Dexamethasone for Antiemesis in Laparoscopic Gynecologic Surgery
Bibliographic record
Abstract
OBJECTIVE: To estimate the beneficial and harmful effects of dexamethasone for prevention of postoperative nausea and vomiting in women undergoing laparoscopic gynecologic surgery. DATA SOURCES: We searched the following bibliographic databases: MEDLINE (from 1946 to January 2012), Embase (from 1980 to 2012 week 3), the Cochrane Central Register of Controlled Trials (from inception to January 2012), and ISI Web of Knowledge (from 1950 to January 2012). We also screened trial registries, reference lists of retrieved studies, and other sources of unpublished literature. METHODS OF STUDY SELECTION: Two reviewers screened in duplicate and independently searched results for inclusion. We included randomized controlled trials (RCTs) comparing dexamethasone with a placebo in patients undergoing laparoscopic gynecologic surgery. TABULATION, INTEGRATION, AND RESULTS: Two reviewers completed data extraction and assessed trials for bias in duplicate and independently. We used the Grading of Recommendations Assessment, Development, and Evaluation methodology to assess the quality of evidence across studies at the outcome level. A total of 13 RCTs with 1,695 patients met inclusion criteria. Data were pooled based on the random-effects model. The use of prophylactic dexamethasone significantly decreases the incidence of postoperative nausea (relative risk [RR] 0.56, 95% confidence interval [CI] 0.45-0.71), postoperative vomiting (RR 0.35, 95% CI 0.25-0.48), the need for rescue antiemetics (RR 0.39, 95% CI 0.29-0.52), and time to meet discharge criteria (mean 28.5 minutes, 95% CI 24.6-32.4). The estimated number needed to treat to prevent nausea in one patient was eight (95% CI 5-13), whereas that for vomiting was five (95% CI 4-6). There was no observed increase in adverse events. The quality of the evidence ranged from very low to moderate. CONCLUSION: This systematic review provides evidence that dexamethasone decreases the incidence of postoperative nausea and vomiting after laparoscopic gynecologic surgery, with no observed increase in side effects.
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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 | 0.017 | 0.055 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".