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Evidence-based approach to congenital thoracic malformations

2017· letter· en· W2747578437 on OpenAlexaboutno aff
Andrew Bush

Bibliographic record

VenueArchives of Disease in Childhood · 2017
Typeletter
Languageen
FieldMedicine
TopicCongenital Diaphragmatic Hernia Studies
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineAsymptomaticCongenital malformationsPediatricsGeneral surgerySurgeryPregnancy

Abstract

fetched live from OpenAlex

There is a clear need for more evidence as to how to deal with asymptomatic congenital thoracic malformations (CTMs), and thus the recent series from Great Ormond Street Hospital1 and the accompanying editorial2 are to be welcomed; however, the evidence review is incomplete. The risk of complications in non-operated CTMs after the postnatal period over around a decade was estimated at 3.2% in a meta-analysis.3 Although pleuropulmonary blastoma (PPB) may develop de novo postnatally, undoubtedly PPB may develop in a CTM, as may other malignancies, and the biggest population based study from Canada estimated the risk of PPB as 4% in ‘benign’ resected CTM;4 worryingly there were no radiological features to differentiate them. Unfortunately, and contrary to the editorial statement,2 complete resection of a CTM does not eliminate the risk of malignancy.5 6 Finally, rare but fatal cases of air embolism in adults with a CTM during commercial flight have been described.7 8 Clearly the vast majority of CTMs remain asymptomatic for decades, posing a difficult decision for already anxious parents with a totally well infant. I suggest the above data should be shared with parents in an open discussion, so that informed choices can be made. Personally, I consider the risks of thoracoscopic surgery in competent hands should be far less than the risk of complications, and advocate elective removal of all but the most trivial CTMs, while respecting the views of parents and professionals who disagree. Certainly the follow-up protocol proposed by Cook et al for those non-resected CTMs should be tested prospectively in the sort of big international study which will be truly definitive.

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)0.029
metaresearch head score (Gemma)0.152
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: Commentary · Consensus signal: none
Teacher disagreement score0.029
Threshold uncertainty score0.151

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0290.152
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0070.009
Bibliometrics0.0160.008
Science and technology studies0.0010.003
Scholarly communication0.0090.006
Open science0.0070.004
Research integrity0.0100.017
Insufficient payload (model declined to judge)0.0150.004

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 head0.047
GPT teacher head0.305
Teacher spread0.258 · 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
GenreCommentary

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

Citations1
Published2017
Admission routes1
Has abstractyes

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