1104
Bibliographic record
Abstract
Introduction: In critically ill patients, excessive sedation is a risk factor for psychological morbidity, cognitive impairment and sleep dysfunction. Hypothesis: Psychological, cognitive, functional status, and sleep morbidity differs 1 week (T1) and 6 months (T2) after ICU in adults managed with sedation protocol alone (SP) vs both SP plus daily interruption (DI)1. Methods: At T1 and T2 patients were evaluated for delirium (Confusion Assessment Method), cognitive impairment (Frontal Assessment Battery, FAB), sleep impairment (Medical Outcomes Study Sleep, MOS-sleep), anxiety/depression (Hospital Anxiety and Depression Scale, HADS). At T2 we assessed quality of life (QoL) (SF-36), functional performance (Karnofsky Performance Status, KPS), post-traumatic stress disorder (PTSD) (Impact of Event Scale Revised IES-R) and sleep (Pittsburgh Sleep Quality Index, PSQI). Results: We recruited 63 patients (37 DI;26 SP) from 4 centres; 19 completed measures at T1 only, 21 at T2 only, 23 at both T1 and T2. Mean (SD) age was 50 (15.3) years, APACHE II 22 (7.6), 54% male. No patients had delirium at T1 or T2. HADS anxiety score was 6 (4.5) and 6 (3.6); depression 5 (3.5) and 5 (3.6) at T1 and T2. Depression scores were higher in DI vs SP group at T1, this effect was reversed at T2 (P=.007). HADS>11 indicating probable mood disorder was found for anxiety in 21% (T1) and 14% (T2); 5% (T1) and 7% (T2) for depression. Mean IES-R was 19 (14); 13% scored? 33 suggesting PTSD symptomatology. Lower FAB scores were noted at T1 (14 vs 17 P=.004); 15% had FAB < 12 at T1 indicating cognitive impairment. MOS Sleep-Sleep Problem Index were similar at T1 (42) vs T2 (34) P = 0.10. Mean PSQI score was 8 (4.2) indicating moderate sleep difficulty. Mean SF36 was 61 (12) suggesting acceptable QoL; 25% scored <80 on KPS indicating inability to work. No differences in sleep measures, SF36, KPS and IES-R were noted between SP and DI groups. Conclusions: Short or long-term psychological and cognitive morbidity after sedative minimization strategies was minimal and differed little between SP and DI groups. Sleep impairment was moderate.1. S Mehta et al, AJRCCM 2012;185:A3882Funding: Canadian Intensive Care Foundation/Canadian Institutes of Health Research
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.761 | 0.696 |
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".