The Rothman Index: Assessing risk for 30-day readmission in gynecologic oncology service patients
Bibliographic record
Abstract
Background: The Rothman Index (RI) is a previously validated, continuously computed score derived from 26 clinical measures that assesses a patient's clinical status. It has been used as a prognostic indicator in the intensive care setting and has been incorporated into the electronic medical record. This study was designed to determine its utility in assessing 30-day readmission rates in postoperative gynecologic oncology service patients. Methods: In this retrospective case-control study, gynecologic oncology service surgical patients readmitted within 30 days of discharge (cases) were matched 1:2 by procedure, diagnosis, age and comorbidities to non-readmitted gynecologic oncology surgical patients (controls). All procedures were performed at one center by a single surgeon. Rothman Index values were obtained immediately postoperative (RIp) and before discharge (RId), and the difference between these values was calculated (RIc). Rothman Index scores were compared between cases and controls. Results: In total, 24 cases were matched to 48 controls. The mean age of all study participants was 56 years. The RId was significantly different between groups, with median RId of 70 for readmitted subjects and 75.5 for controls (P = .029). Binomial regression of readmission on RI revealed an RId of 58.9 or less was associated with at least 50% likelihood of readmission (P = .017). Cases and controls did not significantly differ based on RIp or RIc, and were similar with respect to risk factors including diabetes, smoking, and BMI. Conclusion: Delaying discharge for patients with RI below a designated threshold may reduce gynecologic oncology postoperative readmission rates.
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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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| 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".