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Record W3133826804 · doi:10.9778/cmajo.20200176

Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM): protocol for a randomized controlled trial

2021· article· en· W3133826804 on OpenAlexafffundvenueabout
Michael McGillion, Joel L. Parlow, Flávia K. Borges, Maura Marcucci, Michael J. Jacka, Anthony Adili, Manoj M. Lalu, Homer Yang, Ameen Patel, Susan G. O'Ĺeary, Vikas Tandon, Gavin M. Hamilton, Marko Mrkobrada, Carley Ouellette, Marissa Bird, Sandra Ofori, David Conen, Pavel S Roshanov, Valerie Harvey, Gordon Guyatt, Yannick Le Manach, Shrikant I. Bangdiwala, Ramiro Arellano, Ted Scott, Jennifer Lounsbury, Dylan A. Taylor, Rahima Nenshi, Alan J. Forster, Mahesh Nagappa, André Lamy, Elizabeth Peter, Kelsea Levesque, Kristen Marosi, Sultan Chaudhry, Shariq Haider, Lesly Deuchar, Brandi LeBlanc, Colin J. L. McCartney, Emil H. Schemitsch, Jessica Vincent, Shirley Pettit, James Paul, Deborah DuMerton, A Paulin, Marko Šimunović, Samantha Halman, Christopher M. Schlachta, Jessica Shelley, John Harlock, Ralph M. Meyer, Michelle M. Graham, Harsha Shanthanna, Neil Parry, David R. Pichora, Haroon Yousef, Husein Moloo, Herman Sehmbi, Melissa Waggott, Emilie P. Belley‐Côté, Richard Whitlock, P.J. Devereaux

Bibliographic record

VenueCMAJ Open · 2021
Typearticle
Languageen
FieldMedicine
TopicSepsis Diagnosis and Treatment
Canadian institutionsKingston Health Sciences CentreUniversity of Alberta HospitalMcMaster UniversityQueen's UniversityJuravinski HospitalOttawa HospitalPopulation Health Research InstituteUniversity of AlbertaUniversity of Ottawa
FundersMitacsUniversity of AlbertaQueen's UniversityMcMaster UniversityHamilton Health SciencesHeart and Stroke Foundation of Canada
KeywordsMedicineRandomized controlled trialProtocol (science)RandomizationEmergency medicineMedical emergencyPandemicCoronavirus disease 2019 (COVID-19)SurgeryDiseaseInternal medicineAlternative medicine

Abstract

fetched live from OpenAlex

BACKGROUND: After nonelective (i.e., semiurgent, urgent and emergent) surgeries, patients discharged from hospitals are at risk of readmissions, emergency department visits or death. During the coronavirus disease 2019 (COVID-19) pandemic, we are undertaking the Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM) trial to determine if virtual care with remote automated monitoring (RAM) compared with standard care will increase the number of days adult patients remain alive at home after being discharged following nonelective surgery. METHODS: We are conducting a randomized controlled trial in which 900 adults who are being discharged after nonelective surgery from 8 Canadian hospitals are randomly assigned to receive virtual care with RAM or standard care. Outcome adjudicators are masked to group allocations. Patients in the experimental group learn how to use the study's tablet computer and RAM technology, which will measure their vital signs. For 30 days, patients take daily biophysical measurements and complete a recovery survey. Patients interact with nurses via the cellular modem-enabled tablet, who escalate care to preassigned and available physicians if RAM measurements exceed predetermined thresholds, patients report symptoms, a medication error is identified or the nurses have concerns they cannot resolve. The primary outcome is number of days alive at home during the 30 days after randomization. INTERPRETATION: This trial will inform management of patients after discharge following surgery in the COVID-19 pandemic and offer insights for management of patients who undergo nonelective surgery in a nonpandemic setting. Knowledge dissemination will be supported through an online multimedia resource centre, policy briefs, presentations, peer-reviewed journal publications and media engagement. TRIAL REGISTRATION: ClinicalTrials.gov, no. NCT04344665.

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)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: Randomized trial
GenreCandidate signal: Protocol · Consensus signal: Protocol
Teacher disagreement score0.038
Threshold uncertainty score0.706

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
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 head0.045
GPT teacher head0.377
Teacher spread0.332 · 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; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designRandomized trial
Domainnot available
GenreProtocol

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

Citations6
Published2021
Admission routes4
Has abstractyes

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