A69 PATIENT WAIT TIME RECALL ACURRACY FOR GASTROENTEROLOGY SPECIALTY CONSULTATION IN NOVA SCOTIA
Bibliographic record
Abstract
Inflammatory Bowel Disease (IBD) is a chronic disease with lifelong health, social, and economic burden. The province of Nova Scotia (NS) has the highest age-adjusted incidence and prevalence rates of IBD in Canada, with Canada having the highest prevalence rates of IBD in the world. The Canadian Association of Gastroenterology guidelines suggest wait times between 2 weeks and 2 months for those with active IBD symptoms. Despite these guidelines, the 2015 audit of the NS Health Authority (Central Zone) showed 50% of IBD referrals were seen within 81 days and 90% of referrals were seen in 732 years. Long wait times can lead to increased anxiety, decreased quality of life, and reduction in patient satisfaction and overall health. Estimating wait times is complex but essential in order to evaluate access to specialty care. 1) To determine whether patients referred to GI specialty services in NS can accurately estimate the length of time between GP referral and first GI specialty appointment; 2) To examine demographic, disease-related, and system factors which may influence the accuracy of patient wait time estimates. Questionnaires were distributed to patients following their appointment with a luminal GI or IBD nurse practitioner. Patients were asked to estimate their wait time for seeing a GI specialist. They were also asked to report on factors that could influence their wait time recall (geographic locale, age, employment status, completed education, disease severity, and relevant comorbidities). Completed questionnaires were returned to the on-site research associate, who then conducted retrospective chart reviews to validate the patients’ responses. A total of 29 patients were enrolled as of October 2016. Twenty (69%) patients were female, with a mean age of 49 years (SD=20.95 years). When patients were asked to estimate their wait time between their referral and seeing a GI specialist, they reported an average of 36 weeks. Following retrospective chart reviews, the patient estimates were shown to be conservative. In reality, records showed the average patient waited 40 weeks from the time the referral was sent to seeing a GI specialist. A Spearman’s correlation was used to determine the relationship between patient estimates and referral dates. There was a strong positive correlation between patient estimates and referral dates (rs=0.680, N=29, p<0.001). This study is the first of its kind to look at patient recall of wait times for gastroenterology in NS. The initial pilot data highlights the reality of excessive wait times in NS for patients seeking care from a GI specialist. Future research will look at access to GI care using a healthcare systems mapping approach to better inform clinical care pathways in the province. None
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".