Improving the use of sputum cultures in lower respiratory tract infection
Bibliographic record
Abstract
BACKGROUND: The clinical value of sputum culture in suspected lower respiratory tract infection (LRTI) remains contentious. The quality of samples submitted significantly impacts their clinical usefulness. METHODS: Using pre-defined criteria we prospectively analysed the appropriateness of sputum samples submitted from consecutive patients with suspected LRTI attending two acute hospital units over ten weeks. We then provided an education package for staff on when and how to collect appropriate sputum samples, and repeated the evaluation. RESULTS: Our intervention reduced sample numbers from 347 to 133, simultaneously increasing the proportion of appropriately sent samples from 40.5 to 60.2% (p=0.001) and reducing cost. Appropriate sampling was associated with a higher yield of pathogens (relative risk 1.51, 95% confidence intervals 1.03-2.21, p=0.03). The rate at which sputum samples appeared to alter clinicians' management remained low and constant at 18% pre- and post-intervention. CONCLUSION: A simple educational intervention can significantly increase appropriateness of sputum sampling, reducing workload and cost.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 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".