The Infrequency of Spirometry Use in Medical Clinics
Bibliographic record
Abstract
Background: Spirometry is advocated for adults with obstructive lung disease such as asthma or chronic obstructive lung disease (COPD), for individuals with risk factors such as cigarette smoking, and for patients with chronic respiratory symptoms. This record review study was performed to determine how frequent medical residents order spirometry for the above indications. Methods: Outpatient general medical clinic records from 337 patients followed in the medical clinics of a large, teaching hospital in an urban setting were reviewed. Inclusion criteria for review included age > 45 yr and one of the following: 1) a diagnosis of asthma and/or COPD, 2) either current or previous cigarette smoking, 3) one or more of the following chronic respiratory symptoms: dyspnea, cough, sputum production. Results: The mean (SD) age was 57 + 10 yr. Of this group, only 31% had spirometry or an order for spirometry documented in the outpatient record. Conclusion: This finding underscores the under-utilization of spirometry as a diagnostic tool, even in an academic setting.
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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 | 0.003 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".