Realities of Expectorated Sputum Collection in the Pediatric Cystic Fibrosis Clinic
Bibliographic record
Abstract
OBJECTIVES: To determine the proportion of pediatric patients with cystic fibrosis who do not produce expectorated sputum during routine ambulatory clinic visits and to identify clinical predictors of these patients. DESIGN: Cross-sectional study. SETTING: The cystic fibrosis clinic at The Hospital for Sick Children, Toronto, Ontario. PARTICIPANTS: One hundred eighty-three patients aged 6 to 18 years who attended the cystic fibrosis clinic between March 1, 2004, and November 30, 2004. INTERVENTION: Study patients were asked to expectorate sputum for bacterial culture. MAIN OUTCOME MEASURES: The proportion of patients unable to produce expectorated sputum was determined. Age, sex, forced expiratory volume in 1 second, pancreatic sufficiency, body mass index, and antibiotic use were compared between patients producing sputum and those not producing sputum. RESULTS: Eighty-three patients (45%) did not expectorate sputum. Patients not producing sputum as compared with those producing sputum were younger (mean age, 10.3 years vs 13.9 years, respectively; difference, 3.6 years; 95% confidence interval, 2.6-4.5) and had higher forced expiratory volume in 1 second (mean forced expiratory volumes in 1 second, 88% of predicted vs 72% of predicted, respectively; difference, 16%; 95% confidence interval, 10.1-22.2). Eighty-eight percent of patients not producing sputum had cough and 45% reported sputum production at home. CONCLUSIONS: Almost half of pediatric patients with cystic fibrosis aged 6 years and older do not expectorate sputum in the clinic, although nearly half of these patients do report producing sputum at home. The utility of home collection on the morning of a clinic visit and/or hypertonic saline induction should be evaluated to increase the number of useful specimens for microbiological culture.
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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 | 0.002 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".