Are We Making a Real Difference? Update on ‘Hidden Mortality’ in the Management of Congenital Diaphragmatic Hernia
Bibliographic record
Abstract
Reports of improved survival rates for cases of congenital diaphragmatic hernia (CDH) patients have prevailed in the literature over the past 10 years. These improvements have been attributed to advances in medical management in the postnatal period. However, further inquiries into the true survival of CDH patients through population-based studies have revealed that the reported increase in survival outcomes, which are often single institution-based reports, are confounded by case selection bias which fails to consider those CDH patients who do not reach the referral centers. This apparent discrepancy between population-based and institution-based statistics raises the question of 'hidden mortality' and the role it plays in both research and clinical medicine. In this review we will examine the reported survival outcomes of CDH from both institution- and population-based perspectives and explore the presence and implications of hidden mortality on research methodology and clinical practice.
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How this classification was reachedexpand
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| 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 | 0.001 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".