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Record W2103030117 · doi:10.3121/cmr.2.1.63

Evidence-based Medicine: Answering Questions of Diagnosis

2004· review· en· W2103030117 on OpenAlex
Laura Zakowski, Christine S. Seibert, W. S. VanEyck

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.

fundA Canadian funder is recorded on the work.
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

VenueClinical Medicine & Research · 2004
Typereview
Languageen
FieldMedicine
TopicColorectal Cancer Screening and Detection
Canadian institutionsnot available
FundersU.S. Public Health ServiceUniversity of Toronto
KeywordsMedicineData scienceInformation retrievalBioinformaticsComputer science

Abstract

fetched live from OpenAlex

Using medical evidence to effectively guide medical practice is an important skill for all physicians to learn. The purpose of this article is to understand how to ask and evaluate questions of diagnosis, and then apply this knowledge to the new diagnostic test of CT colonography to demonstrate its applicability. Sackett and colleagues have developed a step-wise approach to answering questions of diagnosis: Step1: Define a clinical question and its four components: Patient, intervention, comparison and outcome. Step 2: Find the evidence that will help answer the question. PubMed Clinical Queries is an efficient database to accomplish this step. Step 3: Assess whether this evidence is valid and important. A quick review of the methods and results section will help to answer these two questions. Step 4: Apply the evidence to the patient. This step includes: assessing whether the test can be used; determining if it will help the patient; finding whether the study patients are similar to the patient in question; determining a pretest probability; and deciding if the test will change one's management of the patient. A relatively new diagnostic test, CT colonography, is explored as a scenario in which the steps presented by Sackett et al.1 can be helpful. A patient who is interested in completing a CT colonography instead of a colonoscopy is the basis of the discussion. Because a CT colonography does not detect polyps of less than 10 mm accurately, many patient are not likely to prefer this test over a colonoscopy. Evidence-based medicine is an effective strategy for finding, evaluating, and critically appraising diagnostic tests, treatment and application. This skill will help physicians interpret and explain the medical information patients read or hear about.

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)0.013
metaresearch head score (Gemma)0.050
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow), Science and technology studies, Research integrity, Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.960
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0130.050
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0040.001
Bibliometrics0.0020.003
Science and technology studies0.0000.003
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0010.004
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.609
GPT teacher head0.614
Teacher spread0.005 · 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