Bibliographic record
Abstract
Introduction Acute myocarditis (AM) is a major cause of troponin positive chest pain in patients without obstructive coronary disease. Many cases relate to viral infection. Drug toxicity, alcohol and auto-immune diseases have also been implicated. Diagnosis is difficult and cardiac MR (CMR) can confirm/exclude the diagnosis. We reviewed all cases of suspected AM referred for CMR in 2017. Methods Patients were identified from referral information recorded in the CMR daybook. All cases underwent pre- & post-contrast imaging to assess bi-ventricular function, myocardial oedema and late gadolinium enhancement (LGE). Results Of 1753 adult patients undergoing CMR, 95 (5%) were for suspected myocarditis. 37 had no troponin rise or peak troponin I < 0.5µg/L (normal range ≤ 0.15µg/L). None of these had AM by MRI criteria (15 dilated cardiomyopathy, 1 pericarditis, 1 LV hypertrophy and 20 normal). Of the remaining 58, 31 showed edema and LGE typical of AM and 9 had non-ischemic LGE suggesting possible myocarditis. 9 patients had acute infarcts and 9 were normal. Seven of the normal patients had troponin I rise of <2 µg/L. Conclusion Suspected acute myocarditis is a common indication for CMR. None of our cohort had a positive CMR for AM if troponin I was < 0.5µg/L. The demographics of positive cases mirrors previous series in terms of age and gender. Interestingly, the majority of positive AM cases had normal bi-ventricular function (26/40 or 65%). Longterm outcome of these patients has yet to be established and routine follow-up CMR may not be needed.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".