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Enregistrement W3197046587 · doi:10.1016/j.xjon.2021.08.033

Reply: Implications of innovations on clinical outcomes

2021· article· en· W3197046587 sur OpenAlexaff
Fraser D. Rubens

Notice bibliographique

RevueJTCVS Open · 2021
Typearticle
Langueen
DomaineMedicine
ThématiqueCardiac and Coronary Surgery Techniques
Établissements canadiensUniversity of Ottawa
Organismes subventionnairesnon disponible
Mots-clésConflict of interestSpecialtyMedicineProcess (computing)Intervention (counseling)Relevance (law)Public relationsPolitical scienceLawComputer scienceFamily medicineNursing

Résumé

récupéré en direct d'OpenAlex

The author reported no conflicts of interest.The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. The author reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. This letter's authors,1Lobo Filho H.G. Lobo Filho J.G. Pimentel M.D. Left internal thoracic artery and saphenous vein composite grafts: the value of valveless veins.J Thorac Cardiovasc Surg Open. 2021; 8: 379Google Scholar and the original source article's authors, reflect opinions in their practice that emphasize that much of what we do is based on personal opinion. We have taken our best shots at trying to parse out physiology to do what surgeons do best—innovate. This process is a practical implementation of ideas that results in the introduction of new goods or services. When one considers the question presented in this strategy of coronary revascularization, we can demonstrate multiple steps at which our true quality as innovators shines through. The first is the question of the application of the valvulotome, a tool introduced in another surgical specialty for peripheral vascular intervention.2Connolly J.E. The history of the in situ saphenous vein bypass.J Vasc Surg. 2011; 53: 241-244Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar The benefit of this approach is the ability to use the vein in an orientation that preserves its normal tapering course in terms of diameter of inflow and outflow. In contrast, this may result in trauma that could jeopardize long-term outcomes, and are the acceptable outcomes of in situ bypass in the leg due to preserved adventitial blood supply by not removing the vein?3Dreifaldt M. Souza D.S. Loesch A. Muddle J.R. Karlsson M.G. Filbey D. et al.The “no-touch” harvesting technique for vein grafts in coronary artery bypass surgery preserves an intact vasa vasorum.J Thorac Cardiovasc Surg. 2011; 141: 145-150Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar Having done a lot of basic research looking at endothelial injury, would I feel comfortable doing this? Likely not. The next is the question of anastomosing the vein, prone to atherosclerosis, to the smaller internal thoracic artery. Is this folly? The theoretical benefit of local antiatherogenic materials is appealing, but is there proof? Do we need more information to properly avoid the potential complication of jeopardizing the superb results of an isolated left internal thoracic artery–left anterior descending coronary artery anastomosis? To this reviewer, these papers have supported that this strategy is feasible and in “a pinch” I feel ever so slightly better to apply them if my standard tried-and-true strategy is not available. But, to move forward, we need to encourage surgeons to break down innovations step by step and test each stride along the innovation pathway before encouraging universal acceptance. These communications are what they are—you can do it. Should you do it routinely? That is for another day. Left internal thoracic artery and saphenous vein composite grafts: The value of valveless veinsJTCVS OpenVol. 8PreviewWe read with great interest the study published by Hwang and colleagues,1 which demonstrated equivalence between the clinical results obtained in coronary artery bypass graft (CABG) surgery with composite arteriovenous grafts when compared with using exclusively arterial composite grafts. Our team has considerable interest in this topic, as we are part of a pioneering and enthusiastic group that regularly performs CABG without cardiopulmonary bypass and avoiding manipulation of the ascending aorta, with studies since the 1990s indicating good results with this technique. Full-Text PDF Open Access

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 distillée sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.

score de la tête « metaresearch » (Codex)0,000
score de la tête « metaresearch » (Gemma)0,000
Version: codex-gemma-dda1882f352aStatut de validation: machine_predicted_unvalidated
Catégories candidatesaucune
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Observationnel · Signal consensuel: Observationnel
GenreSignal candidat: Empirique · Signal consensuel: Empirique
Score de désaccord entre enseignants0,455
Score d'incertitude au seuil0,338

Scores Codex et Gemma par catégorie

CatégorieCodexGemma
Métarecherche0,0000,000
Méta-épidémiologie (sens strict)0,0000,000
Méta-épidémiologie (sens large)0,0000,000
Bibliométrie0,0000,000
Études des sciences et des technologies0,0000,000
Communication savante0,0000,000
Science ouverte0,0000,000
Intégrité de la recherche0,0000,000
Charge utile insuffisante (le modèle a refusé de juger)0,0000,000

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.

Tête enseignante Opus0,119
Tête enseignante GPT0,456
Écart entre enseignants0,338 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_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 découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.

Les modèles n’ont appliqué aucune catégorie : rien dans la taxonomie ne correspondait à ce travail.
Devis d'étudeObservationnel
Domainenon disponible
GenreEmpirique

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations0
Publié2021
Routes d'admission1
Résumé présentoui

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