32 * EVALUATION OF AN IN-REACH SINGLE COMPREHENSIVE GERIATRIC ENCOUNTER IN FRAIL OLDER PEOPLE ADMITTED TO AN ACUTE ADMISSIONS UNIT
Bibliographic record
Abstract
Background: Frail hospitalised patients benefit from Comprehensive Geriatric Assessment (CGA) provided on a dedicated ward, as this improves quality of life, function and reduces institutionalisation. Innovation: In an acute hospital, with neither acute geriatric wards nor geriatric teams, a pilot winter pressure frailty service in-reached into the acute medical unit for 3 months. Patients were identified using the Bournemouth criteria and frailty measured with the Edmonton Frailty Scale (EFS). Pre-set documentation contained a trigger for palliative care planning and discharge advice. A copy of each completed document was immediately despatched to the patient's GP. Patient events were tracked for 3 months after discharge on the county's electronic notes portal. Evaluation: Of 95 patients (mean age of 89 (SD 6.5); 63.2% female) 26.3% were from care homes. Mean EFS was 10.6(SD 3.7) i.e. advanced frailty. Each patient had a median of 5 co-morbidities and a median Charleson Co-morbidity index of 2. Dementia (30.9%) and falls (52.6%) were well represented and delirium newly diagnosed in 62.1%. A median of 5 drugs were reduced per patient as part of multi-factorial intervention (median 5 interventions per patient). Palliative advice was given in 47.4%. After a median LOS of 9days, 27.9% returned to their usual residence and 7.4% newly placed in care homes. 3 months after discharge 41.1% of the patients had died including the 18.9% who had died in hospital. Of the 39 deaths only 26 had been anticipated by us during our assessments. Of the 15 patients that we had assessed as being palliative who were alive at 3 months, 10 remained in their usual residence and 5 were admitted to care homes.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 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".