{"id":"W4311441880","doi":"10.1136/bmjqs-2022-014977","title":"Top-down and bottom-up approaches to low-value care","year":2022,"lang":"en","type":"letter","venue":"BMJ Quality & Safety","topic":"Healthcare cost, quality, practices","field":"Health Professions","cited_by":21,"is_retracted":false,"has_abstract":false,"ca_institutions":"University of Toronto; Ottawa Hospital; Sinai Health System; University of Ottawa","funders":"","keywords":"Medicine; Top-down and bottom-up design; Value (mathematics); Value-Based Purchasing; Data science; Operations management; Nursing; Computer science; Engineering; Software engineering","routes":{"ca_aff":true,"ca_fund":false,"ca_venue":false,"about_ca":false,"invisible_to_affiliation_only":false},"retraction":null,"screen":null,"direct_labels":[],"prediction":{"model_version":"codex-gemma-dda1882f352a","candidate_categories":["metaepi_narrow","sts","research_integrity","insufficient_payload"],"consensus_categories":["research_integrity","insufficient_payload"],"category_scores_codex":[0.01965359,0.001090626,0.002197774,0.0004049333,0.003226409,0.00009258191,0.001293052,0.002782492,0.003071123],"category_scores_gemma":[0.006795929,0.001088752,0.0004065239,0.00073405,0.0002735619,0.0004268144,0.002193998,0.01555533,0.001054467],"about_ca_system_candidate":false,"about_ca_system_consensus":false,"about_ca_system_score_codex":0.002416006,"about_ca_system_score_gemma":0.005083243,"about_ca_topic_candidate":true,"about_ca_topic_consensus":false,"about_ca_topic_score_codex":0.01477689,"about_ca_topic_score_gemma":0.001408024,"domain_scores_codex":[0.9564096,0.03190221,0.004759566,0.002309523,0.002346323,0.002272787],"domain_scores_gemma":[0.9830049,0.01071791,0.002078444,0.002925619,0.0004837276,0.0007894243],"domain_codex":null,"domain_gemma":null,"domain_candidate":null,"domain_consensus":null,"study_design_codex":"not_applicable","study_design_gemma":"not_applicable","study_design_scores_codex":[0.0006668579,0.00006691349,0.007106892,0.01684932,0.0001755147,0.0001532172,0.04626855,0.000004971198,0.000003980272,0.005228108,0.915204,0.008271651],"study_design_scores_gemma":[0.0009699375,0.0001744403,0.00774286,0.000719487,0.0001320345,0.00001193215,0.0400404,0.000006882853,0.00000294703,0.0005490505,0.9484029,0.001247166],"study_design_candidate":"not_applicable","study_design_consensus":"not_applicable","genre_codex":"commentary","genre_gemma":"commentary","genre_scores_codex":[0.01220491,0.001425416,0.0002377799,0.954735,0.005642877,0.008466626,0.003108417,0.0005383359,0.01364066],"genre_scores_gemma":[0.004615107,0.0003485818,0.001495714,0.9579701,0.0103201,0.002848967,0.003702959,0.0003060191,0.01839247],"genre_candidate":"commentary","genre_consensus":"commentary","teacher_disagreement_score":0.03319883,"threshold_uncertainty_score":0.9997233,"prediction_status":"machine_predicted_unvalidated"},"machine_scores":{"provisional":true,"baseline":true,"maturity_gate_passed":false,"score_opus":0.7316720423206377,"score_gpt":0.559734997687121,"score_spread":0.1719370446335167,"validation_status":"score_only:v0-immature-baseline","note":"Baseline scores from an immature model (maturity gate not passed). Scores rank; they never assert a category."}}