Reliability of Neck Mass Point‐of‐Care Ultrasound by Pediatric Emergency Physicians
Bibliographic record
Abstract
OBJECTIVES: Neck masses are a common reason for presentations to the pediatric emergency department (PED). We sought to determine the agreement and time difference between point-of-care ultrasound (POCUS) imaging by pediatric emergency physicians compared to radiology department imaging for children with neck masses in the PED. METHODS: We performed a retrospective study of patients aged 0 to 18 years presenting to our tertiary PED who received both POCUS by a pediatric emergency physician and radiology department imaging. Charts were reviewed for POCUS diagnoses, final diagnoses, and imaging time metrics. RESULTS: Seventy-five patients met the study criteria. In 58 of 75 cases there was agreement between the POCUS diagnosis and final diagnosis (κ = 0.71; 95% confidence interval, 0.6-0.83). There was agreement in 25 of the 28 cases in which POCUS examinations were performed by PED physicians with fellowship training in POCUS (κ = 0.87; 95% confidence interval, 0.72-1.00). The results for POCUS were generated in a median of 115 minutes (interquartile range, 68-185 minutes) before radiology department imaging results. CONCLUSIONS: Point-of-care ultrasound imaging by pediatric emergency physicians for children with neck masses is a promising new POCUS application that may be able to save time in the PED.
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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 | 0.010 | 0.080 |
| 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 | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".