Bibliographic record
Abstract
### Learning objectives Specialist outpatient clinics were first established by cardiologists with a broader involvement in valve disease including inpatient opinions and care (figure 1).1 2 This article will concentrate on the core outpatient clinic. Figure 1 Roles of a specialist valve clinic. This includes the clinical and organisational aims of the valve clinic itself and the broader aims of a comprehensive valve service. GP, general practitioner, MDT, multidisciplinary team meeting. Guidelines3–5 now recommend prophylactic surgery for severe mitral regurgitation caused by prolapse provided that repair can be virtually guaranteed at close to zero risk. This has led to discussion of service requirements and quality standards to define ‘heart valve centres’.6 7 Valve clinics are important in a heart valve centre since their core aim is to follow patients and refer to a surgeon before significant left ventricular (LV) decompensation or adverse clinical events supervene. However, valve clinics can also improve care in district hospitals with no onsite cardiac surgery or transcatheter programmes. It is easy to see valve care almost exclusively in terms of surgery or interventional procedures since these dominate cost, commercial concerns, news items and in consequence governmental and regulatory discussions. However, the majority of patients in hospital services are initially managed conservatively (figure 2).8–11 Furthermore, a large proportion of patients with valve disease are undiagnosed or being seen within the community and better methods of detection and …
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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.050 | 0.016 |
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".