Randomized trial of a supportive oncology care at home intervention for patients with cancer receiving curative treatment.
Bibliographic record
Abstract
11003 Background: Patients with cancer receiving curative treatment often endure substantial symptoms and utilize significant healthcare resources. Symptom monitoring interventions and hospital at home care models represent a promising approach for improving these patients’ outcomes. Methods: We conducted a randomized trial of a Supportive Oncology Care at Home intervention versus usual care in adult patients receiving treatment with curative intent (chemotherapy and/or chemoradiation) for pancreatic, rectal, gastroesophageal, and head and neck (H&N) cancer, as well as non-Hodgkin lymphoma, who resided in-state, within 50 miles of our hospital. Patients were randomized to receive the Supportive Oncology Care at Home intervention or usual care within two weeks of initiating therapy and remained on trial for up to 6 months. The intervention entailed: 1) remote monitoring of daily patient-reported symptoms, vital signs, and body weight; 2) a hospital at home care model for symptom assessment and management; and 3) structured communication with the oncology team. The primary outcome was the proportion of patients requiring inpatient hospital admission or emergency department (ED) visits during the study period. Secondary outcomes included urgent visits to the clinic, treatment delays, and longitudinal changes in monthly assessments of quality of life (QOL; Functional Assessment of Cancer Therapy-General), symptoms (Edmonton Symptom Assessment System [ESAS] and Hospital Anxiety and Depression Scale [HADS]), and activities of daily living (ADLs). Results: We enrolled 50.8% (199/392) of potentially eligible patients. One patient withdrew consent and 2 became ineligible following consent, resulting in 196 participants (median age=65.8 [range: 21.1-92.0], 39.8% female, cancer types: 34.2% pancreatic, 27.0% H&N, 16.3% lymphoma, 12.8% rectal, 9.7% gastroesophageal). The proportion of patients requiring hospital admission or ED visit did not differ significantly between the intervention and usual care groups (37.1% v 35.7%, p=.87). Intervention participants were less likely to require an urgent visit (7.2% v 24.5%, p<.01), but there were no differences in rates of treatment delays >7 days (29.9% v 33.0%, p=.62). Compared to baseline assessments, intervention participants had greater improvement in ESAS symptoms (p<.01) and ADLs (p=.04) over time. QOL and HADS depression/anxiety symptoms did not differ longitudinally between groups. Conclusions: Although this Supportive Oncology Care at Home intervention did not have a significant impact on rates of hospital admissions or ED visits, we found encouraging results for reducing urgent visits to the clinic and substantial improvement in symptom burden and ADLs, underscoring the potential utility of this novel care model for enhancing care delivery and outcomes for patients with cancer receiving curative treatment. Clinical trial information: NCT04544046 .
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.015 | 0.002 |
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".