Development of a Standardized Follow Up for Pediatric Transplant Long Term Survivors by Family Physicians
Bibliographic record
Abstract
Indications for stem cell transplantation (SCT) in the pediatric population are increasing, and patients are expected to live long and productive lives. However, they do require lifelong follow up, dictated by the initial diagnosis and late toxicities. Like most pediatric centers, patients over 21 years old can no longer be followed by our pediatric team and need to be transferred to an adult facility. At our institution, we are facing the challenge of a lack of available resources to transfer all of our patients to an adult transplant facility. In this situation, how can we best provide patients with a proper and safe follow-up when the adult transplant center cannot accept the entire patient cohort? In order to achieve this goal, we have developed a standardized protocol to direct our patients toward the most appropriate facility. Referral to the adult transplant team is restricted to those patients presenting with GVHD, hematologic toxicity or more than two organs' involvement. All of our other patients, which represent the vast majority, will be referred to their family physician with specific guidelines. However, most of them don’t have a family physician as the follow up of SCT patients may seem complex. First, our protocol will help guide and support our patients in identifying a family physician, which can take up to two years. Once a referring doctor is found, the transplant physician and the nurse navigator will prepare a file containing the patient medical summary and guidelines detailing the recommended follow up and possible long term sequelae. Also, our team remains available to answer questions. Finally, we encourage family physicians to send us periodical summary charts. Information about the recommended follow up and good life habits are previously given to patients to promote their autonomy and facilitate a smooth transition. This procedure is an important part of our teenagers transplant clinic that was just implemented. This procedure started about a year ago, and so far, it seems to be a positive experience for everyone involved.
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 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 | 0.026 | 0.045 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.005 |
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".