<p>Incidental intracranial pathology: a retrospective case review of structural neuroimaging results amongst young adult psychiatric patients</p>
Bibliographic record
Abstract
Objective: Given that there continue to be conflicting recommendations on the inclusion of routine structural neuroimaging amongst the investigations ordered in psychiatric patients, our group aimed to add to the data on intracranial pathology amongst, specifically, the young adult psychiatric population. This is a novel study in that it includes all presentations (mania, depression, psychosis, anxiety, substance use disorders) and presents, to the authors’ knowledge, the largest cohort of imaging results amongst this group. Method: The neuroimaging (CT and MRI) reports of 224 patients admitted to the Young Adult Assessment, Evaluation and Reintegration Unit (12-A) at the Alberta Hospital Edmonton (AHE) between the years of 2012–2015 were reviewed, and all findings were classified into one of four categories (normal, abnormal/benign, abnormal and unlikely linked to symptoms, and abnormal with possible link to symptoms). This study is largely a review of CT scans, as there were only six MRI reports available in the study population. Results: In total, 86.6% of findings were classified as normal. Amongst the scans with abnormal findings, 10.7% were deemed benign and non-specific. 1.8% of abnormal findings required an outside consultation or follow-up, but were unlikely linked to symptoms; and 0.9% were deemed possibly causally related to symptoms, though follow-up imaging deemed otherwise. The most prevalent findings were cerebral atrophy (n=6), arachnoid cysts (n=5), ventricular asymmetry (n=3), and cavum septum pellucidum (n=3). Conclusions: This study represents the largest cohort of incidental findings in the young adult psychiatric population. These findings do not support the practice of ordering structural imaging tests in the young adult (17–26 years) psychiatric population. This suggestion agrees with recent recommendations on this question, and highlights the need for ongoing review in this area. Keywords: computed tomography scan, magnetic resonance imaging, incidental findings, intracranial anomalies
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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) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".