ANTIBIOTIC PROPHYLAXIS IN NECROTISING PANCREATITIS
Bibliographic record
Abstract
Introduction: Infection of pancreatic necrosis is the most important cause of late mortality in necrotising pancreatitis (NP). The available evidence on the prevention of infection by systemic antibiotic prophylaxis is conflicting and the methodological quality of the published trials has been criticised. At present there is no international consensus on the indication for antibiotic prophylaxis in ANP. Methods: To evaluate the methodological quality of randomised controlled trials of antibiotic prophylaxis in relation to the reported effects on infection of pancreatic necrosis and mortality a previously published methodological scoring system was adapted to the situation in NP in accordance to the revised CONSORT guidelines. The scored items consisted of patient selection, patient characteristics, allocation sequence, concealment of allocation, blinding, description of antibiotic intervention, description of feeding protocol and participant flow. The maximum score for study quality is 17 points. Subsequently, a systematic search in the Medline and Embase databases was performed. Five randomised controlled trials were included (Pederzoli et al., Sainio et al., Delcenserie et al., Schwarz et al., Isenmann et al.) and assessed using the methodological scoring system. Results: The methodological quality score varied from 5 (Schwarz et al.) to 15 points (Isenmann et al.). For infection of pancreatic necrosis the absolute risk reduction (ARR) ranged from −0.031 to 0.333, the relative risk reduction (RRR) from −35.2% to 100%. For mortality the ARR ranged from 0.02 to 0.2, the RRR from 27.6% to 100%. No association was found between the methodological quality of the trials and the reported risk of infected pancreatic necrosis. There was a trend towards an inverse relationship between methodological quality and ARR on mortality (Spearman's correlation coefficient −0.667, tested 2-tailed; P-value 0.219) and a significant inverse relationship between the methodological quality and RRR on mortality (Spearman's correlation coefficient −0.975, tested 2-tailed; P-value 0.005). Conclusion: The methodological quality of the trials on systemic antibiotic prophylaxis is objectified by the described scoring system. There seems to be a significant inverse relationship between methodological quality and the reported effect of systemic antibiotic prophylaxis on mortality in ANP.
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How this classification was reachedexpand
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 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".