Annals for Hospitalists Inpatient Notes - Timely Hip Fracture Surgery
Bibliographic record
Abstract
Web ExclusivesMarch 2021Annals for Hospitalists Inpatient Notes - Timely Hip Fracture SurgeryFlavia K. Borges, MD, PhD and P.J. Devereaux, MD, PhDFlavia K. Borges, MD, PhDPopulation Health Research Institute and McMaster University, Hamilton, Ontario, Canada (F.K.B., P.J.D.).Search for more papers by this author and P.J. Devereaux, MD, PhDPopulation Health Research Institute and McMaster University, Hamilton, Ontario, Canada (F.K.B., P.J.D.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-0298 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Hip fractures are common and affect millions of elderly patients annually (1). Surgery is the ideal treatment for hip fracture to control pain, recover mobility, and improve quality of life. Moreover, surgery can interrupt the cascade of related physiologic disturbances.Patients with hip fractures are exposed to pain, bleeding, inflammation, and immobilization as well as prothrombotic, catabolic, and stress states, which can precipitate significant clinical complications (for example, myocardial infarction, pneumonia, and venous thromboembolism).Often, patients with hip fractures are older, have multiple medical comorbidities, and receive many medications at the same time. Some even present with acute comorbidities. Given ...References1. Brauer CA, Coca-Perraillon M, Cutler DM, et al. Incidence and mortality of hip fractures in the United States. JAMA. 2009;302:1573-9. [PMID: 19826027] doi:10.1001/jama.2009.1462 CrossrefMedlineGoogle Scholar2. Simunovic N, Devereaux PJ, Sprague S, et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ. 2010;182:1609-16. [PMID: 20837683] doi:10.1503/cmaj.092220 CrossrefMedlineGoogle Scholar3. Pincus D, Ravi B, Wasserstein D, et al. Association between wait time and 30-day mortality in adults undergoing hip fracture surgery. JAMA. 2017;318:1994-2003. [PMID: 29183076] doi:10.1001/jama.2017.17606 CrossrefMedlineGoogle Scholar4. HIP ATTACK Investigators. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial. Lancet. 2020;395:698-708. [PMID: 32050090] doi:10.1016/S0140-6736(20)30058-1 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Population Health Research Institute and McMaster University, Hamilton, Ontario, Canada (F.K.B., P.J.D.).Financial Support: Dr. Borges holds a McMaster University Department of Medicine Career Research Award. Dr. Devereaux is supported by a McMaster University/Hamilton Health Sciences Chair in Perioperative Care and a Tier 1 Canada Research Chair in Perioperative Medicine.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-0298.Corresponding Author: Flavia K. Borges, MD, PhD, David Braley Cardiac, Vascular and Stroke Research Institute, 237 Barton Street East, Hamilton, ON L8L 2X2, Canada; e-mail, flavia.[email protected]ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - March 2021 David H. Wesorick , Jawad Al-Khafaji , and Matthew Luzum Metrics March 2021Volume 174, Issue 3Page: HO2-HO3KeywordsHazard ratioHipHip fracturesHospitalistsMedical conditionsMortalityMyocardial infarctionSurgeryTreatment guidelinesTroponin ePublished: 16 March 2021 Issue Published: March 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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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 | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.523 | 0.267 |
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".