Notice bibliographique
Résumé
Antimicrobial therapy of infectious diseases has become complex, even to the most pragmatic clinical practitioner. There are increasing numbers and classes of antibiotics and adjunctive therapies, increasingly specific clinical and microbiological diagnoses of infectious diseases, and an increasingly aged, immune-compromised and debilitated patient population, with chronic concurrent diseases and complex care requirements. On top of that is a proliferation of increasingly extensive, complex and changing treatment guidelines, which are scattered across professional journals and websites, and are usually confined in content to a clinical disease syndrome or to a specific infection at a subspecialty level. As a consultant specialist physician practicing in the field, I see concise tabular therapeutic manuals used to inform diagnosis and diagnostic manuals to instruct on treatment. Manuals of medical management abound, are usually instructive if not explanatory and have sometimes outgrown the marsupial capacity of their users. Manuals are appearing on PDAs and handheld computers, which might accommodate tome-like quantities of information for viewing through the keyhole of a three-inch digital display. Brought to us by a clinical microbiologist, STAT is a speedy summary guide to key medical information on common infectious diseases. STAT is a reliably low-tech wire-bound lab-coat-pocket-sized clinical manual that guides the treating physician in a concise, explanatory and stepwise manner on antimicrobial therapy of 15 syndromes – from head to toe, from sinusitis to meningitis, and from cystitis to diabetic foot infection. There is a current guidelines-referenced key information display, in one-page columns and figures, or two-page tables. There is explanatory diagnostic, management and treatment information, along with pros and cons of alternatives. Points on evaluation of response and convalescent management take one further into practice problems than the usual tabulation of diagnoses and treatments. For the interested, there is an introductory section on antimicrobial resistance. For the engaged, there is a section on the pharmacodynamic concept of the drug concentration dependence of mutational resistance selection and its prevention in therapy. For those who especially enjoy numeracy, a closing section offers a formulaic approach to deriving empiric treatment choices from etiological and drug-resistant fractions of pathogens. For instance, from the etiologic fractions of five pathogens of community-acquired pneumonia, and the fractions of each with resistance to a candidate antibiotic treatment, the sum probabilities of appropriateness of antibiotic treatment options for the syndrome are numerically ranked. For those communities and hospitals with diagnostic and susceptibility surveillance, this allows rational treatment guidelines to be informed by local data. Where resistance is changing in time and by locale, and as it drives choice and success of treatments, this is a simple explanatory contribution to local patient care and antibiotic stewardship. It was a pleasure to see the intention of the author to teach the user in the STAT manual. The novel contribution is the conceptual background on antibiotic resistance and explanatory practical treatment guidelines in an accessible pocket reference. It is a welcome addition to the pockets of our doctors and workbenches of our clinics.
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 | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,006 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,515 | 0,424 |
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 ».