Nasotracheal Intubation, Direct Laryngoscopy and the GlideScope®
Bibliographic record
Abstract
In Response: We agree with Dupanovic that not having to use Magill forceps when using the GlideScope® for nasotracheal intubation may have accounted for some of the improvement seen in time to intubation, ease of intubation, and the lower incidence of moderate to severe sore throat.1 Indeed, we stated as much in the original manuscript: …“ Magill forceps were not used when using the GlideScope®—reducing the amount of time necessary for insertion of the Magill forceps, manipulation of the nasotracheal tube tip, and removal of the Magill forceps.”2 However, we do not agree that it would be helpful to separately analyze time to intubation in the subset of direct laryngoscopy patients in whom the Magill forceps were not used. Using Magill forceps was optional in the trial protocol, and hence the forceps were only used if the operator deemed them necessary to successfully complete the intubation. Direct laryngoscopy for nasotracheal intubation is inextricably linked with the usage of Magill forceps in a certain proportion of cases.3,4 Analyzing only the subset of those patients in whom Magill forceps usage was not necessary would only be reasonable if that subset could be reliably predicted ahead of time. Since this is not possible, it is necessary to analyze all patients in the groups to which they were randomized. In addition, subgroup analysis is rarely warranted and is prone to false conclusions.5 Because of the randomized trial design, any observed differences between the groups can be attributed solely to the intervention: it just so happens that one intervention (direct laryngoscopy) often requires the use an adjunct (Magill forceps) in order for it to be successful, and the other does not. Philip M. Jones, MD Timothy P. Turkstra, MD Department of Anesthesia and Perioperative Medicine London Health Sciences Centre University Hospital London, Ontario Canada [email protected]
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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 | 0.012 | 0.090 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.021 | 0.025 |
| Insufficient payload (model declined to judge) | 0.014 | 0.003 |
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".