138: Respiratory Illness and Respiratory Syncytial Virus Hospitalizations in Infants with Congenital Airway Anomalies in the Canadian Registry of Synagis® Following Prophylaxis (2005–2013)
Bibliographic record
Abstract
Palivizumab is recommended by national and international pediatric advisory committees for the prevention of respiratory syncytial virus (RSV) infection and subsequent related hospitalization in high-risk infants. The CARESS registry tracks palivizumab use and respiratory outcomes in such infants, including those with congenital airway anomalies (CAA). The primary objective of this study is to compare hazards for hospitalization for respiratory illness (RIH) and RSV positive infection (RSVH) in CAA infants versus those prophylaxed for other pre-existing medical illnesses (MI) and standard indications (SI). Infants who received ≥1 dose of palivizumab during the 2005–2013 RSV seasons were recruited from 32 Canadian sites and followed prospectively. The MI group included a spectrum of infants with underlying disorders such as cystic fibrosis, neuromuscular impairments, Down syndrome and immune-compromised individuals. The SI group comprised preterm infants (≤35 weeks gestational age who were <6 months at the start of the RSV season) and those aged <2 years with either chronic lung disease (bronchopulmonary dysplasia) or infants with hemodynamically significant congenital heart disease. Palivizumab utilization and hospitalization outcomes were collected monthly throughout respective seasons. A Cox proportional hazard analysis adjusting for risk factors compared hazard ratios (HR) across prophylaxis indications. 16,290 infants were enrolled (447 CAA; 2120 MI; 13,723 SI). Infants received an average of 90.5±18.2% of their expected injections, and no significant differences (P<0.05) were seen across groups (F[2, 16268]=2.66; P=0.07). Adjusting for significant (P<0.05) group differences (enrolment age, having siblings, aboriginal origin and multiple birth status) showed CAA infants had a significantly higher hazard of RIH (HR [95% CI]; P value) compared to MI (1.59 [95% C1.03 to 2.44]; P=0.03) and SI (95% C1.85 [95% C1.27 to 2.69]; P=0.001). However, the CAA group had a similar HR for RSVH compared to MI (2.15 [95% C0.75 to 6.21]; P=0.16) and SI (2.28 [95% C0.92 to 5.659]; P=0.08), but other risk factors remained significant (P<0.05). This is the largest report of CAA infants who have received palivizumab world-wide. CAA infants have an increased hazard for RIH compared to MI and SI but appear to have a similar RSVH hazard despite differences in risk factors.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".