Utility of Outpatient Cardiac Telemetry Monitoring
Bibliographic record
Abstract
PURPOSE: Chest pain, syncope, dizziness and palpitations during unstructured physical activity, exercise training or sedentary activity are common referrals to pediatric cardiologists. However, due to the sporadic nature of a child’s symptoms, exercise testing may not satisfy the cardiac evaluation. Outpatient transtelephonic mobile cardiac monitoring is the next step in evaluation used by the SickKids cardiac clinic. The objective of this study is to assess the yield of pathological arrhythmia diagnoses in children and teenagers with and without congenital heart disease. METHODS: Retrospective data collection and analysis of all outpatients at our cardiac clinic who were prescribed transtelephonic event monitoring during the year of 2010. RESULTS: 171 patients (ages 14.1 +/- 3.1 years, 50.6% female, 49.4% male) were loaned monitors for a duration of 43 +/- 19.5 days. Out of 171 patients, 112 sent at least 1 transtelephonic recording. Of this group, 55.4% of symptoms were experienced during sedentary activities whereas 29.5% of of episodes were during physical activity such as sports or walking. 15.2% of the recordings sent did not include an activity statement. A positive arrhythmia yield of 18.8% was detected amongst patients who sent a recording. Of the positive yield, 66.7% were captured during physical activity. 10 of these patients underwent subsequent electrophysiology studies. CONCLUSIONS: Documentation of arrhythmia is difficult in children and teenagers, particularly in those who only present with occasional symptoms. For this reason and potential cost-effectiveness, transtelephonic event monitoring should be considered in conjunction with or prior to stress testing.
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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 | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| 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".