97: Variations in Patent Ductus Arteriosus Treatment of Very Preterm Neonates from 7 Countries: The iNeo Experience
Bibliographic record
Abstract
Consensus regarding management for patent ductus arteriosus (PDA) in preterm infants is lacking and practices vary internationally. To compare PDA treatments in very preterm infants from seven national neonatal networks worldwide. Infants born at 24–28 weeks GA during 2007–10 with birth weight (BW) <1500 g and no major congenital anomalies were retrieved from the International Network for Evaluating Outcomes in Neonates (iNeo) database. PDA treatments of pharmacologic-only, ligation-only, or both pharmacologic and ligation were compared between each country and all others, using standardized ratios (SRs) and 95% confidence intervals (CI) with adjustment for case-mix factors. SR compared the observed and expected number of infants with each PDA treatment. For each country, the expected number was determined as the sum of the predicted probabilities from a multivariable logistic model derived using data from all other countries, and adjusted for linear and quadratic GA and BW Z-score, multiple birth, sex, antenatal steroid, cesarean section, and interactions GA*BW Z-score, BW Z-score*multiple birth. Marked variations in PDA treatment rates (either pharmacologic or ligation) were detected between countries ranging from 14% in the United Kingdom Neonatal Collaborative (UKNC) to 50% of neonates in Japan who received active treatments.[figure 1]. The rates of any ligation (with or without pharmacological treatment) varied from 3.2% in UKNC to 12% in Canada. PDA treatment rates varied significantly between countries. This may relate to differences in case ascertainment, diagnostic criteria, timing of evaluation, care provision practices, availability of surgical services, or unmeasured population characteristics. Future study is required to characterize differences in selection/indication of PDA treatment approaches and their effects on infants' outcomes.
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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 | 0.011 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| 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".