Referral for Colonoscopy in Patients with Streptococcus bovis Bacteremia and the Association with Colorectal Cancer and Adenomatous Polyps: A Quality Assurance Study
Bibliographic record
Abstract
The association between Streptococcus bovis (S. bovis) bacteremia and colorectal cancer is well established. We aimed to review patients with S. bovis bacteremia at our local hospital system and determine the percentage of patients referred for colonoscopy. Methods: We searched the regional database to identify S. bovis-positive blood cultures from 2002 to 2016 and the clinical characteristics and outcomes of those patients. Results: A total of 86 patients with S. bovis bacteremia were identified. From the 86 patients, 14 were excluded. The mean age of the 72 remaining patients was 74.5 (SD 13), 42/72 (58%) were male, 12/72 (17%) had infective endocarditis, and 19 (26%) died during admission. Of the 53 patients who survived, 37 (70%) were referred for colonoscopy or CT colonography, of which 30 had a colonoscopy. Thus, 3/30 (10%) cases showed adenocarcinoma and 11/30 (37%) cases showed adenomatous polyps. Age, gender, or the presence of infective endocarditis were not associated with adenocarcinoma or adenomatous polyps. Discussion: In our local centers, a significant proportion of patients with S. bovis were found to have colon cancer or significant polyps, and thus the importance of referral to colonoscopy remains paramount.
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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 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".