New models of care for advanced lung disease
Bibliographic record
Abstract
Chronic lung disease is growing in prevalence and patients are living longer with long-term illness and a high-symptom burden: as these diseases are so common there are now millions of affected individuals and their families living with the sequelae worldwide. This has profound effects on the individual concerned (who is often highly symptomatic with breathlessness), their family, and on health services. There is a growing recognition that the historical model of medical management aimed at the disease alone is not meeting patients' needs and leading to high levels of unscheduled use of medical services at high financial cost and without health gain leading to further frustration for the patient. Service models for palliative care aimed at patients with a rapid deterioration from good health to death can also fail to meet the needs of this group. This paper examines new models of care for patients with advanced lung disease, outlining three services in some detail with a brief review of available evidence. It calls for new ways of evaluating the impact of such services.
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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 | 0.006 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.007 |
| Scholarly communication | 0.005 | 0.008 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.004 | 0.005 |
| Insufficient payload (model declined to judge) | 0.008 | 0.002 |
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".