Patient-Reported Symptom Burden Associated with Treatment Modality for Malignant Bowel Obstruction
Bibliographic record
Abstract
OBJECTIVE: To compare patient-reported outcomes after hospitalization for malignant bowel obstruction (MBO) treated with surgical, procedural, or medical intervention. BACKGROUND: The optimal palliative treatment for MBO is unclear due to the paucity of research examining patient-reported outcomes, including symptom relief, after MBO treatment. METHODS: We performed a population-level analysis of individuals with incurable gastric, pancreatic, and colorectal cancer and hospitalized with a MBO from 2010-2019 with prospectively collected Edmonton Symptom Assessment System (ESAS) scores in Ontario, Canada. Mixed linear models were used to compare scores by treatment from -1-6 months from MBO admission. RESULTS: Of 1,749 MBO patients, 55.3% underwent surgery, 38.5% underwent medical care, and 6.2% underwent a procedure. Moderate-to-severe symptom scores (≥4) were highest for tiredness, lack of well-being, and lack of appetite the month prior to (46.6%, 45.8%, & 42.9%) and after MBO (53.4%, 51.9%, & 42.9%). There was a ≥10% decrease in percentage of patients reporting moderate-to-severe ESAS scores for pain, tiredness, and lack of appetite and well-being over the 6-month period. Except for lack of appetite and pain, there were no differences in scores over time based on treatment (P>0.05). Those who underwent surgery reported a greater decrease in symptom scores for lack of appetite and pain over time compared to those who underwent medical care (P≤0.05). CONCLUSIONS: Patients hospitalized with MBO reported improvements in symptoms over time, with surgical patients reporting slightly greater symptom relief over time for appetite and pain. These data suggest a potential palliative benefit associated with surgery in select patients.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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".