A Cellulitis Guideline at a Community Hospital – We Can Reduce Costs by Standardizing Care
Bibliographic record
Abstract
Objectives To assess whether there is: a) a clinical difference between patients with cellulitis treated according to the recommendations of a clinical cellulitis guideline, and those treated otherwise and b) a difference in the cost of antibiotic treatment of the two groups Methods Emergency Department (ED) patients diagnosed with cellulitis at a community hospital were graded using a 4-point scale, and physicians were encouraged to treat based on an established practice guideline. Patients were contacted 5 days after their ED visit, and again at 10 days if they had not improved by 5 days. Physician ‘compliance’ was defined as having followed three or more of the five elements of the guideline. Results Of the 272 patients, 147 (54.1%) were classified as Grade I, 53 (19.5%) Grade II, 33(12.1%) Grade III, and 6 (2.2%) Grade IV. In 12.1% the grade was not assigned. 43.5% were treated in compliance with the guidelines, of which 83.3% reported improvement at 5 days, compared to 87.7% of those treated otherwise. At 10 days, 98.8% of the patients treated in compliance with the protocol had improved compared to 94.7% of those treated otherwise. Average antibiotic cost/patient was: Grade 1: $8.48, Grade II: $16.65, Grade II: $96.53 in the ‘compliance’ group, and $35.68, $51.28, and $150.18 respectively in the ‘non-compliance’ group. Conclusion Patients treated in accordance with the cellulitis guideline had similar outcomes to those treated otherwise, at significantly lower cost. Efforts to encourage compliance with the guideline are indicated.
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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 | 0.007 | 0.039 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 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".