Managing paediatric gastroenteritis in primary care: is there a role for ondansetron?
Bibliographic record
Abstract
Despite the reduction in hospital admissions 1 and deaths 2 due to the rotavirus vaccine, acute gastroenteritis remains a major cause of morbidity and healthcare service use worldwide.While typically a self-limited illness, the mainstay of therapy is oral rehydration therapy (ORT) to prevent the need for intravenous fluids and hospital admission due to severe dehyration.3 In 2006, a randomised controlled trial (RCT) by Freedman et al showed that a single dose of ondansetron in the emergency department (ED), compared with placebo, reduces the likelihood of vomiting and the need for intravenous rehydration.4 This seminal trial changed the standard of ED care for children with gastroenteritis but evidence was lacking for its use in primary care. LATEST RESEARCH ON ONDANSETRON IN THE BJGPIn this issue of the BJGP, Bonvanie et al report an important pragmatic RCT evaluating the addition of oral ondansetron to usual care in children presenting with acute gastroenteritis in the out-of-hours primary care setting.5 The trial was conducted between 2015 and 2018 in three Dutch centres for out-of-hours care, and included children aged between 6 months and 6 years diagnosed with acute gastroenteritis -defined as ≥4 episodes of vomiting in the 24 hours before presenting, including one episode within 4 hours of presentation.Usual care for children included the provision of ORT, either 10 ml/kg or 15 ml/kg for 4 hours based on hydration status along with administration instructions.Children randomised to the intervention group received a single dose of oral ondansetron syrup (0.1 mg/kg).The trial was open label without a placebo arm -participants, parents, GPs, and the research team were not blinded.The primary outcome was the proportion of children who continued vomiting in the first
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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 | 0.008 | 0.035 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.007 | 0.005 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.014 | 0.019 |
| Insufficient payload (model declined to judge) | 0.008 | 0.005 |
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".