Use of Guidelines and Risk Stratification in Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Bibliographic record
Abstract
Guidelines have been developed to simplify the antimicrobial treatment decision for patients with acute exacerbations of chronic obstructive lung disease. Approximately half of these patients will have a demonstrable bacterial infection and antibiotics have been demonstrated to shorten the clinical illness and prevent significant deterioration. Patients can be stratified by the risk of treatment failure with usual first-line antimicrobial agents. Patients presenting with worsening dyspnea, increased sputum volume and purulence should be offered antimicrobial therapy. In the presence of significant impairment of lung function (FEVI 50% predicted), frequent exacerbations, significant comorbidity, malnutrition, chronic corticosteroid administration and long duration of disease, should be treated with more aggressive therapy such as with a fluoroquinolone, amoxicillin-clavulanate, or a second or third generation cephalosporin or second generation macrolide. In the absence of these risk factors, first-line agents such as amoxicillin appear adequate. Patients with chronic suppurative airway disease (mainly bronchiectasis) should be treated with an antipseudomonal fluoroquinolone if P. aeruginosa is identified in pulmonary secretions. More prospective randomized trial are warranted to validate this approach.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.026 | 0.139 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| 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".