Importance of a Regular Source of Primary Care in Adolescents
Bibliographic record
Abstract
AIM: Primary care practitioners should screen young adolescent patients for idiopathic scoliosis and refer those who could benefit from bracing to prevent curve progression and the need for surgery. Adolescents without a regular source of primary care may be at higher risk for not having their scoliosis diagnosed in time to benefit from bracing. We sought to determine whether adolescents with idiopathic scoliosis and a regular source of primary care are at lower risk of scoliosis surgery. METHODS: We followed a cohort of 3722 adolescents (10-18 years) whose diagnosis of adolescent idiopathic scoliosis was confirmed by an orthopedist or physiatrist, using linked administrative data of physician visits and hospital admissions, from 2001 to 2010. We used survival analysis to compare those with and without a regular source of primary care with regard to having scoliosis surgery, adjusting for covariates. RESULTS: Among the 3722 adolescents with scoliosis, 12% did not have a regular source of primary care and 158 had scoliosis surgery. Adolescents with a regular source of primary care had a lower risk of scoliosis surgery (hazard ratio 0.60, 95% confidence interval 0.40-0.89), especially those whose regular source of primary care was a pediatrician (hazard ratio 0.48, 95% confidence interval 0.30-0.76). CONCLUSION: Adolescents with scoliosis and a regular source of primary care were less likely to undergo scoliosis surgery. Policy makers need to be aware of the importance of primary health care for children and adolescents and ensure that they are not forgotten in their campaign for primary care improvement.
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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 | 0.001 | 0.008 |
| 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 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".