The impact of Quality-Based Procedures on radical prostatectomy outcomes in Ontario
Bibliographic record
Abstract
Ontario’s new health funding model, Quality-Based Procedures (QBP), designated certain performance outcomes that would determine future cancer care funding. We examined pre-specified outcomes for radical prostatectomy, one of the procedures integrated into QBP funding in 2015. We conducted two retrospective studies using provincial administratively-linked databases, including patients who underwent radical prostatectomy between April 2010 and March 2019. Our first study evaluated the 30-day complication rate and the trend in surgical approach. Our second study compared QBP outcomes before and after implementation of the funding model. The first study demonstrated that complication rate improved over the study period, possibly due to a transition to robotic approach for radical prostatectomy. The second study showed that complication rate and length of stay did improve after implementation of QBP, but not clearly because of the model. Unplanned visit rate and Wait 2 time worsened significantly, and there was no change in re-operation rate.
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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 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 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) | 0.001 | 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".