Does domperidone prolong QTc in a clinically relevant manner in infants with GORD?
Bibliographic record
Abstract
A male premature infant born at 26 weeks of gestation is now at 32 weeks corrected age. He has developed chronic lung disease and is currently on low-flow oxygen. His growth has been faltering, falling below the 10th centile despite 180 mL/kg/day of fortified mother’s own milk. Postprandial regurgitation of milk has been occurring, with suspected gastro-oesophageal reflux. Ultrasound of the abdomen reveals no evidence of pyloric stenosis. Despite a trial of Gaviscon, he continues to regurgitate milk and his growth rate remains inadequate, so a decision is made to commence domperidone. Prior to initiation of therapy, an ECG performed to exclude prolonged QT interval reveals a corrected QTc of 400msec and an electrolyte panel was found to be entirely within normal range. You are asked to consider whether the risk of harm in developing a prolonged QTc and sudden death from a cardiac arrhythmia while receiving domperidone is low enough to warrant the introduction of this medication and whether follow-up ECGs are indicated. In the case of inpatient infants with GORD ( population ), does domperidone administration ( intervention ) cause clinically relevant QTc prolongation and/or arrhythmia ( outcomes ) when compared with baseline ( control )? PubMed, MEDLINE ( via EBSCOhost) and Cochrane CENTRAL databases were searched from article inception to 01/09/2019 with the following strategy: ‘((infant) OR (neonate) OR (newborn)) AND (domperidone) AND ((QT) OR (QTc) OR (prolonged) OR (ECG) OR (EKG) OR (arrhythmia))’. In all, 37 abstracts were identified (Medline 21, Embase 16, Cochrane 0) with 21 unique studies, of which five were included (table 1). Of the articles excluded, three were concerned with the use of domperidone as a galactagogue agent in lactating …
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".