Multimodal strategies to improve APACHE II score documentation
Bibliographic record
Abstract
The APACHE II score is used widely in the ICU setting. In our phase I study [ 1 ], APACHE II scores collected by an expert research coordinator and two research clerks were reliable (intraclass correlation coefficient = 0.90, lower 95% confidence interval [L-95% CI] = 0.85). However, we found substantial variability in the Chronic Health Index (CHI) (0.67, L-95% CI = 0.53) and Glasgow Coma Scale, verbal component (GCS-V) (0.42, L-95% CI = 0.25). To improve the reliability of the APACHE II score, we conducted phase II, aimed at changing the behaviour of ICU clinicians who are involved in documenting the APACHE II score in practice. To educate ICU clinicians regarding two specific components of the APACHE II score with suboptimal reliability: CHI and GCS-V.
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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 | 0.004 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
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".