74 Variability on decision to discontinue supplemental oxygen among Canadian Pediatric respirologists in premature patients with BPD: A cross sectional survey study
Notice bibliographique
Résumé
Approximately 8% of all Canadian births are preterm and one of the most common pulmonary complications associated with prematurity is bronchopulmonary dysplasia (BPD) which is defined as the persistent need for oxygen at 36 weeks post menstrual age or 28 days of postnatal life. Close to half of all premature infants with BPD are discharged from hospital with home oxygen and Pediatric respirologists are commonly involved in the decision of discontinuing home oxygen use after the newborn period. Our aim was to assess whether there is variability among Canadian pediatric respirologists on when to discontinue supplemental oxygen and given the lack of evidence based guidelines we hypothesize that there will be variability in this decision making process. Gathering data on current practices in Canada can help fuel quality improvement projects to help improve standardization and clinical practice guidelines specific to the Canadian population of premature infants with BPD. A cross sectional survey study was completed and anonymous surveys were distributed in both English and French through the Cross Canada respiratory rounds list serve and the Canadian Respiratory conference 2018. Surveys included four oximetry test interpretations, 8 follow up questions on the decision making process and 4 questions on physician demographics. Ethics approval was obtained through the Research and Ethics Board prior to data collection. The survey response rate was 27%. There were responses from 6 provinces, 71% reported having more than 15 patients who required home oxygen use in their practice and 63% had practiced in the field for at least 5 years. The decision to discontinue home oxygen varied amongst Canadian Pediatric respirologists with 29% in favor of discontinuing home oxygen using the 4 provided oximetry tests to 71% against the decision. The decision to discontinue home oxygen did vary based on the province of current work; Alberta had a highest rate of respondents choosing to discontinue home oxygen (47.5%) in comparison to British Columbia and Quebec (18% and 20% respectively). Respirologists who completed their fellowship training in Canada were more likely to discontinue home oxygen compared to respondents who trained in the United States (31% vs 25%). The presence of pulmonary hypertension was rated as being the highest likelihood in affecting the decision to discontinue home oxygen (97%). Close to half of the respondents (42%) reported not being aware of any existing guidelines on supplemental oxygen use and amongst the respondents who did use a guideline, 72% reported using the British Thoracic Society guidelines for home oxygen use in children. This project allowed us to gather data on current practices on home oxygen use decision making amongst Canadian respirologists and informs that there is variability on care that patients receive across the country based on the experience and training of the pediatric respirologists.
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 | 0,014 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
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 ».