EPID-31. Days alive and at home in glioblastoma patients across age groups: a population-based study in Ontario, Canada
Bibliographic record
Abstract
Abstract The optimal management of glioblastoma (GBM) in older adults remains uncertain, with limited evidence to inform treatment decisions in this population. Older patients are consistently underrepresented in clinical trials, and conventional endpoints such as overall survival may not fully capture outcomes that align with patient’s values and priorities. “Days spent alive and at home” (DAAH) is a novel, patient-centered measure that reflects both survival and functional independence. We conducted a population-based retrospective cohort study to examine the association between age and DAAH following surgery for GBM. Using linked administrative databases from Ontario, Canada between 2006 – 2022, we identified adults (≥18 years) with a new diagnosis of glioblastoma who underwent either biopsy or surgical resection. Patients were stratified into four age groups: ≤50, 51-65, 66-75, 76-85, and >85. The primary outcome was DAAH in the first 365 days post-surgery. Secondary outcomes included overall survival, post-operative complications, and length of stay during index surgery. Multivariable regression models adjusted for sex, surgery type, frailty status, resource utilization band, tumor location, year of treatment, and neighborhood material deprivation and rurality indices. A total of 6,847 patients met inclusion criteria (mean age 63.6; 59% male). Median DAAH within 365 days was 355 (IQR 263-362) for patients ≤ 50 years, 308 days (IQR 126-359) for those 51-65, 171 days (IQR 61–336) for 66-75, 91 days (IQR 27-227) for 76-85, and 61 days (IQR 9-123) for those >85. Increasing age was independently associated with fewer DAAH (p<0.001), shorter overall survival (p<0.001), higher post-operative complication rates (p=0.015), and longer hospital stays during index surgery (p<0.001) in multivariable regression models. Older age is strongly associated with reduced DAAH following surgery for GBM. DAAH may offer a more relevant and patient-centered metric to guide treatment planning and shared decision-making in this understudied patient population.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.006 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".