68 Prognostic Value of Bronchopulmonary Dysplasia, Brain Injury and Severe Retinopathy in Determining Neurodevelopmental Outcome in Extremely Low Birth Weight Infants
Bibliographic record
Abstract
Extremely low birth weight infants (ELBW) are at high risk for developmental impairment. Predicting such risk for ELBW survivors is difficult. Recently, Schmidt et al. proposed such risks can be accurately predicted for ELBW infants surviving to 36 weeks corrected gestational age (cGA), using a simple numerical count of three specific neonatal morbidities: bronchopulmonary dysplasia (BPD) – defined as supplemental oxygen at 36 weeks cGA, brain injury – defined as the presence of Grade 3 or 4 intra-ventricular haemorrhage, porencephalic cyst, ventriculomegaly, periventricular leukomalacia, or hydrocephalus, and severe retinopathy of prematurity (ROP) – defined as bilateral Grade 3 or 4 or threshold disease. We evaluated this prediction rule using a regional follow-up database of ELBW infants. The study included a total of 225 ELBW infants (birth weight 500–999 g) who were born in Manitoba, Canada between 1992 and December 2001 and survived to 36 weeks cGA. The morbidities of interest (BPD, brain injury, and ROP) were abstracted. Poor outcome was defined as death or neurodevelop-mental impairment (the presence of one or more of cerebral palsy, cognitive delay, severe hearing loss, and bilateral blindness by 14–26 months of age cGA). Of the 225 infants, 86 developed BPD (38.2%), 80 (35.6%) had a brain injury, 82 infants (36.4%) had severe ROP. Five of the 225 infants died after 36 weeks cGA. The overall risk of death or poor neurodevelopmental impairment was 46.2%. Without any of the three neonatal morbidities, the risk of poor outcome was 22%. There was an increase in risk of poor outcome with increasing number of neonatal morbidities. The risk of poor outcome with any single neonatal morbidity, any two neonatal morbidities and any three neonatal morbidities was 37.7%, 75% and 84.8% respectively (Figure 1). We conclude that the simple count of the three neonatal morbidities suggested by Schmidt et al. can be a useful predictor of the risk of death or neurodevelopmental impairment in ELBW infants surviving to 36 weeks cGA. Percentage of Poor Outcome (14–26 Months) in Study Infants With 0, 1, 2, and All 3 Neonatal Morbidities. Dotted line indicates overall percentage of poor outcome (46.2%). 0 morbidity=22%, 1 morbidity=37.7%, 2 morbidities=75%, 3 morbidities =84.8% of poor outcome
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 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) | 0.001 | 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".