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Record W2791759226 · doi:10.1093/jcag/gwy009.222

A222 TRAINEE INVOLVEMENT IN EUS PROCEDURES MAY INITIALLY BE ASSOCIATED WITH GREATER RISK AND LOWER DIAGNOSTIC YIELD: A LARGE SINGLE CENTRE STUDY

2018· article· en· W2791759226 on OpenAlexaffabout
Usman Khan, M J Abunassar, Avijit Chatterjee, Paul D. James

Bibliographic record

VenueJournal of the Canadian Association of Gastroenterology · 2018
Typearticle
Languageen
FieldMedicine
TopicMinimally Invasive Surgical Techniques
Canadian institutionsUniversity of TorontoOttawa HospitalUniversity Health NetworkUniversity of Ottawa
Fundersnot available
KeywordsMedicineEndoscopic ultrasoundDemographicsAdverse effectEndoscopyGeneral surgeryEmergency medicineSurgeryInternal medicine

Abstract

fetched live from OpenAlex

Limited data exists on the quality of advanced endoscopic procedures completed by trainees. The aim of this study was to describe the quality of endoscopic ultrasound (EUS) procedures performed by advanced endoscopy trainees with staff supervision (TS), using diagnostic yield (DY) and adverse event risk (AE) as quality indicators. We performed a retrospective chart review of patients who underwent EUS at The Ottawa Hospital between September 2009 and May 2015. Data was collected regarding patient demographics, procedure details, and DYs. AEs were identified by reviewing all emergency room visits and hospitalizations within 30 days of the patient’s EUS procedure. Relation of the hospital encounter (definitely, possibly and not) to the EUS procedure was established by consensus using pre-defined criteria. 1647 EUS cases were analyzed. The median patient age was 64 (IQR, 53–73) years and 50% of the patients were male. The EUS DY was 78% and the risk of an AE was 3.5% (58 cases). 27% (450) of all EUS procedures were performed by TS. Overall, TS procedures were not associated with a reduction in DY (80%, p = 0.2) or excess AE risk (4.9%, p = 0.06) in comparison to procedures performed by a staff alone (SA). However, TS DY improved every 4 months (Table 1; 76%, 79%, 84%) and TS AE risk was highest in the first and last 4 months of training (Table 1; 6.8%, 2.1%, 5.9%). This trend was not seen for procedures performed by SA (see Table 1). In the first four months of training, EUS procedures performed by trainees may be associated with lower DY and increased risk of AEs. This warrants further evaluation to determine how to avoid compromising service quality during advanced endoscopy training. Table 1. Adverse event risk and diagnostic yield during the training period. *Chi-square or Fisher exact test as required comparing the SA and TS groups. SA= staff alone; TS = trainee with staff None

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 distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.006
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.698
Threshold uncertainty score0.672

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.006
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.019
GPT teacher head0.243
Teacher spread0.224 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2018
Admission routes2
Has abstractyes

Explore more

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