Review of: "Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study"
Notice bibliographique
Résumé
Potential competing interests: The author(s) declared that no potential competing interests exist.The authors have performed a secondary analysis of the electronic health records of individuals aged 65 and above, living in the Friuli-Venezia Giulia region of northeastern Italy, covering the period from 2000-2014, investigating hospitalizations and emergency department visits (EDV) two years preceding death in people (n=142,834) who died between 2000 and 2014.Death was defined using death certificates.Residents who were "not continuously registered" in the region during the two years before dying (n=19,291 individuals) were excluded.Researchers estimated the percentage of one or more hospitalization or EDV two-year preceding death, stratified results by age group [65-74 years], [75-84 years], [85-94 years], and [>=95 years]), by sex, the leading cause of death (cancer, cardiovascular disease, respiratory disease).They also reported on other outcomes, including the duration of hospitalizations (please refer to the outcome section).Authors reported that (1) percentage of individuals accessing [acute?] healthcare services increased exponentially in proximity to death (hospitalizations = 4.7 months, EDVs = 3.9 months before death); this was inversely related to age, with changes among the youngest and eldest decedents at 6.6 and 3.5 months for hospitalizations and at 4.6 and 3.3 months for EDVs, respectively; (2) healthcare use among individuals with cancer increased "earlier in life" (hospitalizations = 6.8,EDVs = 5.8 months before death);(3) individuals with respiratory diseases were most likely to access hospital-based services during the last month of life; and (4) no sex-based differences were found.Researchers concluded that "greater use of acute healthcare services among younger individuals and cancer patients suggests that policies potentiating primary care support targeting these at-risk groups may reduce pressure on hospital-based services."The strength of the data utilized in this study includes its population relevance and the ability to examine a range of hospitalizations and EDV, covering approximately 2% of the population of Italy (i.e., 1.2 mil people live in the Friuli-Venezia Giulia region).Likewise, there was a possibility to compare individuals across the age categories and biological sexes and the cause of death.The results are important for surveillance and public health.Below are some points that limit appreciation of the study results as they concern study methodology and reporting:
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 | 0,006 | 0,043 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,003 | 0,002 |
| Bibliométrie | 0,011 | 0,013 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,004 |
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 ».