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RF14 A systematic review of 30-day readmissions in adults hospitalised with community-acquired pneumonia

2018· review· en· W2905386555 on OpenAlex
AM Klukowska, Wee Shiong Lim, Tricia M. McKeever, Harry Pick, Deborah Ashton

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueOral Presentations · 2018
Typereview
Languageen
FieldMedicine
TopicChronic Disease Management Strategies
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineMeta-analysisPneumoniaCommunity-acquired pneumoniaConfidence intervalSubgroup analysisMortality rateMEDLINEInternal medicineEmergency medicinePediatrics

Abstract

fetched live from OpenAlex

<h3>Background</h3> Community-acquired pneumonia (CAP) is one of the most common communicable diseases worldwide associated with significant levels of morbidity and mortality causing a substantial economic burden. 30-day hospital readmission rate is often used as a secondary outcome in studies of CAP. This data can be used to define the burden of disease and the reasons for readmissions potentially amenable to intervention. A systematic review and random meta-analysis were conducted to estimate the pooled 30-day readmission rate of adult patients with CAP and 30-day pneumonia-related/non-pneumonia-related and cardiovascular-related readmission rates of such patients. <h3>Methods</h3> MEDLINE, EMBASE, AMED (until October 2017) and reference lists of papers were searched to identify studies of CAP including 30-day hospital readmission rate of adult patients. Each step of the study selection process was conducted by two independent reviewers. The quality was assessed using a pre-tested form based on the Newcastle-Ottawa Scale. Pooled proportions of patients readmitted within 30 days with 95% confidence intervals (CI), were estimated. Additional subgroup analyses were conducted. <h3>Results</h3> A total of 63 studies were included in the statistical analysis, covering the period from 1994 to 2017. The pooled 30-day readmission rate estimate was 0.10 (CI 0.08–0.11). High levels of heterogeneity were identified, I<sup>2</sup>=98.95%. Only two subgroups analysis reported statistically significant differences (<i>p-value</i> &lt;0.05). Retrospective studies had a higher readmission rate of 0.12 (95% CI 0.10 to 0.14, I<sup>2</sup>=99.39%) compared to prospective studies, 0.07 (95% CI 0.06 to 0.09, I<sup>2</sup>=93.35%). Europe had significantly lower 30-day readmission rate, 0.08 (95% CI 0.07 to 0.10, I<sup>2</sup>=94.98%) than North America, which reported 0.11 (95% CI 0.09 to 0.14, I<sup>2</sup>=99.50%). Non-pneumonia-related readmissions accounted for 0.60 (95% CI 0.48 to 0.72, I<sup>2</sup>=89.00%) of all 30-day readmissions. Additionally, 0.31 (95% CI 0.25 to 0.37, I<sup>2</sup>=79.74%) of 30-day readmissions were pneumonia-related, while 0.20 (95% CI 0.14 to 0.26, I<sup>2</sup>=33.55%) were cardiovascular-related. The studied populations were mostly composed of elderly patients. High levels of heterogeneity may have been due to different selection criteria of included studies and variations among health-care systems and treatment practices. <h3>Conclusion</h3> Among all adult patients with CAP, 10% are readmitted to the hospital within 30 days. The majority of all-cause readmissions are non-pneumonia-related, specifically 20% are cardiovascular related. Only one third of 30-day readmissions are due to pneumonia.

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.

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)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.025
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0030.000
Bibliometrics0.0000.001
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 head0.079
GPT teacher head0.403
Teacher spread0.325 · 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