A Tertiary Centre Experience in the Diagnosis of Biliary Atresia
Bibliographic record
Abstract
Biliary atresia (BA) is rare but is the most common cause of liver transplant in children. Early diagnosis and Kasai portoenterostomy (KP) improves outcomes. A retrospective chart review of all infants diagnosed with BA between January 1, 2002 and December 31, 2009 was conducted. The median age at referral, KP, and place of residence at presentation were determined. Age at which a conjugated bilirubin was first ordered was compared for various health care providers. Survival at 2 years of age with a native liver was determined. Seventeen patients were diagnosed with BA and 13 underwent a KP. Biliary atresia splenic malformation (BASM) was present in 23.5% of patients. The median age of referral to a tertiary centre was 56d (IQR 42; range: 19-118 d) and the median age at KP was 55d (IQR: 30; range 26-102 d), neither of which differed significantly from established Canadian medians. Paediatricians requested conjugated bilirubin level more frequently than family physicians; 58% vs 29%. Neither the rurality of patients’ residence nor the type of health care provider for well-baby care influenced age at referral to subspecialist. Two-year survival with native liver was 15.4%. There was no evidence of a difference in age at referral or age at KP observed in this study compared with established median for Canada. The place of residence didn’t influence timing of referral. The study noted a lower than expected survival with native liver at 2 years.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
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.
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".