OP05.01: Can we improve prenatal diagnosis of total anomalous pulmonary venous return using standard images at routine second trimester ultrasound?
Bibliographic record
Abstract
To determine the utility of sonographic markers in prenatal diagnosis of isolated total anomalous pulmonary venous return (TAPVR) using standard second trimester ultrasound images. This was a matched case-control study from a regional referral centre (2005–2019). Isolated TAPVR cases were identified from a pediatric cardiology clinic repository. Controls were matched by gestational age at delivery, natal sex and calendar date of birth. Post-processing review of second trimester ultrasound images was performed by 2 blinded and independent observers evaluating 9 markers: confluence behind left atrium (LA), pulmonary venous entry into LA, coronary sinus, coumadin ridge, left/right heart disproportion, distribution of the great vessels, distance between LA and aorta, post-LA space index, and aortic diameter. Descriptive statistics and comparative analysis using Chi-square, student t-test and logistic regression was completed. A Bland-Altman plot was used to evaluate inter-observer reliability. 31 cases of isolated TAPVR were diagnosed during the study period. Excluding those without stored images, there remained 21 cases subsequently matched to 84 controls (n = 105). There was significant difference in post-LA space and aortic diameter: for cases, the post-LA space was larger at 0.41cm (SD 0.14) compared to 0.31cm (SD 0.09) in controls (p = 0.0001); aortic diameter was also larger in cases compared to controls (0.38 cm (SD 0.11) vs. 0.32cm (SD 0.08); p = 0.003). When 3 or more markers were present, the odds of TAPVR was also significantly increased (OR 6.25 (95%CI 1.5-25.9); p = 0.01). Fetuses with TAPVR have significantly larger post-LA spaces and aortic diameters compared to controls and when 3 or more sonographic markers are present during routine second trimester scan, there is a 6-fold higher odds of TAPVR. By using a systematic approach to evaluate fetuses for these markers, improved prenatal diagnosis could be achieved using routine images at time of the second trimester scan.
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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 | 0.005 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".