P.008 Surgical Procedures are Common in Patients with Prion Disease
Bibliographic record
Abstract
Background: Surgical instruments used in patients with prion disease must be decontaminated or decommissioned to prevent iatrogenic transmission. This is only done when the diagnosis of prion disease is known. To assess the potential for iatrogenic transmission, we determined the prevalence of surgeries and use of precautions in patients with prion disease at two academic medical centers. Methods: Clinical details, results of investigations, and surgical interventions (performed within one-year of symptom onset) were extracted for patients with probable/definite prion disease at Mayo Clinic (n=107; 1-2014 to 12-2020) and Washington University School of Medicine (n=14; 2-2015 to 12-2019). Results: Twenty-six patients (21.5%) underwent 32 procedures, including 2 high-risk procedures involving the brain. Most procedures (17/32, 53%) occurred in the 1-year period preceding the onset of symptoms attributed to CJD. History of arthritis (OR: 7.4, 95%CI: 1.05-51.8), lack of behavioral symptoms (OR: 3.0, 95%CI 0.97-9.1), and greater time (months) from symptom onset to first MRI (OR: 1.1, 95%CI 1.03-1.2) were independently associated with odds of undergoing an invasive procedure. Prion disease precautions were observed in one case (diagnostic brain biopsy). Conclusions: Procedures were common in patients with diagnosis of prion disease; precautions were not. Coordinated approaches to screening and reporting are needed to prevent iatrogenic transmission.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.028 | 0.004 |
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".