Hospital-Based Inter-professional Strategy to Reduce In-patient Admissions and Emergency Department Visits for Pediatric Asthma
Bibliographic record
Abstract
Pediatric asthma is a common reason for emergency department (ED) visits and in-patient hospital admissions. Evidence demonstrates that asthma management initiated in the ED has limited benefit unless followed by ongoing coordinated inter-professional care (IPC). The Royal Victoria Hospital (RVH) of Barrie, Ontario, has developed a best practice model of care for pediatric asthma. Primary care providers and ED physicians are actively encouraged to refer children with any recurrent respiratory problems consistent with asthma to the Paediatric Asthma Clinic (PAC). Quarterly PAC visits with a certified asthma educator and a pediatrician include lung function measurement, written action plans and primary care provider communication. Ongoing outcome monitoring of patients receiving IPC has revealed that, compared with 12 months prior to enrolment in the PAC, patients show a two-thirds decrease in asthma-related ED visits and an 85% decrease in admissions. The PAC has contributed to an ongoing decline in the rates of pediatric asthma-related ED visits and admissions at RVH, which are currently less than half the rates seen at our peer hospitals. IPC for chronic diseases is best practice, and our model of care for pediatric asthma continues to provide critical data demonstrating and supporting the advantages of IPC in chronic disease management. RVH modifies practice and policy to meet best practices, optimizing the care provided to children with pediatric asthma.
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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 | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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 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".