OP74 Stoma Cover Use By Fully Laryngectomized Patients
Bibliographic record
Abstract
Introduction The use of stoma covers has been a common clinical practice for laryngectomized patients for several years. In the province of Québec, Canada, laryngectomized patients can obtain stoma covers through a dedicated program providing them with medical supplies and voice re-education services. For many years, the program's supply has included cloth and/or foam covers, but the supply of Heat and Moisture Exchangers (HME) has been limited. Two hospital-based HTA units joined their expertise to assess the opportunity of providing HMEs to more patients, depending on their clinical characteristics. Methods Their joined assessment rested on a systematic review (SR) and a field assessment. The systematic review aimed at assessing the efficacy, clinical effectiveness and safety of various types of stoma covers. The field inquiries intended to assess the perceptions of clinicians and managers towards stoma covers in clinical practice. Results We included 27 studies in the SR. Most of them appraised the clinical effectiveness or safety of HME filters. Their methodological quality was very low with potential conflicts of interest whereas many studies were financed by the industry. The heterogeneity of study designs, expected outcomes and paucity of comparative studies prevented the pooling of results. Industry sponsorship appeared to be an important issue, since 17 of the included studies were sponsored. The SR did not provide conclusive evidence concerning the efficacy, clinical effectiveness and safety of the various types of stoma covers. The field inquiries intended to assess the perceptions of clinicians and managers towards stoma covers in clinical practice. It showed that industry representatives are quite active in clinical settings, promoting their products. Clinicians’ opinions and preferences were coherent with the systematic review main observations: in a context where the quality of the evidence is low, clinicians’ recommendations of stoma protectors for laryngectomies are mainly based on their professional experience and academic training. Conclusions Future research of high methodological quality would strengthen the evidence concerning the relative efficacy and safety of different stoma protectors. These studies would help define evidence-based allocation criteria and set parameters so that the choice of a stoma protector is best adapted to a laryngectomized patients’ condition.
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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 | 0.003 | 0.020 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 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) | 0.007 | 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".