Watchful waiting was as safe as surgical repair for minimally symptomatic inguinal hernias
Bibliographic record
Abstract
Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, et al . Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA 2006;295:285–92. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q In men with asymptomatic or minimally symptomatic inguinal hernias, is watchful waiting as safe as surgical repair? Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Surgery—general ★★★★★★★ Surgery—gastrointestinal ★★★★★★★ ### ![Graphic][5] Design: randomised controlled trial. ### ![Graphic][6] Allocation: concealed.* ### ![Graphic][7] Blinding: blinded (site investigators and study personnel were blinded to outcome data).* ### ![Graphic][8] Follow up period: 2 years. ### ![Graphic][9] Setting: 4 community and academic centres in the US (Omaha, NE; Marshfield, WI; Dallas, TX; and Albuquerque, NM) and 1 in Canada (Montreal, Quebec). ### ![Graphic][10] Patients: 724 men who were ⩾18 years of age (mean age 58 y) and had asymptomatic or minimally symptomatic inguinal hernia (including chronically incarcerated hernias). Exclusion criteria: undetectable hernias, local or systemic infection, or American Society of Anesthesiologists physical status >3. 4 patients were excluded after randomisation because of ineligibility. ### ![Graphic][11] Intervention: watchful waiting (n = 366) or tension free hernia repair (n = 358). ### ![Graphic][12] Outcomes: pain and … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.stitle%253DJAMA%26rft.issn%253D0002-9955%26rft.aulast%253DFitzgibbons%26rft.auinit1%253DR.%2BJ.%26rft.volume%253D295%26rft.issue%253D3%26rft.spage%253D285%26rft.epage%253D292%26rft.atitle%253DWatchful%2BWaiting%2Bvs%2BRepair%2Bof%2BInguinal%2BHernia%2Bin%2BMinimally%2BSymptomatic%2BMen%253A%2BA%2BRandomized%2BClinical%2BTrial%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.295.3.285%26rft_id%253Dinfo%253Apmid%252F16418463%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jama.295.3.285&link_type=DOI [3]: /lookup/external-ref?access_num=16418463&link_type=MED&atom=%2Febmed%2F11%2F3%2F73.atom [4]: /lookup/external-ref?access_num=000234684500021&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif [8]: /embed/inline-graphic-4.gif [9]: /embed/inline-graphic-5.gif [10]: /embed/inline-graphic-6.gif [11]: /embed/inline-graphic-7.gif [12]: /embed/inline-graphic-8.gif
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Not applicable | high |
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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 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, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
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".