Early neonatal presentations to the pediatric emergency department
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
UNLABELLED: As a result of shorter postpartum hospital stays, many medical concerns, which traditionally have been managed in newborn nurseries, are presenting to the pediatric emergency department (PED). We undertook a study to determine the profile of early neonatal visits to the PED. In addition, we examined the influence of maternal factors and length of postpartum hospital stay on PED visits. METHODS: We conducted a retrospective chart review of all neonates < or = 8 days of age who presented to the PED between June 1990 and May 1995. Data gathered from neonatal and corresponding maternal charts included neonatal and maternal demographics, prenatal instruction, length of postpartum stay, source of referral, age at presentation, presenting complaint, diagnosis, disposition, and course in hospital, if admitted. RESULTS: A total of 559 neonatal visits were identified. Neonatal use of the PED increased 245% compared to an overall increase in PED use of 8.7% during the study period. Jaundice, difficulty breathing, feeding problems, and irritability were the most common presenting complaints while the most frequent diagnoses were normal physiology, jaundice, feeding problems, and query sepsis. Our overall admission rate was 33%. Self-referred patients were at a significantly lower risk of serious illness (16% admitted vs 49 % of consult patients). The self-referral rate increased with maternal age less than 21, single marital status, no prenatal classes, and primiparity. The length of postpartum hospital stay was identified in 389 neonates (55 early discharge (ED) and 334 non-early discharge (NED). The ED group had a significant increase in annual PED utilization compared to the NED group changing from 2% of the total population in study year 1 to over 31% in the final year. The ED and NED groups did not differ significantly with respect to the majority of chief complaints, frequency of PED diagnoses, admission rates, or maternal characteristics. CONCLUSIONS: Use of the PED by neonates < or = 8 days of age increased significantly over the study period. The majority of neonates presented by self-referral and were discharged with advice only. Mothers who were young, single, primiparous, or who had not attended prenatal classes presented with neonates who were less seriously ill. Although ED neonates represent an enlarging subset of PED visitors, they do not appear to differ significantly from NED neonates with respect to PED complaints, diagnoses, and disposition.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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) | 0.010 | 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 it