VARIABILITY IN ONTARIO LONG-TERM CARE PRACTICES FOR SCREENING AND TREATMENT OF VITAMIN B12 DEFICIENCY
Bibliographic record
Abstract
Background: Vitamin B12 deficiency is avoidable through screening and treatment. Deficiency in long-term care impacts ~35% of residents, yet it remains unclear as to what long-term care homes are doing to address this issue. Objective: For the first time, to describe the state of B12 screening and treatment protocols in Ontario long-term care homes, influence of geography and corporate structure on protocols, and the proportion of residents who are currently under treatment. Design: This cross-sectional study used stratified random sampling. Setting: Ontario long-term care homes. Participants: Forty-five standardized phone interviews were completed with the directors of nursing care. Measurements: The following measurements were collected: home demographics (geography, for-profit status etc.), protocols pertaining to vitamin B12 testing, treatment, the cutpoint each home uses to define B12 deficiency, proportion of residents receiving B12 and the treatment method (intramuscular injection vs. oral). Results: Cut-off values for determination of B12 deficiency varied (31% <156 pmol/L). Admission and follow-up B12 testing were routinely conducted in 66% (30/45) and 88% (35/40) of long-term care homes respectively. On average 25 16% of current residents received treatment (41/45 homes reporting). Conclusions: Variability in detection and treatment of B12 deficiency in LTC, potentially places residents at risk for undetected deficiency. Regular testing and monitoring beginning at admission may provide a solution, however, there is a need both for further studies targeted at addressing the effect of treatment on improved clinical outcomes as well as a formal cost-benefit analysis for screening and subsequent treatment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.027 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| 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".