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Record W3159425302

Ventilator withdrawal for reallocation during a covid-19 surge needs a deeper discussion

2021· article· en· W3159425302 on OpenAlexvenueaboutno aff
Jonathan M. Breslin, Jill Oliver

Bibliographic record

VenueUniversity of Toronto Medical Journal · 2021
Typearticle
Languageen
FieldHealth Professions
TopicDisaster Response and Management
Canadian institutionsnot available
Fundersnot available
KeywordsCoronavirus disease 2019 (COVID-19)TriageElement (criminal law)PandemicSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)2019-20 coronavirus outbreakSurgeSurge CapacityVentilation (architecture)Risk analysis (engineering)BusinessMedicineIntensive care medicineMedical emergencyPolitical scienceLawEngineeringVirology
DOInot available

Abstract

fetched live from OpenAlex

Many jurisdictions around the world have developed ventilator triage protocols in the event that demand for ventilation during the COVID-19 pandemic overwhelms the available supply. These protocols would be used to determine which patients get priority access to potentially life-saving ventilation. One particularly controversial element of these protocols is what we refer to as “withdrawal for reallocation” – that is, the practice of withdrawing a ventilator from one patient in order to provide it to another patient with a comparatively higher likelihood of benefit. This element raises several ethical issues that have not been given due consideration in the protocols themselves and the literature on the topic. In this paper we highlight these issues and provide recommendations for addressing them. © 2021, University of Toronto. All rights reserved.

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)0.072
metaresearch head score (Gemma)0.160
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.072
Threshold uncertainty score0.382

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0720.160
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.002
Bibliometrics0.0010.001
Science and technology studies0.0100.017
Scholarly communication0.0110.015
Open science0.0060.005
Research integrity0.0200.026
Insufficient payload (model declined to judge)0.0090.002

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 head0.028
GPT teacher head0.353
Teacher spread0.325 · 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 designNot applicable
Domainnot available
GenreCommentary

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

Citations1
Published2021
Admission routes2
Has abstractyes

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Same venueUniversity of Toronto Medical JournalSame topicDisaster Response and ManagementFrench-language works237,207