Cost-utility Analysis of Oral Antiseptic Chlorhexidine in decreasing Ventilator-associated Pneumonia in Intensive Care Units
Bibliographic record
Abstract
Purpose: To evaluate the cost-utility of chlorhexidine (CHX) mouthrinse (0.12-2%) as compared to placebo/usual care in preventing ventilator-associated pneumonia (VAP), among ventilated intensive care unit (ICU) patients. Methods: A cost-utility (and its sensitivity) analyses were performed using a state transition model. We assumed a daily cycle, lifetime horizon, third party payer perspective, 2015 Canadian Dollars adjusted costs, and a 5% discounted benefits. We performed a meta-analysis to obtain CHX effectiveness in preventing VAP and associated survival. Results: Use of CHX was associated with 0.008 life-years, 0.005 Quality-adjusted life-years (QALYs) lived, and a cost savings of $804.53/patient. Sensitivity analyses showed that an increased mortality risk or reduced effectiveness associated with CHX, or reduced number of prolonged ICU days results in reduced life-years lived and QALYs. Conclusions: CHX oral antiseptic in ICU for preventing VAP as compared to the care without CHX resulted in comparable health outcome, yet it was cost saving.
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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 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.007 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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, 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".