141: Evaluation of a Feeding Adequacy Scale for Infants Hospitalized with Bronchiolitis
Bibliographic record
Abstract
Poor feeding is a common nonspecific symptom of bronchiolitis in infants. Poor feeding predicts hospital admission in infants, while adequate feeding predicts safe discharge home from the emergency department in infants with bronchiolitis. A simple, reliable and valid measure of feeding adequacy may improve clinical decision-making about disposition in infants hospitalized with bronchiolitis. However, no such measurement tool exists. To evaluate the measurement properties—validity, reliability, discriminatory power and responsiveness to change—of a visual analogue scale of feeding adequacy, for use in infants hospitalized with bronchiolitis. Otherwise healthy infants six weeks to 24 months admitted to hospital with bronchiolitis were enrolled. On each day of the infant's hospital stay, the primary caregiver and nurse were asked to independently rate the infant's feeding on a feeding adequacy scale (FAS), a visual analogue scale (range 0–10). Other measures of the infant's health status and hospital stay were recorded from the hospital chart. Spearman's rank correlation, intra-class correlation, Ferguson's delta and Wilcoxon signed rank were used to assess validity, reliability, discriminatory power and responsiveness to change, respectively. Twenty-six infants participated in this study. Median age was 2.9 months (range 1.5 to 18 months), and 17 (65%) were male. The FAS was valid, with a negative correlation between FAS on admission and length of stay (Spearman's rank correlation=−0.52, P=0.008). Inter-rater reliability was good (intra-class correlation coefficient=0.72, 95% CI 0.46, 0.87) and the FAS was discriminatory (Ferguson's delta=0.99). There was a significant difference between admission and discharge FAS scores (Wilcoxon signed rank test, P=0.002), reflecting responsiveness to change. This study suggests that the FAS is valid, reliable, discriminatory and highly responsive to change in infants hospitalized with bronchiolitis. This scale may be incorporated into future clinical practice guidelines to standardize efficient and safe discharge practices.
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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 | 0.003 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".