MétaCan
Menu
Back to cohort
Record W2171733960 · doi:10.1136/heart.89.3.349

DO GUIDELINES INFLUENCE PRACTICE?

2003· review· en· W2171733960 on OpenAlexaff
Paul W. Armstrong

Bibliographic record

VenueHeart · 2003
Typereview
Languageen
FieldMedicine
TopicClinical practice guidelines implementation
Canadian institutionsUniversity of Alberta
Fundersnot available
KeywordsMedicineMEDLINEIntensive care medicine

Abstract

fetched live from OpenAlex

Clinical practice guidelines are consensus statements systematically developed to help physicians, and ultimately patients, make decisions about appropriate health care for specific clinical circumstances. Over 20 years ago the American College of Cardiology (ACC) and the American Heart Association (AHA) established a joint task force to define the role of specific, non-invasive and invasive procedures in the diagnosis and management of cardiovascular disease.1 More specifically, this was initially aimed at establishing the appropriate utilisation of technology in the diagnosis and treatment of cardiovascular patients and was initially directed towards the development of guidelines for permanent cardiac pacemaker implantation. Subsequently, task forces have played an important role in developing other guidelines for a host of cardiovascular, medical, and surgical conditions as well as diagnostic procedures. Using rules of evidence and clinical recommendations originally developed by Sackett for the use of antithrombotic agents, a relatively systematic approach (see box) towards the generation of guidelines has emerged.2 Framed by three levels of evidence, recommendations are categorised as: (1) data derived from multiple randomised clinical trials; (2) data derived from a single randomised trial or non-randomised studies; and (3) where data does not exist but a consensus opinion is developed from a variety of experts. When recommendations emerge from consensus opinion, these often emanate from strongly held and sometimes diverse views giving some substance to the perspective of Abba Eban, former Israeli Ambassador to the United Nations, who suggested that “consensus means that lots of people say collectively what no one believes individually”. Approximately 25 such guidelines have emerged since the ACC/AHA commenced joint production of these in 1980 making it difficult to stay abreast of the volume of recommendations. Indeed, as recently reported by Ohman and Peterson, even within the three guidelines for ischaemic heart disease encompassing chronic stable angina, unstable …

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 distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.048
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.824
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.048
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.001
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.003

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 head0.613
GPT teacher head0.651
Teacher spread0.037 · 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 teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreReview

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

Citations22
Published2003
Admission routes1
Has abstractyes

Explore more

Same venueHeartSame topicClinical practice guidelines implementationFrench-language works237,207