR. Results 514 patients received our survey with a response rate of 23.7% (n = 122). The average age of diagnosis and treatment were 65.2 and 65.9 respectively. Most common treatments included 63.9% radical prostatectomy (RP), 54.1% radiotherapy (RT), and 36.1% androgen deprivation therapy (ADT). 71.9% reported sexual health to be very or somewhat important, but 27.9% reported no pre-treatment discussion of potential ED. 14.9% reported lacking understanding of treatment impact on erections. 76.9% reported no counselling on penile shortening and 95.0% reported no counselling on climacturia, prior to treatment. 27.3% reported no pre-treatment discussion of urinary incontinence and 11.5% reported lacking understanding of treatment impact on urination. Predictors of DR included treatment with RP, and low pre-treatment understanding of potential ED and urinary incontinence. Common open answer responses included desire for more information regarding support groups, treatment side effects, and management of such. Conclusions PCa survivors are at high risk of DR. Virtual care does not seem to impact DR. However, the degree of pre-treatment understanding of treatment options and their functional impact does. Survivors are motivated to learn about their condition, requesting more information on treatments, side effects, and local support groups. Apart from PCa diagnosis and management, it is equally as important to discuss functional aspects. Disclosure No.
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".