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Record W2568920249 · doi:10.1111/nhs.12320

The complex patient: A concept clarification

2017· review· en· W2568920249 on OpenAlexafffund
Elizabeth Manning, Marilou Gagnon

Bibliographic record

VenueNursing and Health Sciences · 2017
Typereview
Languageen
FieldMedicine
TopicChronic Disease Management Strategies
Canadian institutionsUniversity of OttawaSimon Fraser University
FundersSimon Fraser UniversitySFU Community Trust Endowment FundMcGill University
KeywordsMultidisciplinary approachMeaning (existential)Dual (grammatical number)Health careEpistemologyDisciplinePsychologyInterpretation (philosophy)Engineering ethicsManagement scienceSociologyComputer sciencePsychotherapistSocial scienceEngineeringPolitical science

Abstract

fetched live from OpenAlex

Over the last decade, the concept of the "complex patient" has not only been more widely used in multidisciplinary healthcare teams and across various healthcare disciplines, but it has also become more vacuous in meaning. The uptake of the concept of the "complex patient" spans across disciplines, such as medicine, nursing, and social work, with no consistent definition. We review the chronological evolution of this concept and its surrogate terms, namely "comorbidity," "multimorbidity," "polypathology," "dual diagnosis," and "multiple chronic conditions." Drawing on key principles of concept clarification, we highlight disciplinary usage in the literature published between 2005 and 2015 in health sciences, attending to overlaps and revealing nuances of the complex patient concept. Finally, we discuss the implications of this concept for practice, research, and theory.

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 machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.022
metaresearch head score (Gemma)0.041
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.022
Threshold uncertainty score0.117

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0220.041
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0020.002
Bibliometrics0.0070.005
Science and technology studies0.0020.011
Scholarly communication0.0080.016
Open science0.0030.008
Research integrity0.0050.010
Insufficient payload (model declined to judge)0.0040.001

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.

Opus teacher head0.523
GPT teacher head0.561
Teacher spread0.039 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreReview

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".

Quick stats

Citations109
Published2017
Admission routes2
Has abstractyes

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