PC.107 Do Words Matter?
Bibliographic record
Abstract
Introduction Reorientation of care decisions are a core part of neonatology. While the majority die rapidly after a decision has been made, a proportion may live for days or weeks. Clear communication of an end of life plan is vital in emergencies. We compared two forms available across Bristol neonatal units. Methods We surveyed a cross section of medical and nursing staff. The first was the trust standard paediatric form entitled ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR). The second; a simple form entitled ‘Allow natural death’. There was a clear statement that the baby would not be for resuscitation along with spaces to document what the parents did and didn’t want in the event of acute deterioration. We investigated perceived ease of use in discussions with the parents and in a subsequent emergency. Results 89% preferred the phrase ‘allow natural death’ rather than ‘do not attempt cardiopulmonary resuscitation’. 93% thought that the simple form would be adequate in a emergency whereas only 44% felt that the complex form would be easy to follow. Most agreed that both were appropriate for a NICU, however the complex form was thought to have too much detail. More than half felt that the complex form would be distressing and confusing to parents, whilst feelings regarding the simple form included sadness, acceptance and understanding. Conclusion The use of an allow natural death approach which allowed parents to document how they wanted their baby to die was more acceptable to neonatal staff than a DNACPR form.
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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 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.007 | 0.004 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.752 | 0.493 |
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".