P-174PLEURAL DISEASES WORKING GROUP OF EUROPEAN SOCIETY OF THORACIC SURGEONS (ESTS): UPDATE OF PROJECT AND ONGOING RESULTS
Bibliographic record
Abstract
Objectives: The last pleural disease guidelines were published in 2010. Despite large number of papers published on malignant pleural effusion (MPE), there are still many doubts and controversies on diagnosis and management. The Pleural Disease Working Group of ESTS is an ambitious initiative for quality improvement of care in MPE. We present an update of the project and the available ongoing results. Methods: The working group undertook 4 projects: analysis of baseline survey of MPE management (analysis of systems of care in different countries); benchmarking project on quality of previous guidelines with Appraisal-of-Guidelines-for-Research-and-Evaluation-II (AGREE-II) instrument; systematic review/meta-analysis of literature according to PRISMA (Preferred-Reporting-Items-for-Systematic-Reviews-and-Meta-Analysis) system; development of updated ESTS Recommendations on MPE management. Results: Survey demonstrates poor adoption of existing clinical guidance, as well as the need for more contemporary and up-to-date guidelines for a better-informed practice. Quality of guidelines assessed by AGREE-II criteria was found to be extremely variable; guidelines achieving higher scores were more likely to come from European Union with direct involvement of scientific societies in development. Systematic review/meta-analysis found that talc poudrage is a more efficient pleurodesis method in MPE than many other frequently used methods. Development of updated ESTS Recommendations has been done using Population-Intervention-Comparison-Outcome (PICO) questions formulated on epidemiology, diagnosis, treatment of MPE; we employ Grading-of-Recommendations-Assessment-Development-and-Evaluation (GRADE) evidence to decision frameworks in Recommendations development to help organize discussion around each recommendation; recommendations and their strength are ongoing and will be decided by consensus, according to GRADE approach. Working Group writing committee has drafted 2 different papers for these projects, which have been submitted to EJCTS/ICVTS. Conclusions: Although there are many guidelines published in literature, quality was extremely variable. It was recognized that some fundamental unanswered questions remain about MPE management. ESTS Pleural Diseases Working Group is still developing updated recommendations with the aim to improve the quality of care for people with MPE across Europe. Disclosure: No significant relationships.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".