Notice bibliographique
Résumé
ANSWER One of the primary obligations of a doctor-patient relationship is confi dentiality. Legislation and College policies in most jurisdictions emphasize this obligation. Doctors also have a duty of care to the patients they see. That duty of care includes obtaining an adequate history, performing an adequate examination, and advising patients appropriately. It is important to remember that the Narcotic Control Regulations require patients to tell doctors what narcotics they have obtained in the last 30 days. It is equally important for doctors to inquire, before prescribing narcotics, whether patients have recently received any narcotics, and if so, what kind and how much. Patients’ answers to these questions should be clearly documented. These questions should, of course, be asked of every patient and about all medications before prescribing, but documenting the question and a negative answer from the patient is very important in this situation. Although patients are not always forthright about drug use, you are not expected to be a private investigator. You are, however, expected to ask the appropriate questions and take appropriate action. If you were to have evidence, for example from a hospital emergency department or a walk-in clinic, that a patient was lying, you should consider confronting him or her with that evidence. If you are not reassured by the response, you might want to inform the patient of your and his or her legal obligations and refuse to prescribe the medication. Some patients are labeled “drug seekers.” This can interfere with objective assessment of their health. A patient who has sought drugs can develop genuine symptoms; for example, a patient claiming he or she has renal colic to get narcotics might, on a subsequent visit, suffer from right lower quadrant pain due to appendicitis. The duty of care requires that doctors assess each patient appropriately. Failure to make the correct diagnosis might lead to a bad clinical outcome for a patient and subsequently to a lawsuit against the doctor that could be diffi cult to defend. Dealing with apparent drug seekers is always diffi cult. You cannot report to the police because that would be a breach of confi dentiality, and you can terminate your care of a patient only if that patient’s condition is not medically urgent or you have made arrangements for another physician to take care of him or her. If you prescribe only those drugs you believe necessary for a patient’s condition, however, you will fulfi l your responsibility to that patient.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,027 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,089 | 0,035 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».