Practice Patterns Surrounding Surveillance Biopsies in Pediatric Kidney Transplant Patients
Bibliographic record
Abstract
There have been very few advancements in the long-term outcomes of children who have had a kidney transplantation in the current era of immunosuppression. Because of this, some centers have started to perform surveillance biopsies in an attempt to diagnose and potentially treat early or subclinical findings of renal allograft injury. There is very little information on the practice patterns of pediatric nephrologists regarding these biopsies. To gain a better idea of how many centers in North American are doing surveillance biopsies, we sent out a brief survey electronically via the PedNeph email list (https://lists.uchicago.edu/web/info/pedneph), with a reminder sent 4 weeks later. Of the survey respondents, currently 34.3% (23/67) perform surveillance biopsies. We were unable to determine the actual percentage of attending pediatric nephrologists who completed the survey due to 1) membership of people in the listserv who are not physicians, 2) members who are no longer practicing who are still on the list, and 3) members whose email has changed but both of their emails are on the list. We received responses from 60% (33/50) of the top 50 ranked pediatric nephrology centers in the 2016-2017 U.S. News & World Report rankings comprising 29 different states, Canada, and Europe. The majority of responding centers, 68.4% (13/19) do continuous direct sonographic guidance. Not all centers biopsied children at the same time points. 52% (12/23) of centers biopsied patients at 3mo, 69.5% (16/23) at 6 months, 78.2% (18/23) at 1 year and 43.4% (10/23) at 2 years post-transplant. Of the 19 centers that responded to this question, 12 (63.2%) observe the patient and discharge home. Eighty-two percent (18/22) centers who answered the question and perform SB said that the pediatric nephrologist does the SB, and 68.2% (15/22) use direct sonographic guidance. Sixty two percent (13/21) have someone from pathology (technician, pathologist, etc.) present in the room during the procedure to collect the tissue and examine for adequacy. All respondents stated that their complication rates were low, but most did not have specific numbers available. Having a better understanding of the practice patterns among pediatric nephrologists is critical as this is the first step in developing protocols and future research studies. More work needs to be done to examine the finding of these biopsies.
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 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 | 0.002 | 0.012 |
| 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 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".