Incorporation of a Comprehensive Pediatric Thrombosis Program into the Multidisciplinary Care Team for Children with Congenital Heart Disease: A Prospective Cohort Study.
Bibliographic record
Abstract
Abstract BACKGROUND: Over the last 10 years, children with congenital heart disease (CHD) have been experiencing increased survival due to diagnostic and surgical techniques. However, associated with this is a requirement for prolonged central venous access which has serious associated sequelae, of which thrombosis is one of the most important. In a busy comprehensive cardiovascular program, the diagnosis, treatment and management of children with or at risk for thrombosis is extremely demanding and constantly changing based on current evidence based recommendations. The Stollery Children’s Hospital, a member of the Western Canadian Children’s Heart Network (WCCHN), is the cardiovascular surgical centre for children with CHD from British Columbia, Manitoba, Alberta, and Saskatchewan An expert Pediatric Thrombosis Team has been incorporated into the multi disciplinary management of children with CHD. This team is dedicated entirely to the diagnosis, management and long term followup of children requiring anticoagulation. MATERIALS/METHODS: A standard approach to the diagnosis, management and long term followup of children with CHD with or at risk for thrombosis was initiated. The Pendragon data base was custom designed to prospectively collect the following data on all children: demographics, treatment and long term outcome. RESULTS: Since the inception of the Thrombosis service (Oct 2003) there have been 325 children who required cardiac surgery with 40% (n=129) of these children requiring Thrombosis consultation. The 4 most common causes for Thrombosis referral have been primary prophylaxis post CHD surgery including mechanical valves, Blalock Taussig shunts, and Fontan procedures, 51% (n=66), suspected CVL related thrombosis 26% (n=33), arterial catheter related thrombosis (catheterization or monitoring) 16% (n=19), and extracorporeal membranous oxygenation 9% (n=11). By Oct 2004, it is anticipated that 300 children will have been consulted on. CONCLUSIONS: The 1st year results of the data collected on this prospective cohort will be presented including demographics, reason for anticoagulation, diagnosis, and long term outcome.
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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 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".