Bibliographic record
Abstract
PURPOSE OF REVIEW: Intensivists have a professional and personal interest in trying to answer whether immediate review of patients by a consultant intensivist improves outcomes. Although some advocate in-hospital around-the-clock consultant intensivist presence, does the available evidence suggest all ICUs should be staffed in such a manner and is such a service sustainable given the shortage of intensivists, potential loss of staff from burnout and cost? RECENT FINDINGS: We present in narrative form the background and recent literature for a consultant resident service in terms of the ethical tenets of nonmaleficence, beneficence, autonomy and justice. Nonmaleficence - what is the evidence it is bad for patients not to provide a resident service? Beneficence - what is the evidence a resident intensivist service is good for patients? Autonomy - is it in intensivists' own interests to provide a 24-h service? And justice - is it a justifiable use of healthcare resources? SUMMARY: A unified staffing solution within a country's different ICUs, let alone between countries, is unlikely. The current evidence does not universally support or justify 24 h/7 days consultant intensivist presence. International differences in staffing models and ICU structures make direct comparisons difficult and in some circumstances the balance may favour 24 h/7 days consultant intensivists.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 teacher head, 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".