Guidelines unmet: Assessing gaps in breast cancer survivorship care
Bibliographic record
Abstract
BACKGROUND: In Canada, after completing their treatment at oncology centers in tertiary care facilities, most breast cancer patients are discharged and receive survivorship care from primary care providers (PCPs). Evidence-based guidelines exist to inform appropriate care for breast cancer survivor follow-up. OBJECTIVES: This study analyzed the concordance of breast cancer survivorship follow-up care by PCPs with recommended guidelines at an academic Family Health Team (FHT) in Ottawa. DESIGN: Retrospective chart review of electronic medical records of rostered patients from FHT. METHODS: Data was extracted from the charts of 60 breast cancer survivors. Concordance of breast cancer survivorship care by PCPs with evidence-based guidelines was established in three key survivorship domains: surveillance for recurrence or new cancers, management of treatment side effects and preventative health. RESULTS: PCPs provide care concordant with guidelines only 20% of the time, with areas such as preventative care at 86.7% concordance far better than management of side effects at 58.3% and oncological surveillance at 38.3%. Care did not significantly differ by age at diagnosis. CONCLUSION: These results highlight gaps in the current survivorship care delivery and function as a baseline for comparative analyses for future interventions to optimize survivorship follow-up care.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".