Systematic Review of Models of Follow-up Care for Childhood Cancer Survivors: The Role of Policies and Guidelines in Guiding Future Care
Bibliographic record
Abstract
Background/Objectives: Within Alberta, there exist multiple models of follow-up care for survivors of childhood cancer which has the potential to lead to disparate outcomes. There is a need to review the outcomes of these models so that survivors in Alberta can receive consistent and reliable care. This review aimed to achieve the following objectives: (1) review the existing research that compared outcomes across different models of follow-up care, (2) review the policies and guidelines for follow-up care in Canada, (3) create policy recommendations to guide the long-term care of survivors of childhood cancer. Methods: This systematic review utilized the Cochrane Handbook’s Population, Intervention, Comparison(s), Outcome (PICO) systematic review tool and the Cochrane risk-of-bias tool to identify and evaluate eligible studies. The following databases were searched: MEDLINE (Ovid), EMBASE, PsycINFO, Cochrane Library, PubMed, CINAHL, and Web of Science. A Canada-wide scan for follow-up care guidelines and policies was conducted as a separate search that looked through grey literature from provincial healthcare websites. Results: 2051 articles were identified from the search. One article met our inclusion and exclusion criteria. The limited findings of this review indicated that a cancer-center follow-up care model ensured that a high percentage of survivors of childhood cancer were appropriately screened for diagnosis-specific late effects, that patients experienced fewer longterm effects, and received more Children’s Oncology Group (COG)-recommended tests than those who utilized a community-based follow-up care model. The Canada-wide scan for care guidelines and policies revealed substantial gaps and inconsistencies across the country, with limited follow-up care policies and guidelines available. Conclusions: The results of this review demonstrate that there is a significant need for 1) further research that compares models of follow-up care to guide the province of Alberta in establishing follow-up care guidelines and policies specific to survivors of childhood cancer, and 2) the creation of a national standard for follow-up care for survivors of childhood cancer.
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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 | 0.048 | 0.184 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.008 |
| Bibliometrics | 0.011 | 0.014 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".