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Record W2041205484 · doi:10.1055/s-2001-18492

Outpatient Treatment of Patients with Pulmonary Embolism

2001· review· en· W2041205484 on OpenAlexaff
Philip Wells, Harry R. Büller

Bibliographic record

VenueSeminars in Vascular Medicine · 2001
Typereview
Languageen
FieldMedicine
TopicVenous Thromboembolism Diagnosis and Management
Canadian institutionsOttawa HospitalUniversity of Ottawa
Fundersnot available
KeywordsMedicinePulmonary embolismDeep veinThrombosisVenous thromboembolismVenous thrombosisInternal medicineIntensive care medicineSurgery

Abstract

fetched live from OpenAlex

Very few treatment studies have included patients with pulmonary embolism (PE) but there have been many enrolling patients with deep vein thrombosis (DVT). Should treatment for PE be different from treatment for DVT? Post-mortem and clinical studies have shown a strong association between PE and the presence of venous thrombosis in the lower limbs but some recent data suggest that certain clinical factors will predict patients at higher risk of death from PE. Unfortunately, it is not clear that identifying patients as high risk will affect outcome. Two large studies recently compared treatment with unfractionated heparin to treatment with low-molecular-weight heparin in patients with PE. Combining the two studies, the rates of recurrent DVT or PE were 2.9% (13/442) in the low-molecular-weight heparin group and 3.2% (14/441) in the unfractionated heparin group, and major hemorrhage occurred in fewer than 3% of patients. The feasibility of providing outpatient care to many patients presenting to tertiary care hospitals with acute PE has become evident. In our institutions, the data suggest about 50% of patients with PE could be treated as outpatients. Until further knowledge is available, it is not unreasonable to perform echocardiography and cardiac troponin T on patients with PE if they are not completely stable or if concern over concomitant cardiopulmonary disease exists. If they meet criteria demonstrated to result in early death, it is of course reasonable not to treat such patients on a solely outpatient basis. Evidence is accumulating that patients with PE as their initial symptom complex of their venous thromboembolic disease have a worse prognosis, specifically, higher risk of recurrence and higher risk of death, but there are no data to suggest outpatient therapy will affect their prognosis. Low-molecular-weight heparin or intravenous unfractionated heparin, followed by oral anticoagulant therapy, provide adequate therapy in most patients with PE, and many can be treated as outpatients.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.977
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0060.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.024
GPT teacher head0.300
Teacher spread0.276 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designOther design
Domainnot available
GenreReview

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".

Quick stats

Citations14
Published2001
Admission routes1
Has abstractyes

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