Impact of Timing of Diagnosis of Respiratory Syncytial Virus (RSV) Disease on Hospital Length of Stay (LOS) in Adults: Final Analysis from a Retrospective Chart Review Study
Bibliographic record
Abstract
Despite growing clinical awareness of RSV disease in at-risk adult subpopulations, significant gaps remain in knowledge, especially around diagnosis. This analysis aimed to understand the impact of timing of diagnosis on hospital LOS. A retrospective review of patient charts was conducted. Data for adults ≥18 years with confirmed RSV (Oct 2014–Oct 2016; USA) were collected. Each physician (n = 132) submitted up to 3 randomly selected patient cases via an online survey. This study comprised 379 patients, collected in 4 groups (Table). >80% of patients received an RT-PCR test; rapid antigen tests were uncommon (≤10%) with an RT-PCR test also performed in 45% of these. Early RSV diagnosis and less severe disease were associated with a shorter mean LOS (Figure 1and2). Patients diagnosed >24h post-admission had a longer mean [SD] LOS (9.8 [8.6] days; n = 29) than patients diagnosed <12h post-admission (6.2 [3.9] days; n = 67; P = 0.006), and patients diagnosed 12–24h post-admission (7.4 [4.2] days; n = 56; P = 0.038). LOS was higher (P = 0.005) in patients diagnosed in the intensive care unit (9.4 days) than the emergency room or hospital ward (both 6.8 days). RSV disease in adults was typically diagnosed by PCR. Delayed diagnosis and greater RSV disease severity are associated with longer LOS, but results need to be confirmed by prospective trials. Introduction of diagnostic testing protocols may lead to earlier identification of patients in need of supportive care and reduce mean LOS. Patient demographics and method of diagnosis E. Walsh, Janssen Pharmaceuticals: Scientific Advisor, Consulting fee; I. Sander, Janssen Pharmaceuticals: Independent Contractor, Licensing agreement or royalty; R. Stolper, Janssen Pharmaceuticals: Independent Contractor, Licensing agreement or royalty; J. Zakar, Janssen: Independent Contractor, Licensing agreement or royalty; G. De La Rosa, Janssen Pharmaceuticals: Employee, Salary; V. Wyffels, Janssen Pharmaceuticals: Employee, Salary; D. Myers, Janssen Pharmaceuticals: Employee, Salary; R. Fleischhackl, Janssen Pharmaceuticals: Employee, Salary
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".