Canadian/Us integrative Oncology Study (Cusios) : Protocol and Study Status
Bibliographic record
Abstract
D. Seely (1,2), L. Standish (3), L. Dale (3), E. McDonell (2), D. Abdelfattah (2), E. Sweet (3), P. Chiang (3), K. Ronnie (3), F. Dowd (3), R. McLaughlin (3) (1) Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada; (2) Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada; (3) Bastyr University, Kenmore, Washington, United States of America Background: The Canadian/US Integrative Oncology Study (CUSIOS) is a prospective, observational study of advanced stage cancer patients receiving Advanced Integrative Oncology (AIO) care by experienced naturopathic doctors. Objectives: (1) Measure survival of advanced stage breast, colorectal, ovarian and pancreatic cancer patients receiving AIO treatments; (2) Describe AIO treatments recommended by naturopathic oncologists; (3) Pilot the collection of health-related quality of life (HR-QOL) data; (4) Evaluate the cost of AIO care; (5) Qualitatively describe the experience of AIO care.Methods: CUSIOS is an uncontrolled, prospective observational study in 11 North American clinics. The sample size is 400 patients, which includes 80 patients each in HR-QOL and cost-analysis sub-studies. Eligibility criteria include adults with confirmed stage 4 breast or colorectal cancer, or stage 3 or 4 ovarian or pancreatic cancer receiving care from a participating AIO clinic, who consent. Data regarding conventional treatments, AIO treatments, diagnosis and survival are collected and will be compared to the medical literature, and Surveillance, Epidemiology and End Results (SEER) database. Data from validated questionnaires and qualitative interviews are collected to evaluate HR-QOL, cost utilization and patient experience.Results: Study recruitment began January 2015 with 6 sites. Enrollment as of June 2018 is 278, with an expansion to 11 sites. Enrollment for HR-QOL is complete, and screening for cost analysis began May, 2018. Expected completion including follow up is July 2022. Conclusions: This is the first multi-centre, prospective observational study evaluating survival outcomes for patients receiving AIO care in North America. Findings from the study will inform the profession and public of the potential impact that AIO has on survival and quality of life. In addition, this research will provide a thorough description of the range of therapies recommended by experienced naturopathic oncologists, cost utilization by patients, and a longitudinal analysis of patient experience.
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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 | 0.019 | 0.022 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.003 | 0.007 |
| Science and technology studies | 0.008 | 0.002 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.080 | 0.012 |
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".