A180 SENSITIVITY AND SPECIFICITY OF LOWER GASTROINTESTINAL BLEEDING SCORES TO PREDICT ADVERSE OUTCOMES: SYSTEMATIC REVIEW AND META-ANALYSIS
Bibliographic record
Abstract
Abstract Background Acute lower gastrointestinal bleeding (LGIB) is a common reason for emergency hospitalization. In most patients bleeding resolves spontaneously, although some presentations result in adverse outcome such as transfusion, therapeutic intervention, rebleeding and mortality. Risk prediction scores are important to stratify patients at presentation with LGIB. Aims To perform a systematic review and meta-analysis comparing LGIB risk prediction scores. We provide a summary effect measure of their predictive values for 30-day mortality, safe discharge, rebleeding, need for blood transfusion, and need for endoscopic therapy/IR/surgery. Methods Electronic search for relevant publications after 1990 was conducted in PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, NIH ClinicalTrials.gov, and Cochrane Database of Systematic Reviews. We also searched relevant published conference abstracts over the past 5 years. Studies with a primary goal of deriving or validating a LGIB risk score were included. Title and abstracts were reviewed by two independent reviewers and then full text review was done by both reviewers. Results Our search identified 1,832 citations for review. After title and abstract review, 68 publications were selected for full text review. So far, a total of 16 citations were excluded since we started full text review including: insufficient information (n=14), review article (n=2). Thus far, we identified 14 risk scores and algorithms from 9 studies. Two of the risk scores are UGIB risk scores that were assessed for LGIB. Of these studies, 3 were validation studies, one derivation study and five for both validation and derivation. The scores assessed safety of discharge (n=3), mortality (n=4), need for therapy (n=8), severe bleeding (n=8) and requirement for blood transfusion (n=1). A meta-analysis will follow. Conclusions We conducted a systematic review of LGIB risk scores, with a meta-analysis to follow if appropriate, for use to predict 30-day mortality, safe discharge, rebleeding, required blood transfusion, endoscopic therapy/IR/surgery. Funding Agencies None
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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 | 0.023 | 0.065 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.054 |
| Bibliometrics | 0.011 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".