Comparison between ultrasound and nerve stimulation for infraclavicular catheter placement – a reply
Bibliographic record
Abstract
I thank Drs. Dalay and Jagannathan for their interest in our study, which compared nerve stimulation with ultrasound guidance for infraclavicular catheter placement 1. We agree that patients with higher BMI may benefit from regional anesthesia, even though the risk of block failure is higher 2, 3. We excluded very obese patients (BMI > 35 kg.m−2) in order to reduce the contribution of obesity as a confounding factor in our comparison. However, we did include overweight (BMI 25.0–29.9 kg.m−2) and obese (BMI 30.0–34.9 kg.m−2) participants, as it would have been unreasonable to exclude them, given rates of obesity within the general population. Effectively, therefore, we excluded approximately 8–11% of potential participants, based on Canadian population statistics for obesity 4. With regard to using ultrasound and nerve stimulation together, the present study originated from a previous, small study in which we compared dual guidance with nerve stimulation 5. As the usefulness of dual guidance is debatable 6, 7, we designed the present study to compare only one method of guidance with the other. We retained equipoise when comparing complications between the two techniques, as there appears to be no difference in neurological injury between ultrasound and nerve stimulator-guided peripheral nerve blockade 8.
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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 | 0.007 | 0.049 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.019 | 0.020 |
| Insufficient payload (model declined to judge) | 0.004 | 0.003 |
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".