EPI-01REVIEW OF CLINICAL PRESENTATION AND TRAJECTORY OF PEDIATRIC PATIENTS (0-18 YEARS OF AGE) WITH A DIAGNOSIS OF PRIMARY BRAIN TUMOUR (BT) IN A PEDIATRIC TERTIARY CENTER
Bibliographic record
Abstract
INTRODUCTION: Recognition of BT remains a challenge among pediatric patients. Few studies have treated initial presentation, clinical evolution and healthcare system factors in the same cohort. OBJECTIVES: To determine the presentation patterns and health care trajectory of patients with primary BT. Compare presentation patterns between different age groups and different settings of diagnosis. METHOD: Through a retrospective chart review of patients <18 yo diagnosed with primary BT by neuroimaging between 2003 and 2014. RESULTS: 288 patients were identified. Mean age at diagnosis: 7.44 ± 0.29 years. 35% consulted only once prior to diagnosis. Mean time between the onset of symptoms and diagnosis: 147 ± 19 days; or first consultation: 84 ± 14 days. Most frequent symptoms/signs at onset and diagnosis were respectively: headache (44% vs 59%, p <0.001), nausea/vomiting (31% vs 58%, p <0.001), gait abnormalities (10% vs 32%, p <0.001). 129 patients (45%) were diagnosed in an Emergency Department (ED), while 96 patients (33%) were diagnosed as outpatients. Symptoms/signs that differed for those diagnosed in ED were: headache (71% vs 42%, p <0.001), nausea/vomiting (73 % vs 32%, p <0.001), lethargy (26% vs 9%, p = 0.002). Clinical presentations of infants <3 yo (20%) differed from other age groups. They presented mostly with lethargy (35%), irritability (33%), macrocephaly (26%). CONCLUSION: Headache is the most common presenting symptom of BT. Diagnosis is most frequently made in the ED. The delay between the onset of symptoms and diagnosis is up to five months, mostly after multiple consultations.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 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 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".