The ‘Natural History’ of Declined Outpatient Gastroenterology Referrals
Bibliographic record
Abstract
OBJECTIVE: To evaluate the 'natural history' of outpatients who were referred to the Division of Gastroenterology at the University of Alberta Hospital (Edmonton, Alberta) for gastrointestinal problems and were subsequently declined. METHODS: Patients were tracked for 12 months after they were referred and declined for the following indications: abdominal pain, rectal bleeding, fecal occult blood test-positive stools and iron deficiency. For each patient, data regarding consultations by other gastroenterologists or surgeons working in the region, clinically relevant diagnoses and the number of gastrointestinal-related x-rays performed were obtained. RESULTS: Of a total sample size of 230 patients, 110 (47.8%) were seen by another gastroenterologist or surgeon after decline. A significant diagnosis was made in 21 patients (9.1%), which had immediate clinical consequences in 29%. Forty per cent of patients underwent one or more gastointestinal-related x-rays before being declined, which increased to 55% after decline. CONCLUSION: Approximately 50% of declined patients were seen by other gastroenterologists or surgeons in the region. In 9.1% of these patients, a clinically important diagnosis was made, of which one-quarter had immediate medical consequences.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".