A215 COMPLICATIONS OF PEDIATRIC PERCUTANEOUS LIVER BIOPSY AMONG PHYSICIANS WITH DIFFERENT DEGREES OF TRAINING
Bibliographic record
Abstract
Percutaneous liver biopsy (PLB) is considered the gold standard method for the diagnosis of liver diseases. The most feared complication is major bleeding, reported in about 1% of the biopsies performed in adults, believed to occur more frequently in children. To compare the effectiveness and safety of PLB in children according to training level (trainees vs. staff). Retrospective single center study. Biopsies over a period of 8 years were reviewed (February 2010 - April 2018). The procedure was performed under sedation with Midazolam and Dextroketamine after the puncture site was demarcated with ultrasonography. Biopsies were performed either by first year pediatric gastroenterology fellows or by experienced staff, using Menghini technique. Complications and number of attempts/ punctures were analyzed according to the level of training of the physician performing the biopsy. A total of 212 PLB were performed. 54.6% of patients were females, with a median age of 3.3 years. The main indication for the biopsy was neonatal cholestasis, in 27.9%. The biopsy was performed by trainees in 81.5% (167) of cases. The number of punctures to obtain a satisfactory sample ranged from 1 to 5, with decreasing frequencies of 52.5%, 32.9%, 20.6%, 2.7%, and 1.1% respectively. Fragments were considered appropriate for histological diagnosis in 95.6% of the biopsies performed. Drop in hemoglobin greater than 15 and 20 g/L were registered in 14.1% and 6.3% of patients, respectively, while bleeding with clinical repercussion occurred in 0.9% - 2 out of the 205 patients (one of these needed a surgical intervention). No differences were observed between the groups (fellows vs. staff physicians) regarding the number of punctures to obtain a satisfactory sample (median of 1.7 in both groups), drop in hemoglobin (median of 0.7 vs. 0.5 g/L), the occurrence of bleeding with clinical repercussion (both events in the trainee group) or sampling of non-representative biopsies (4.2 vs. 2.6%). Percutaneous liver biopsy is a safe procedure in children. The incidence of major bleeding in this population is similar to that reported in adults. Complications of the procedure did not differ on biopsies performed by first year gastroenterology fellows and staff physicians. 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 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".