73 Changes in Palivizumab usage in Canada 2005–2017 (Data from CARESS registry)
Bibliographic record
Abstract
Palivizumabis a monoclonal antibody for preventionof serious lower respiratory tract infection caused by respiratory syncytial virus (RSV) in high risk children. Safety and efficacy were established in infants with bronchopulmonary dysplasia (BPD), prematurity (≤ 35 weeks gestational age), and hemodynamically significant congenital heart disease (CHD). The Canadian Registry of Palivizumab (CARESS) tracks palivizumab utilization in high-risk infants, whatever the indication. The decision to give palivizumab is by individual clinicians, not by the investigators, and is often for conditions not listed in the product monograph. To describe changes over time in indications for palivizumab prophylaxis in Canadian children using a Registry Database. A prospective, observational registry of infants from 32 sites who received ≥1 dose of palivizumab during the 2005–2016 RSV seasons. Usage by indications is shown in two-year increments (Table 1), omitting 2016–17 when enrollment was limited; focused on those with complex medical disorders (CMD). *year defined as beginning of RSV season in one year to beginning of RSV season in the next year 23,598 infants were enrolled, the overall indications for palivizumab were prematurity (62.6%), BPD (8.8%), CHD (11.1%), CMD (17.5%). Comparing groups across the 11 RSV seasons, the percentage with BPD was10.6–8.8%; prematurity decreased from 74.4% to 60.3% and CHD peaked at 12.5% from 2013–15. Palivizumab use in the CMD group rose from 5.6% to 22.6% (2013–15). Total n (%) with specific diagnoses were: Trisomy 21; 942 (21.2), Congenital airway anomalies; 855 (19.2), Neurological disorders; 471 (10.6), Cystic fibrosis; 442 (9.9) other pulmonary; 438 (9.8). The remainder comprised children with multiple indications, or individually less common diseases. Caution is required in interpreting these data from a voluntary registry. Nevertheless the off label use of palivizumab in CMD has increased substantially. We suspect this reflects a desire of individual clinicians to protect “fragile” children whenever possible. Clinical Trial Registration: ClinicalTrials.gov NCT00420966
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.013 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".