Randomized controlled trial of an intervention to facilitate early mobilization after colorectal surgery: Impact on postoperative pulmonary function and complications
Bibliographic record
Abstract
Background: Early mobilization is believed to improve pulmonary function and prevent postoperative pulmonary complications (PPCs) but adherence is low. The value of allocating resources (e.g. staff time) to increase early mobilization is unknown. This study aimed to estimate the extent to which staff-directed facilitation of early mobilization impact on recovery of pulmonary function after colorectal surgery. We also explored the association of the intervention with 30-day PPCs. Methods: Pre-planned analysis of secondary outcomes of a randomized controlled trial (Fiore Jr et al. Ann Surg 2016 [ahead of print]). Patients undergoing colorectal surgery were randomized 1:1 to usual care (preoperative education) or facilitated mobilization (staff dedicated to assist transfers and walking during hospital stay). Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak cough flow (PCF) were measured preoperatively and at 1, 2, 3 days and 4 weeks after surgery. PPCs were defined according to the European Perioperative Clinical Outcome Taskforce. Results: 99 patients were randomized (57% male, 80% laparoscopic, median age 63 and predicted FEV1 97%). There was no between-group difference in recovery of FVC [adjusted difference in slopes 0.002 L/day (95% CI -0.01 to 0.01)], FEV1 [-0.002 L/s/day (-0.01 to 0.06)] or PCF [-0.003 L/s/day (-0.02 to 0.02)]. 30-day PPCs were also not different between groups [adjusted odd ratio 0.56 (0.18 to 1.71)]. Conclusion: This study does not support the need to allocate resources for enhancing early mobilization to improve pulmonary outcomes after colorectal surgery.
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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 | 0.004 | 0.010 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.014 | 0.001 |
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".