Bibliographic record
Abstract
Chang et al.1 share data gathered from an online survey sent to approximately 4000 members of the American Society of Cataract and Refractive Surgery (ASCRS) to understand the effect of the European Society of Cataract and Refractive Surgeons' (ESCRS) multicenter, randomized, controlled trial on surgeon practices with respect to antibiotic prophylaxis for cataract surgery. They received 1312 completed surveys for a response rate of approximately 33%. The survey results indicate that a minority of the respondents (30%) used intracameral antibiotics as an intracameral injection or via irrigating solution. The report also states that the ESCRS study “did not have an impact on the practice of 77% of respondents,” who said they were still not using intracameral antibiotics. We have 2 concerns about the survey results in this report. First, the timing of the survey may have been premature with respect to the complete published results of the ESCRS study. Although preliminary results announcing the discontinuation of the ESCRS study due to ethical concerns were published in March 2006,2 the full study was not published until June 2007.3 The survey to ASCRS members was sent via email in January 2007, months before the completed study was available for review by survey respondents. Even if the completed study results had been published before the survey, it is reasonable to expect a delay between the published results and a major change in the practice behavior of individual surgeons. Second, the survey collected data on each surgeon's annual cataract volume. Table 2 reveals that 362 of the 1312 respondents (27.6%) had an annual case load of over 5001; yet, the report does not share the relative practice behavior of surgeons stratified by the number of cases performed. Since endophthalmitis is a relatively rare disease, one might expect that high-volume surgeons would be most attuned to the best practices of antibiotic prophylaxis. Even before the published results of the ESCRS trial, many high-volume surgeons in the United States and Canada were vocal proponents of intracameral antibiotics, at the risk of significant public criticism (Chang DF. Vancomycin mixture. Available at: www.changcataract.com/pdf/docstools.pdf. Accessed January 12, 2008).4,5 If a large percentage of high-volume cataract surgeons were already using intracameral antibiotics, the ESCRS study results would not change the behavior of this group of surgeons, who are the most likely to be sensitive to new information about best practices. The complete impact of the ESCRS study on surgeon practice may not yet be realized. Perhaps many who were skeptical of the exhortations of our high-volume surgeon colleagues will slowly be persuaded by the best available evidence on this topic: a multicenter, randomized, controlled trial.
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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 | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.004 |
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".