P-39: Endoscopic Multidisciplinary Team for Ea-Tef Patients: A Pilot Study
Bibliographic record
Abstract
Multidisciplinary speciality clinics has been shown to improve clinical outcomes in a variety of conditions such as esophageal atresia- tracheo-esophageal fistula (EA-TEF) patients. To review the outcomes of 1 year of combined multidisciplinary endoscopic procedures (gastroscopy, rigid bronchoscopy, flexible bronchoscopy and/or methylene blue test) on patients with EA-TEF to demonstrate that we can extend the benefits multidisciplinary teams to the endoscopic procedures. All multidisciplinary endoscopic procedures on patients with EA-TEF between March 2013 and June 2014 were reviewed. 25 procedures were performed at Montreal Children's Hospital on 21 patients with EA-TEF aged 7 months to 17 years. Two patients had 2 procedures and one had 3 procedures. 11 procedures consisted of: gastroscopy (EGD), flexible and rigid bronchoscopies and a methylene blue test. 7 procedures consisted of an EGD with rigid bronchoscopy. Indications for various procedures were tailored to each child. Airway evaluation as well as excluding a laryngeal cleft or recurrence of TEF accounted for the majority of Respirology and Otolaryngology procedures. 6 procedures were performed to cure a recurrent TEF. Gastroenterology procedures included screening esophagitis as well as endoscopic treatment of esophageal stricture. The common approach allowed the diagnosis of 5 new esophagitis, 1 esophageal stricture, 15 tracheomalacia and 8 laryngeal clefts. We also confirmed the existence of 2 laryngeal clefts, 4 recurrent TEF and 2 esophageal strictures. Six procedures led directly to further investigations (CT-scan or thoracic MRA) before a treatment could be done. A multidisciplinary approach is clearly advantageous to address the medical and surgical needs of the EA- TEF population.
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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 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".