Staging the ductus arteriosus facilitates identification of neonates at increased risk of respiratory morbidity
Bibliographic record
Abstract
Background: None of the studies assessing effects of treatment of symptomatic duct on outcomes have considered heterogeneity of ductus arteriosus in terms of clinical and echocardiographic significance. Objectives: To characterize outcomes of neonates who received treatment for a haemodynamically significant ductus arteriosus and were classified according to the ductal staging system. Methods: Neonates were classified according to ductal disease severity score: clinical (C 1–4) and echocardiography (E 1–4) criteria (sum of C-score and E-score) as low-risk (composite score < 6), intermediate risk (composite score = 6) and high-risk (composite score > 6) groups. A comparative evaluation of neonatal demographics, respiratory outcomes and neonatal morbidities was made between low and high risk groups. Results: Data from 45 evaluations of the ductus arteriosus were analysed. Infants in high-risk group had significantly increased median transductal diameter [3.2 mm (2.7, 3.4) vs. 2.5 mm (2.4, 2.7), p = 0.02] and were more likely to require >1 course of indomethacin or surgical ligation. Infants with a high-risk stage were also more likely to require longer duration of oxygen support, home oxygen therapy and a higher, though statistically non-significant, trend for chronic lung disease. In the short term, at the end of the treatment course, no significant alteration in the ventilatory requirements was noted. Conclusions: Staging the ductus arteriosus may facilitate the identification of neonates at greatest risk of neonatal respiratory morbidity. It may also shed more light as to which babies, if any, benefit from therapeutic intervention. In this cohort, treatment with indomethacin did not reduce the morbidities assessed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".