Perceptions Among Canadian Physicians and Patients Regarding the Risk of Human T-Lymphotropic Virus in Solid Organ Transplantation
Bibliographic record
Abstract
Human T-Lymphotropic Virus (HTLV) has a low prevalence in the general Canadian population, and rarely causes disease. Solid organ donors are screened for HTLV, however the incidence of transplant-related HTLV disease is low. We assessed knowledge, attitudes, and risk acceptance of HTLV in solid organ transplantation (SOT) among Canadian physicians and local ambulatory care patients. After piloting and ethics approval, physicians in Canadian academic institutions completed a web-based survey. Randomly-chosen local patients attending select clinics completed a questionnaire in person or by telephone. Surveys assessed knowledge of HTLV and assessed theoretical risk of HTLV in SOTs, using standard-gamble and time-tradeoff methods. Patient surveys featured hypothetical scenarios where the particpant estmiated their willingness to accept an organ with potential risk for viral infections, including HTLV. In total, 68 clinicians responded to the survey (response rate of approximately 14.8%). Approximately 26.1% of participants would recommend SOT regardless of community HTLV prevalence. In a community where the prevalence was similar to that of the general Canadian population, SOT recommendation rose to 45.8%. A minority of participating physicians would recommended elimination of HTLV screening in SOT. A total of 75 patients, with a median age of 61.5 years, particpated in the survey. Approxmiately 26% of those surveyed would accept an organ regardless of HTLV risk, however risk acceptance fell to approximately 15% when HTLV was described in terms of rare neurological outcomes. A similar trend was seen in time-tradeoff scenario, whereby participants were willing to trade a median of 4 years (of a 20 year survival after SOT) to ensure an HTLV-free organ, which increased to a median of 10 years, when neurological sequelae were emphasized. This is the first known study to address the opinions of Canadian physicians and patients regarding HTLV risk in SOT. Both groups were willing to accept some risk related to HTLV in SOT, however physicians would not abandon HTLV screening completely. This was consistent with concerns implied bythe patient group, especially regarding the potential for neurological disease. T. Hatchette, GSK: Grant Investigator, Grant recipient. Pfizer: Grant Investigator, Grant recipient. Abbvie: Speaker for a talk on biologics and risk of TB reactivation, Speaker honorarium
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".