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Systematic review and meta-analysis of outcomes in patients with suspected pulmonary embolism

2021· review· en· W3157363204 on OpenAlexafffund
Payal M. Patel, Meha Bhatt, Cody Braun, Housne Begum, Robby Nieuwlaat, Rasha Khatib, Carolina Castro Martins, Yuan Zhang, Itziar Etxeandia‐Ikobaltzeta, Jamie Varghese, Hani Alturkmani, Waled Bahaj, Mariam Baig, Rohan Kehar, Ahmad Mustafa, Rakesh Ponnapureddy, Anchal Sethi, Merrill Thomas, David Wooldridge, Wendy Lim, Shannon M. Bates, Eddy Lang, Grégoire Le Gal, Linda B. Haramati, Jeffrey A. Kline, Marc Righini, Wojtek Wiercioch, Holger J. Schünemann, Reem A. Mustafa

Bibliographic record

VenueBlood Advances · 2021
Typereview
Languageen
FieldMedicine
TopicVenous Thromboembolism Diagnosis and Management
Canadian institutionsOttawa HospitalImpactUniversity of CalgaryWestern UniversityMcMaster UniversityUniversity of OttawaThrombosis and Atherosclerosis Research Institute
FundersMcMaster UniversityAmerican Society of Hematology
KeywordsMedicinePulmonary embolismIncidence (geometry)Confidence intervalMeta-analysisInternal medicineMortality ratePediatricsSurgery

Abstract

fetched live from OpenAlex

Prompt evaluation and therapeutic intervention of suspected pulmonary embolism (PE) are of paramount importance for improvement in outcomes. We systematically reviewed outcomes in patients with suspected PE, including mortality, incidence of recurrent PE, major bleeding, intracranial hemorrhage, and postthrombotic sequelae. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase for eligible studies, reference lists of relevant reviews, registered trials, and relevant conference proceedings. We included 22 studies with 15 865 patients. Among patients who were diagnosed with PE and discharged with anticoagulation, 3-month follow-up revealed that all-cause mortality was 5.69% (91/1599; 95% confidence interval [CI], 4.56-6.83), mortality from PE was 1.19% (19/1597; 95% CI, 0.66-1.72), recurrent venous thromboembolism (VTE) occurred in 1.38% (22/1597; 95% CI: 0.81-1.95), and major bleeding occurred in 0.90% (2/221%; 95% CI, 0-2.15). In patients with a low pretest probability (PTP) and negative D-dimer, 3-month follow-up revealed mortality from PE was 0% (0/808) and incidence of VTE was 0.37% (4/1094; 95% CI: 0.007-0.72). In patients with intermediate PTP and negative D-dimer, 3-month follow-up revealed that mortality from PE was 0% (0/2747) and incidence of VTE was 0.46% (14/3015; 95% CI: 0.22-0.71). In patients with high PTP and negative computed tomography (CT) scan, 3-month follow-up revealed mortality from PE was 0% (0/651) and incidence of VTE was 0.84% (11/1302; 95% CI: 0.35-1.34). We further summarize outcomes evaluated by various diagnostic tests and diagnostic pathways (ie, D-dimer followed by CT scan).

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 machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.013
metaresearch head score (Gemma)0.041
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: Meta-analysis
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.023
Threshold uncertainty score0.071

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0130.041
Meta-epidemiology (narrow)0.0030.001
Meta-epidemiology (broad)0.0230.035
Bibliometrics0.0070.008
Science and technology studies0.0010.001
Scholarly communication0.0030.002
Open science0.0020.002
Research integrity0.0020.002
Insufficient payload (model declined to judge)0.0030.000

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 head0.027
GPT teacher head0.320
Teacher spread0.294 · 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 source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designMeta-analysis
Domainnot available
GenreReview

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

Citations12
Published2021
Admission routes2
Has abstractyes

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