New Concepts in the Assessment of Exercise Capacity Among Children with Congenital Heart Disease: Looking beyond Heart Function and Mortality
Bibliographic record
Abstract
Cardiopulmonary exercise testing is a valuable tool in the diagnosis and management of pediatric congenital heart disease. Parent and child reports of the child’s physical activity relative to peers are also routinely used to monitor heart function. Unfortunately, objective measures of their physical activity indicate that most children with congenital heart disease lead sedentary lives, which increase their risk of secondary morbidities. Current recommendations emphasize the need to proactively counsel patients to engage in at least 60 minutes of physical activity daily. Information regarding the child’s current capacity for physical activity can be obtained through a physical literacy assessment and enhanced use of cardiopulmonary exercise results. Physical literacy is the knowledge, motivation, behaviour and physical competence needed to adopt and maintain a physically active lifestyle. Protocols to assess these physical literacy domains are well established, with the Canadian Assessment of Physical Literacy offering the first comprehensive assessment of all domains. Cardiopulmonary exercise protocols that incorporate sub-maximal stages, and measures of the child’s willingness to perform maximal intensity exercise provide important information about the child’s capacity for physically active play with peers, which seldom requires a maximal effort. Measures of physical literacy and sub-maximal cardiorespiratory capacity thus provide important information when counselling children with congenital heart defects and their parents regarding the child’s daily physical activity participation.
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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 | 0.018 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.002 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.003 | 0.008 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.004 |
| 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".