Notice bibliographique
Résumé
Dr Baggs has taken issue with several aspects of our recent publication on timing of transfer out of intensive care unit (ICU).1 First, her observation that we failed to identify the bedside nurse as part of the care team is a valid and appropriate criticism. In fact, we do believe that nurses are key members of the ICU team, and they were included in transfer decisions, when possible. We say “when possible” because in the ICU studied, the patient:nurse ratio was most commonly 2:1 or 3:1. As a result, only about half the time was a given patient’s own nurse able to be present in the morning rounds sessions during which such decisions were most frequently made. This information should have been included in the description of the ICU care team and the decision-making process for transfers.Dr Baggs also noted that none of our references related to the role of nurses in such transfer decisions. She identified 86 indexed references she found by cross-referencing search terms. However, ours was a quantitative study in which the topic was the affect of the timing of transfer on mortality, our addition of the term timing to her search resulted in just 5 publications, none of which were actually on the topic.Whereas involvement of nurses or others in decision-making might help avoid premature transfers (the initial descending slope of the curve in our article’s Figure), it seems quite unlikely that it would influence the harm we observed from patients whose transfer is delayed due to unavailability of regular ward beds. Nonetheless, we agree that studies of nurse participation in transfer decisions are germane to the issue, and it would have been reasonable to include them in the Discussion section of our article.Finally, referring to her own publications, Dr Baggs suggests that collaborative decision-making with nurses and other members of the care team might be superior to developing objective measures of readiness for transfer. Of course this is a testable hypothesis which, to-date, has not been tested. It seems most plausible to us, however, that both approaches have something to offer.
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 enseignantsNi 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.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 tête enseignante, 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 ».