P.039 In-hospital endocrinology consultation in post-operative pituitary surgery: is it necessary?
Bibliographic record
Abstract
Background: In-hospital Endocrinology consultation (IHEC) following transsphenoidal surgery is often routine but may be -unnecessary, lead to excessive blood testing, and prolong in-hospital stay. Purpose of this study: to determine whether the necessity of IHEC can be predicted by a standardized operative assessment tool. Methods: Retrospective review of all transsphenoidal surgeries from January 1, 2016, when we instituted an operative assessment tool to identify patients for which IHEC is required. Minimum follow-up: 3 months. Results: 78 patients (42 male; mean age: 57 yrs); the assessment tool identified 17 patients (22%) for IHEC and accurately identified those who would not require IHEC. IHEC patients had longer hospital stay (8.3 vs. 2.9 days), higher rate of new post-operative hormonal deficit (17.6% vs. 0%) and higher 30-day readmission rates (35% vs. 16%). Less than 10% had transient symptoms attributable to steroids; there were no long-term complications from routine post-operative steroid administration. Conclusions: Use of our operative assessment tool shows that at least three quarters of pituitary surgery patients can be managed safely without IHEC. Our data indicate that identifying these patients may reduce in-hospital stay and costs with no evidence of compromise of hormone-related care.
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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 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".