MétaCan
Menu
Back to cohort
Record W2082274370 · doi:10.1136/bmj.331.7528.1338-b

Challenges of private provision in the NHS

2005· letter· en· W2082274370 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueBMJ · 2005
Typeletter
Languageen
FieldHealth Professions
TopicHealth Services Management and Policy
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineCataract surgeryOptometryMedical emergencySurgery

Abstract

fetched live from OpenAlex

Editor—Timmins questions whether the benefits of using independent providers for health care outweighs the risks.1 He notes the tendency for treatment centres to take on simpler cases, leaving the NHS to deal with complex surgery, but he brushes over the devastating effect that this is having on surgical training.1 Cataract surgery is the most common operation performed by treatment centres. It takes intensive training to become a good cataract surgeon. It is usually possible to predict which cataract operations are going to be difficult or high risk when the patient is seen before the procedure.2 In our department, these complex cases are listed as “consultant to do.” The remainder are listed as “any surgeon to do,” and it is these patients who may be suitable for training.​training. Figure 1 Credit: PASCAL GOETGHELUCK/SPL Since Netcare, a mobile treatment unit, and the Shepton Mallet treatment centre started operating in Somerset, we have noticed a dramatic reduction in training opportunities for cataract surgery. The number of “any surgeon to do” patients on each consultant list has halved from three patients per operating list in 2003 to 1.5 patients per list in 2005. Trainees are often unable to operate because of a lack of suitable cases. This will affect all ophthalmic training grades, but particularly senior house officers. Fielder and Watson, noting that Action on Cataracts had failed to consider surgical training, made some excellent suggestions about how training could be improved.3 Their ideas of high volume service and low volume training surgical lists, with blocks of intensive surgical training seem eminently sensible. The demand for surgery was apparently overestimated when planning treatment centres.1 Could the NHS now use this excess capacity in the form of low volume surgical training lists? It seems very “short sighted” that, although the number of cataract operations performed in the UK is increasing, the future of cataract surgery training is under threat.

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.

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)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesResearch integrity
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.167
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0000.001

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 head0.182
GPT teacher head0.498
Teacher spread0.316 · 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