Intravenous Drug Use–Associated Infective Endocarditis in Canada: A Call for a Standardized Treatment Strategy That Includes In-Hospital Addiction Medicine and Harm Reduction Services
Bibliographic record
Abstract
ABSTRACT Amidst the Canadian opioid crisis, the incidence of infective endocarditis associated with intravenous drug use (IVDU-IE) has increased. A survey assessing current perceptions and practice patterns of Canadian cardiac surgeons found a lack of objective evidence to guide decision making, limited interprofessional management programs, and a need and willingness to create a national strategy to better respond to IVDU-IE. These findings are in keeping with evidence of gaps in health care services for people who inject drugs and the need for a multidisciplinary approach that includes the specialty of addiction medicine and the implementation of harm prevention and reduction services. This commentary is a call for the Canadian Society of Cardiac Surgeons to take the lead in initiating an effective treatment strategy for IVDU-IE in Canadian hospitals. Au centre de la crise des opioïdes au Canada, l’incidence de l’endocardite infectieuse associée à l’usage de drogues intraveineuses (IVDU-IE) a augmenté. Une enquête évaluant les perceptions et les modèles de pratique actuels des chirurgiens cardiaques canadiens a révélé un manque de preuves objectives pour guider la prise de décision, des programmes de gestion interprofessionnelle limités et un besoin et une volonté de créer une stratégie nationale pour mieux répondre à l’IVDU-IE. Ces résultats sont conformes aux preuves de lacunes dans les services de santé pour les personnes qui s’injectent des drogues et à la nécessité d’une approche multidisciplinaire que comprend la spécialité de la médecine de l’addiction et la mise en œuvre de services de prévention et de réduction des méfaits. Cette présente anyalyse est un appel à la Société canadienne des chirurgiens cardiaques pour qu’elle prenne l’initiative de lancer une stratégie de traitement efficace pour l’IVDU-IE dans les hôpitaux canadiens.
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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 | 0.006 | 0.025 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.011 | 0.006 |
| Scholarly communication | 0.007 | 0.002 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.008 | 0.011 |
| Insufficient payload (model declined to judge) | 0.006 | 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".