Validation of RSV infections in pediatric transplant recipients reported to a national surveillance program: A PICNIC study
Bibliographic record
Abstract
Background: Respiratory syncytial virus (RSV) infections are a common cause of morbidity and mortality in pediatric transplant recipients. From 2010 to 2013, the Canadian Paediatric Surveillance Program (CPSP) performed national active surveillance of RSV infections occurring in the 2 years following hematopoietic stem cell transplant (HSCT) or solid organ transplant (SOT). This study aimed to validate accuracy of reporting of inpatient cases of post-transplant RSV infections to the CPSP. Methods: Transplant recipients <18 years with potential RSV infection were retrospectively identified from 9 tertiary-care pediatric centres, using ICD-10 codes for RSV and transplant from hospital and local laboratory information systems. Cases included after chart review were cross-referenced with the CPSP database. Sensitivity and positive predictive value (PPV) of the CPSP were calculated, and characteristics of reported and non-reported cases compared. Results: Of 27 cases found using this retrospective search of administrative databases, 8 (30%) had been reported to the CPSP; 10 additional cases reported to the CPSP were not detected by the study. Sensitivity of the CPSP was 30% (95% CI 14% to 50%), and PPV was 44% (95% CI 22% to 69%). The proportion of HSCTs was lower among cases reported to CPSP than among those not reported (13% versus 59%; p=0.03). More community-acquired RSV infections were noted in the reported group than in the non-reported group (100% versus 59%; p=0.04). Conclusion: The CPSP showed poor sensitivity and PPV for detecting RSV infections in pediatric transplant recipients. Additional strategies are needed to develop a surveillance program sufficiently sensitive to capture the burden of RSV in this population to inform preventive approaches.
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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 | 0.007 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| 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".