{"id":"W4416565835","doi":"10.1016/j.lanepe.2025.101546","title":"Economic pressures threaten surgical quality in Germany: immediate policy action required","year":2025,"lang":"en","type":"letter","venue":"The Lancet Regional Health - Europe","topic":"Healthcare Policy and Management","field":"Economics, Econometrics and Finance","cited_by":1,"is_retracted":false,"has_abstract":true,"ca_institutions":"Pancreas Centre (Canada)","funders":"","keywords":"Centralisation; Quality (philosophy); Action (physics); Patient care; Health care; Ambulatory care","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","insufficient_payload"],"consensus_categories":[],"category_scores_codex":[0.002879927,0.0003991023,0.00143293,0.0005772775,0.00023465,0.00008924278,0.0008884777,0.0004030979,0.0000841987],"category_scores_gemma":[0.0001010421,0.0003630904,0.0001941011,0.0003835017,0.0001477791,0.000150983,0.0002519077,0.001719514,0.0008034903],"about_ca_system_candidate":false,"about_ca_system_consensus":false,"about_ca_system_score_codex":0.0009120734,"about_ca_system_score_gemma":0.0006882951,"about_ca_topic_candidate":true,"about_ca_topic_consensus":false,"about_ca_topic_score_codex":0.0622765,"about_ca_topic_score_gemma":0.001834213,"domain_scores_codex":[0.9956032,0.0006566763,0.001611217,0.0008535247,0.0001169127,0.001158441],"domain_scores_gemma":[0.9972296,0.0004177581,0.001109069,0.001083679,0.00003097758,0.0001289023],"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":[0.00008778601,0.000022821,0.0005217276,0.0008389549,0.00005740524,0.00004206234,0.0001774987,0.00003988046,2.515718e-8,0.208171,0.7886719,0.001368893],"study_design_scores_gemma":[0.0007259744,0.00004553391,0.02250358,0.0001354844,0.000004532252,0.00001032343,0.000005985094,0.00006461931,1.624709e-7,0.01984773,0.9563614,0.0002947394],"study_design_candidate":"not_applicable","study_design_consensus":"not_applicable","genre_codex":"commentary","genre_gemma":"commentary","genre_scores_codex":[0.00081111,0.003674067,0.00001615182,0.9613848,0.0009477906,0.0007609084,0.0007299186,0.00008983026,0.03158537],"genre_scores_gemma":[0.006742242,0.02979225,0.00003339946,0.9256336,0.01662033,0.0001659973,0.0004892179,0.00007681044,0.02044615],"genre_candidate":"commentary","genre_consensus":"commentary","teacher_disagreement_score":0.1883233,"threshold_uncertainty_score":0.9999745,"prediction_status":"machine_predicted_unvalidated"},"machine_scores":{"provisional":true,"baseline":true,"maturity_gate_passed":false,"score_opus":0.2293490638460549,"score_gpt":0.4003134142671818,"score_spread":0.1709643504211268,"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."}}