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Record W3197046587 · doi:10.1016/j.xjon.2021.08.033

Reply: Implications of innovations on clinical outcomes

2021· article· en· W3197046587 on OpenAlexaff
Fraser D. Rubens

Bibliographic record

VenueJTCVS Open · 2021
Typearticle
Languageen
FieldMedicine
TopicCardiac and Coronary Surgery Techniques
Canadian institutionsUniversity of Ottawa
Fundersnot available
KeywordsConflict of interestSpecialtyMedicineProcess (computing)Intervention (counseling)Relevance (law)Public relationsPolitical scienceLawComputer scienceFamily medicineNursing

Abstract

fetched live from OpenAlex

The author reported no conflicts of interest.The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. The author reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. This letter's authors,1Lobo Filho H.G. Lobo Filho J.G. Pimentel M.D. Left internal thoracic artery and saphenous vein composite grafts: the value of valveless veins.J Thorac Cardiovasc Surg Open. 2021; 8: 379Google Scholar and the original source article's authors, reflect opinions in their practice that emphasize that much of what we do is based on personal opinion. We have taken our best shots at trying to parse out physiology to do what surgeons do best—innovate. This process is a practical implementation of ideas that results in the introduction of new goods or services. When one considers the question presented in this strategy of coronary revascularization, we can demonstrate multiple steps at which our true quality as innovators shines through. The first is the question of the application of the valvulotome, a tool introduced in another surgical specialty for peripheral vascular intervention.2Connolly J.E. The history of the in situ saphenous vein bypass.J Vasc Surg. 2011; 53: 241-244Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar The benefit of this approach is the ability to use the vein in an orientation that preserves its normal tapering course in terms of diameter of inflow and outflow. In contrast, this may result in trauma that could jeopardize long-term outcomes, and are the acceptable outcomes of in situ bypass in the leg due to preserved adventitial blood supply by not removing the vein?3Dreifaldt M. Souza D.S. Loesch A. Muddle J.R. Karlsson M.G. Filbey D. et al.The “no-touch” harvesting technique for vein grafts in coronary artery bypass surgery preserves an intact vasa vasorum.J Thorac Cardiovasc Surg. 2011; 141: 145-150Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar Having done a lot of basic research looking at endothelial injury, would I feel comfortable doing this? Likely not. The next is the question of anastomosing the vein, prone to atherosclerosis, to the smaller internal thoracic artery. Is this folly? The theoretical benefit of local antiatherogenic materials is appealing, but is there proof? Do we need more information to properly avoid the potential complication of jeopardizing the superb results of an isolated left internal thoracic artery–left anterior descending coronary artery anastomosis? To this reviewer, these papers have supported that this strategy is feasible and in “a pinch” I feel ever so slightly better to apply them if my standard tried-and-true strategy is not available. But, to move forward, we need to encourage surgeons to break down innovations step by step and test each stride along the innovation pathway before encouraging universal acceptance. These communications are what they are—you can do it. Should you do it routinely? That is for another day. Left internal thoracic artery and saphenous vein composite grafts: The value of valveless veinsJTCVS OpenVol. 8PreviewWe read with great interest the study published by Hwang and colleagues,1 which demonstrated equivalence between the clinical results obtained in coronary artery bypass graft (CABG) surgery with composite arteriovenous grafts when compared with using exclusively arterial composite grafts. Our team has considerable interest in this topic, as we are part of a pioneering and enthusiastic group that regularly performs CABG without cardiopulmonary bypass and avoiding manipulation of the ascending aorta, with studies since the 1990s indicating good results with this technique. Full-Text PDF Open Access

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)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.455
Threshold uncertainty score0.338

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
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 head0.119
GPT teacher head0.456
Teacher spread0.338 · 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 designObservational
Domainnot available
GenreEmpirical

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

Citations0
Published2021
Admission routes1
Has abstractyes

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