Initiation of dialysis—opinions from an international survey: Report on the Dialysis Opinion Symposium at the ERA‐EDTA Congress, 18 September 2000, Nice
Bibliographic record
Abstract
Traditionally, dialysis therapy has been initiated only when considered absolutely necessary; when the remaining renal function is so low that the uraemic syndrome is becoming insupportable or even life‐threatening. Such clinical practice can be justified from a medical, a psychological and a socio‐economic point of view. It has been believed that the longer the burden of dialysis is postponed, the better for the patient and for society. However, evidence now suggests that malnutrition in renal disease patients develops along with the progression of renal failure, since patients adapt to the lower renal function by reducing their protein intake [1]. Other studies show strong correlation between nutritional status at the start of dialysis and outcome on dialysis [2]. Thus, it has been suggested that starting dialysis at a higher renal clearance than is normally practised, before uraemia and malnutrition have taken their toll, would have a beneficial impact on well being and survival of dialysis patients [3]. An earlier start of dialysis would require significant extension of the resources for dialysis treatment. For additional funds to be allocated to dialysis there is a demand for strong medical evidence of global cost effectiveness in terms of reduced morbidity and mortality. However, no such information is yet available to support the concept of an earlier start of dialysis. On the contrary, the argument of tradition carries considerable weight.
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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 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.012 | 0.006 |
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".