Effect of hospital volume on outcome of pancreaticoduodenectomy in Italy
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.
Bibliographic record
Abstract
BACKGROUND: An inverse relationship between hospital volume and death following pancreatico duodenectomy (PD) has been reported from several countries. The aim of this study was to assess the volume-outcome effect of PD in Italy. METHODS: The study group comprised 1576 patients who underwent PD in 2003. Hospitals were allocated to four volume groups: low volume, five PDs or fewer; medium volume, six to 13 PDs; high volume, 14 to 51 PDs; and very high volume, two hospitals that performed 89 and 104 PDs. RESULTS: Some 221 hospitals performed at least one PD in 2003; hospital volume was low in 74.7 per cent, medium in 17.6 per cent, high in 6.8 per cent and very high in 0.9 per cent. The overall mortality rate was 8.1 per cent. Increasing hospital volume was associated with a significantly reduced mortality rate: 12.4 per cent (adjusted odds ratio (OR) 1.000) for low-volume, 7.8 per cent (OR 0.611) for medium-volume, 5.9 per cent (OR 0.466) for high-volume and 2.6 per cent (OR 0.208) for very high-volume hospitals. Length of postoperative stay was reduced in very high-volume hospitals (P < 0.001). CONCLUSION: The outcome of PD in Italy is dependent on hospital volume and a policy of centralization may therefore be appropriate.
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Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it