196 A clinical audit of use of octreotide in the management of inoperable malignant bowel obstruction at a large cancer centre
Bibliographic record
Abstract
Background Octreotide is a somatostatin analogue used to reduce gastric and intestinal secretions therefore helping to improve symptoms of nausea and vomiting. There is mixed evidence for the use of octreotide however in both local guidelines and the Palliative Care Formulary 6 it is considered second line for the treatment of vomiting and managing secretions in malignant bowel obstruction with hyoscine butylbromide as first line. Objectives 1. To gain insight into the scale of prescribing of octreotide for inoperable malignant bowel obstruction in a tertiary cancer centre. 2. To compare the prescribing practices for octreotide in inoperable malignant bowel obstruction to those outlined in the local and national guidance. Methods A retrospective audit of the electronic notes and online prescriptions for inpatients prescribed octreotide for inoperable malignant bowel obstruction over a one-year period. A total of 17 patients. Audit standards: The patient has been prescribed hyoscine butyl bromide prior to being prescribed octreotide The patient has been started on a dose of octreotide between 300–600 mcg/24hrs The patient has not been prescribed a dose of octreotide greater than 1500 mcg/24hrs The patient has a clearly documented indication for the use of octreotide. Results Only 41% patients had hyoscine butyl bromide prescribed prior to being prescribed octreotide. 100% patients received the recommended starting dose of octreotide. No patients received octreotide received a dose greater than 1500 mcg/24hrs. 71% patients had a specific indication documented in the notes Conclusions There are relatively few prescriptions for octreotide despite the audit data coming from a large cancer centre. Prescriptions generally follow the guidelines however documentation of indication and reason for divergence from the guideline needs improving. Recommendations Consider using standardised documentation for when starting octreotide including indication, other medications concurrently prescribed, dietician involvement and NG tube placement.
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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 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".