Critical Congenital Heart Disease Screening in NICU: Need for Revision and Standardization
Bibliographic record
Abstract
Abstract Screening for critical congenital heart disease (CCHD) at 24 to 48 hours after birth or before discharge in newborn nurseries using pulse oximetry is effective and is mandated by most states. However, there is no established protocol for screening in a neonatal intensive care unit (NICU), a setting where neonates are continuously monitored by pulse oximetry, hypoxemia from noncardiac causes is common, and echocardiograms are frequently obtained. CCHDs with hypoxemia are suspected on admission and investigated with an echocardiogram before a formal screen in the NICU. The most common CCHD lesions missed in a NICU setting are secondary targets of the screen, such as aortic arch anomalies (coarctation or interrupted aortic arch). The sensitivity of the current pulse oximeter–based CCHD screen to diagnose aortic arch anomalies is low. Given that infants are monitored with continuous pulse oximetry and frequent examinations, novel revisions to the current screening methods are necessary to detect asymptomatic NICU infants with aortic arch anomalies before discharge. Exclusions (whom to screen), technique (how to screen), and timing (when to screen) for primary and secondary targets of CCHD in the NICU are not known and require further research.
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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 | 0.012 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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.
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".