Hospital resource utilization associated with pediatric gastrostomy devices
Bibliographic record
Abstract
Objective: Pediatric gastrostomy devices (GD) are associated with frequent planned and unplanned ongoing care. The objective was to examine the association between planned or unplanned repeat intervention and 1) the type of tube at initial placement and 2) the method of initial device placement: operative, endoscopic or image-guided.Methods: We performed a retrospective review from January 1, 2010 – December 31, 2011 of consecutive patients that received a GD or gastrojejunostomy device (GJ) at a freestanding pediatric hospital. We estimated the risk of hospital utilization in terms of repeat interventions or device-related emergency department visits for initial GJ versus GD placement and based on method of initial device placement.Results: Over the two year period, 275 (92.0%) GDs and 24 (8.0%) GJs were placed. One hundred forty-five (48.5%) were placed surgically, 113 (37.8%) endoscopically, and 41 (13.7%) with an image-guided technique. Repeat utilization occurred in 60.9% of patients. Multivariate Poisson regression estimated that GJs compared to GDs were 2.05 (95% CI: 1.01 - 4.16) times as likely to have repeat hospital utilization. Multivariate Cox regression estimated that endoscopic and image-guided placements were associated with higher rates of hospital utilization than surgical placement (HR 2.56; 95% CI: 1.73 - 3.79 and 2.07; 95% CI: 1.20 - 3.58, respectively).Conclusions: Resource utilization after GD/GJ placement is not equal relative to the method of initial placement. Process standardization requires further investigation to reduce this health care burden.
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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 | 0.001 |
| 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 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".