387
Bibliographic record
Abstract
Introduction: Regression analyses of single study cohorts (Ely 2004,Pisani 2009,Shehabi 2010) suggest that increased delirium duration is associated with increased mortality. However, the relationship between delirium duration and mortality in randomized controlled trials (RCTs) testing an intervention hypothesized to reduce delirium burden (i.e., duration, severity or complications) remains unclear. Hypothesis: Delirium duration and hospital mortality are associated in RCTs evaluating intervention(s) suspected to reduce delirium burden. Methods: We searched PubMed and meeting abstracts to identify RCTs evaluating drug or non-drug interventions hypothesized to reduce delirium burden in critically ill adults where both delirium duration and survival status (mortality during hospitalization or 21, 28 or 30 days after randomization) were collected. Missing data were obtained from authors; data were extracted in duplicate. Results: 12 studies identified 10 pharmacologic agents (dexmedetomidine [n=5;Pandharipande 2007,Riker 2009,Ruokenon 2009,Reade 2009,Shehabi 2009]; rivastigmine [n=2;Gamberini 2009,van Eijk 2010]; haloperidol [n=1;Wang 2012]; quetiapine [n=1;Devlin 2010]; ziprasidone [n=1;Girard 2010]),1 multimodal treatment (SAT-SBT [n=1;Girard 2008]) and 1 non-pharmacologic treatment (early mobilization [n=1);Schweickert 2009). The average reduction of delirium duration (vs. control) was?3 days (n=2 studies),?1 d (n=3), 0-1 d (n=5), -0.5 to -2 d (n=2). Across the 12 studies, the relationship between difference in delirium duration (i.e., intervention vs. control groups) and hospital mortality was not significant [OR=0.89, 95% CI (0.70,1.50). Excluding the 2 RCTs where the intervention increased delirium duration, the relationship between delirium duration and hospital mortality using a meta-regression technique was not significant (P=0.48). Conclusions: Among RCTs evaluating an intervention hypothesized to reduce ICU delirium burden, no significant relationship between the effect of the intervention on delirium duration and hospital mortality was found. Either no relationship exists, the relationship varies by intervention,or the effect is small and thus larger RCTs are needed to further investigate this relationship.
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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 | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.608 | 0.461 |
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".