Assessing Penicillin Allergies with a Structured Assessment Form
Bibliographic record
Abstract
ABSTRACT Objective: Assessment for penicillin allergy is not always optimal, and sometimes alternative antibiotics are prescribed for patients who are not in fact allergic to penicillin. The purpose of this study was to compare the current unstructured method of assessing and documenting penicillin allergy at St. Joseph’s Hospital, Hamilton, Ontario, with the use of a structured assessment form. Methods: Adult patients with documented allergy to penicillin who were admitted to the Day Surgery Unit between January and May 1998 were interviewed with an assessment tool that classified their allergy as probably a true allergy, possibly a true allergy, a side effect or intolerance, or an unlikely allergy. A second instrument was used to review the allergy assessment recorded in the patient’s chart. The primary outcome was the difference between the 2 methods in the prevalence of probable and possible true allergies. Secondary outcomes included the consistency of chart recording, documentation of details of the allergic reaction, antibiotics used, and referrals to an allergist. Results: For the 60 patients interviewed, the allergy was classified as probably true in 18 (30%), possibly true in 32 (53%), a side effect or intolerance in 8 (13%), and unlikely in 2 (3%). The prevalence of a probable or possible allergy according to the structured assessment form (50/60 [83%]) was significantly different from the prevalence as determined by the current method (100%) (p = 0.0044). Conclusions: Use of the structured assessment form reduced documentation of penicillin allergies by 17%; use of this form would allow selected patients (those with probable or possible allergies) to be referred to an allergist before surgery. RESUME Objectif : L’evaluation des allergies a la penicilline n’est pas toujours precise et dans certains cas des antibiotiques sont prescrits pour les patients qui ne sont pas en fait allergiques a la penicilline. Le but de cette etude etait de comparer les methodes actuelles non structurees d’evaluation et de documentation des allergies a la penicilline au St. Joseph’s Hospital, de Hamilton, en Ontario, avec une methode structuree fondee sur un formulaire. Methode : Des patients adultes dont l’allergie a la penicilline etait documentee et qui ont ete admis en chirurgie d’un jour entre janvier et mai 1998 ont ete interviewe a l’aide d’un outil d’evaluation qui classifiait leur allergie comme etant probable, possible, un effet secondaire ou une intolerance, ou peu probable. Un autre outil a ete utilise pour analyser les resultats de l’evaluation de l’allergie qui ont ete consignes dans le dossier du patient. La principale observation etait la difference entre les deux methodes au chapitre de la prevalence des allergies qualifiees de probables et de possibles. Les observations secondaires etaient la continuite de la documentation des informations au dossier, les details de la reaction allergique, les antibiotiques prescrits et les demandes de consultation a un allergologue. Resultats : Des 60 patients interviewes, l’allergie a ete classifiee comme etant probable dans 18 (30 %) cas, possible dans 32 (53 %), un effet secondaire ou une intolerance dans 8 (13%), et peu probable dans 2 (3%). La prevalence des allergies probables ou possibles determinee selon la methode d’evaluation structuree (50/60 [83 %]) etait notablement differente de celle determinee selon la methode d’evaluation non structuree actuelle (100 %) (p = 0.0044). Conclusions : Le recours au formulaire d’evaluation structuree a fait diminuer les rapports de cas d’allergies a la penicilline de 17 %; ce formulaire permettrait a des patients choisis (ceux dont l’allergie est probable ou possible) d’etre adresses a un allergologue avant d’aller en chirurgie.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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 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".