162: Diagnosis and Treatment of Kawasaki Disease in a Paediatric Tertiary Care Centre: A Quality Review
Bibliographic record
Abstract
Kawasaki disease (KD) is the leading cause of acquired cardiovascular disease in children in North America and an important cause of childhood morbidity and mortality owing to its predilection for coronary arteries. Proper diagnosis and treatment of KD can decrease this risk. We conducted a retrospective chart review to evaluate adherence to the AHA/AAP guidelines for acute management and follow-up of patients with both typical and incomplete KD. Our objectives were to determine the frequency of KD diagnosed at our institution, and the proportion of KD diagnoses which are made and treated according to the AHA guidelines. This was a retrospective chart review of all patients admitted to our institution with a diagnosis of “Kawasaki Disease” between January 2004 and December 2011. The clinical diagnostic criteria and supporting laboratory criteria were identified for each patient at the time of diagnosis. Each patient was categorized as typical or incomplete KD independently based on the retrospective information and this was compared to the admitting physician's diagnosis. Dose and duration of IVIG and ASA therapy was reviewed. A total of 134 charts were reviewed, with 104 having a discharge diagnosis of KD. Based on retrospective application of criteria, 46 patients (44.2%) had typical KD, 16 (15.4%) had incomplete KD, and 42 (40.4%) who were discharged with a diagnosis of KD did not have the disease based on criteria. At diagnosis, 27 (26%) of patients had abnormal findings on echocardiography. A total of 91 patients (87.5%) were treated with IVIG. Suspected KD patients admitted to our institution are being treated as typical KD at a higher degree than recommended by the AHA/AAP guidelines. Deviation from the algorithm occurred in incomplete KD patients with ≤3 supplemental lab criteria as they often received IVIG despite a negative echocardiogram. This information and ongoing analysis may be used in support of developing a clinical practice guideline for our institution, thus ensuring all patients in our facility are receiving standard of care concerning the diagnosis and treatment of KD.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.005 | 0.027 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.009 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| 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".