Prospective Feasibility Study of Outpatient Stereotactic Brain Lesion Biopsy
Bibliographic record
Abstract
OBJECTIVE: To assess the safety and feasibility of performing computed tomography-guided stereotactic brain lesion biopsy as an outpatient day-surgery procedure. METHODS: In late 1996, a prospective trial of outpatient stereotactic biopsies was initiated. The protocol consists of preadmission education of the patient, computed tomography-guided biopsy with local anesthesia (using a Brown-Roberts-Wells or Cosman-Roberts-Wells frame), postoperative observation in the postanesthetic care unit for 2 hours and in the day surgery unit for 2 hours, and then discharge home 4 hours after the procedure. RESULTS: Seventy-six patients constituted the intent-to-treat group, of whom two were not discharged on the same day (97.4% success rate). The two patients underwent inpatient admission because one required intravenous antibiotic treatment of a brain abscess and the other had a hard lesion in the brainstem that precluded biopsy needle penetration; admission for further investigation of the lesion was elected. Two patients experienced complications (2.6%), i.e., one small area of intraventricular hemorrhage that produced only a mild headache and one case of mild worsening of preexisting leg weakness, with negative computed tomographic results. CONCLUSION: Discharging patients home after 4 hours of observation after stereotactic biopsies seems to be a safe, well-tolerated practice. In this series, there was no major morbidity and no patient was disadvantaged by participating in this protocol. This approach would be expected to result in health care resource and cost savings, with a potential increase in patient satisfaction because of shorter hospital stays.
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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 | 0.006 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".