72 Use of Palivizumab in Canada; Data from the CARESS registry 2005–2017
Bibliographic record
Abstract
The Canadian Registry of Palivizumab (CARESS) tracks palivizumab utilization and hospitalizations for respiratory illness (RI) and respiratory syncytial virus (RSVH) in high-risk infants, whatever the indication. The decision to administer palivizumab is taken by individual clinicians at the participating centers. To provide insight into the current management (utilization, adherence) with palivizumab of children at high risk of RSV infection in the tertiary care centers and community settings through the development of a Canadian Registry Database. A registry may give some indication of safety and effectiveness of an intervention in real life situations in many, uncommon medical conditions. A prospective, observational registry of infants from 32 sites who received ≥1 dose of palivizumab during the 2005–2017 RSV seasons. Palivizumab utilization and RI outcomes were collected monthly over each individual season. 25,003 infants were enrolled, the majority were male (56.3%) and Caucasian (68.6%). Subjects were, on average, 5.7 ± 6.4 months old at the time of enrolment, and had a mean gestational age of 32.6 ± 5.0 weeks. Of the children enrolled, indications for palivizumab were prematurity (≤ 35 weeks gestation, 63.3%), chronic lung disease (8.4%), significant congenital heart disease (10.5%), and other complex medical illnesses (17.8%). A total of 109,579 injections were given; average of 4 ± 1 injections per infant. Serious adverse events were uncommon. Adherence was measured in two ways. The number of actual injections compared with the expected and by this measure 83.8% received all of the expected injections. Adherence was also measured based on the length of the inter-injection interval, and by this measure 74.8% were adherent. Over the 12 seasons of CARESS, 1724 children were hospitalized a total of 2054 times. The overall RIH rate was 6.9%, the lowest being in preterm infants (4.3%). 1474 of 1724 children were tested for RSV;334 were RSV-positive. The cumulative RSVH rate was 1.6%. The most common indications for palivizumab are prematurity, followed by those with medical complexity. Palivizumab is safe, and given that all of the infants are at high-risk for RSV, an adherence of 74.8% is not unreasonable. The low RSVH (1.6%) rate indicates that palivizumab is effective in the populations in which it is administered. 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 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.011 |
| 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) | 0.003 | 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".