MétaCan
Menu
Back to cohort
Record W3007843993 · doi:10.1136/bmjqs-2019-010498

Beyond CLABSI and CAUTI: broadening our vision of patient safety

2020· letter· en· W3007843993 on OpenAlexaff
Kaveh G Shojania

Bibliographic record

VenueBMJ Quality & Safety · 2020
Typeletter
Languageen
FieldHealth Professions
TopicHealthcare cost, quality, practices
Canadian institutionsSunnybrook Health Science CentreHealth Sciences Centre
Fundersnot available
KeywordsMedicinePatient safetyMedical emergencyIntensive care medicineOptometryHealth care

Abstract

fetched live from OpenAlex

In this issue of BMJ Quality & Safety , Meddings et al 1 report the evaluation of a national effort to reduce two well-known safety targets, central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). The paper’s introduction helpfully informs readers of the context. Prior projects funded by the US Agency for Healthcare Research and Quality (AHRQ) have reported well-known successes for both these targets.2 3 One national collaborative reported a greater than 40% reduction in CLABSI in intensive care units (ICUs).2 And, a comparably large project reported a 32% reduction in CAUTI in clinical units other than ICUs, but with no reduction occurring in ICUs.3 This lack of improvement for CAUTI in ICUs might perplex those familiar with the history of these interventions. The AHRQ On the CUSP: Stop CAUTI project3 included the Comprehensive Unit-based Safety Program (CUSP) to support behavioural and cultural changes seen as crucial to support uptake of the technical elements of the CLABSI bundle4 and other checklist-type interventions.5 Why would an intervention for CAUTI modelled after one which has apparently worked so well for CLABSI in ICUs2 6 work only outside ICUs? This unexpected result, along with the fact that, even in the seemingly more successful CLABSI project2 a substantial proportion of ICUs did not improve, led to the national collaborative now reported by Meddings et al .1 The programme recruited 366 ICUs from 220 US hospitals, with 274 ICUs providing complete data. Neither target showed significant improvements. For CLABSI, the incidence rate ratio (IRR) was 0.75, but the 95% CI extended up to an increase of 1.08 (p=0.13). CAUTI showed a similar result: IRR=0.79 but with a CI extending up to 1.06.1 Moreover utilisation for both catheters decreased only marginally and non-significantly. The authors …

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.011
metaresearch head score (Gemma)0.008
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow), Science and technology studies, Research integrity
Consensus categoriesResearch integrity
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.024
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0110.008
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0030.000
Bibliometrics0.0000.001
Science and technology studies0.0020.000
Scholarly communication0.0000.001
Open science0.0010.001
Research integrity0.0030.011
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.447
GPT teacher head0.559
Teacher spread0.112 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designNot applicable
Domainnot available
GenreCommentary

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".

Quick stats

Citations10
Published2020
Admission routes1
Has abstractyes

Explore more

Same venueBMJ Quality & SafetySame topicHealthcare cost, quality, practicesFrench-language works237,207