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Record W2128940445 · doi:10.1093/ejcts/ezr069

Management strategies in aortic coarctation

2011· letter· en· W2128940445 on OpenAlexaff
G. Shanmugam, Gyaandeo Maharajh

Bibliographic record

VenueEuropean Journal of Cardio-Thoracic Surgery · 2011
Typeletter
Languageen
FieldMedicine
TopicCongenital Heart Disease Studies
Canadian institutionsChildren's Hospital of Eastern Ontario
Fundersnot available
KeywordsCardiologyInternal medicineMedicine

Abstract

fetched live from OpenAlex

Früh et al. [1] report their data from a retrospective study of coarctations. The small number of patients in each group and the lopsided distribution of patients in each arm render statistical analysis meaningless. The data in the abstract are different from that in the text. [Abstract: Group A, B and C: n = 48/16/27. Results section: Group A, B and C: n = 48/17/26.] ‘In the whole group 16 patients need reintervention. In the next paragraph, it appears 15 needed reintervention [12 natives + 3 recoarctation]’. The accuracy of this dataset is questionable. There is no data on resolution of hypertension in the various groups. Were the 24 recurrent coarctations, following surgery or catheter intervention? The authors state that the complication and reintevention rates are comparable between the three groups. The primary focus is supposedly a comparison of the modalities of treatment in each group—not a comparison of overall complication and reintervention rates between the three age groups, which could all be good or all be bad! This is not in line with the primary focus of the paper. ‘In group C, stent implantation is an excellent alternative to surgery’. Do the authors recommend stent implantation as a primary modality or as ‘an alternative to surgery’. In Group B, the reintervention rates for surgery vs catheter intervention [balloons + stents] in native coarctation were 0 vs 37.5%. In recoarctation, there were no catheter interventions at all, which precludes any comparison. Based on these data, how would the authors justify catheter intervention in Group B, as part of the protocol? The 37% incidence of recoarctation following catheter intervention, despite comparable acute reductions in gradients, indicates that an acute gradient reduction is an unreliable predictor of subsequent recoarctation. In Group B, it is stated that the preference is for surgery when there is associated arch hypoplasia. Comparing isolated coarctation with that of arch hypoplasia + coarctation is to compare similar pathological entities but at different points on the spectrum of severity, which potentially biases the results against surgery. Yet, reintervention rates were lower for surgery [0 vs 37.5%]. If anything, these data suggest that surgery is a better option in Group B. The authors state that in Group B, the need for reintervention following balloon dilatation is high, and stents are not recommended due to the frequent need for redilatation. If balloons are risky, stents are not recommended and surgery has a reintervention rate of 0, why do patients in Group B have catheter intervention at all? From Table 2, it is obvious that this study has one of the shortest follow-ups, especially in Group C, where most of the patients had stent implantations. The incidence of recoaractation and reintervention could be significantly under-reported. The conclusions of the study have no direct correlation with the data presented. This is essentially an audit of one centre's practice and throws no new light on the management of coarctation.

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.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Commentary · Consensus signal: none
Teacher disagreement score0.002
Threshold uncertainty score0.006

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0020.001
Science and technology studies0.0010.000
Scholarly communication0.0010.001
Open science0.0010.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0020.000

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 head0.043
GPT teacher head0.295
Teacher spread0.252 · 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

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreCommentary

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".

Quick stats

Citations1
Published2011
Admission routes1
Has abstractyes

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