20 Evaluation of Compliance with the 2017 Canadian Pediatric Society (CPS) Position Statement for the Management of Newborns at Risk for Early-Onset Sepsis (EOS): A Retrospective Cohort Study
Bibliographic record
Abstract
Abstract Background Due to the high mortality and non-specific clinical presentation, clinicians often empirically treat newborns at risk of early-onset sepsis (EOS). Recently, the Canadian Pediatric Society (CPS) published updated recommendations that promote a more judicious approach to EOS management. Objectives To examine the compliance with the CPS position statement at a tertiary perinatal site. Design/Methods A retrospective chart review was conducted between Jan 1 – Jun 30, 2018. Newborns were categorized into 5 groups, depending on the number of EOS risk factors. Management strategies were assessed against the CPS recommendations to establish the rate of non-compliance. The reason for non-compliance, readmission rate and rate of culture-positive EOS were also examined. Results were expressed using descriptive statistics. A Chi-squared test was conducted to assess the association between the readmission rate and initial management. Results The total non-compliance rate was 47%. This was mostly due to inappropriate investigations in lower EOS risk groups [3 (71%) and 4 (94%)] and withholding antibiotics in groups with more risk factors [1 (43%) and 2 (67%)]. The rate of readmission for a septic work-up was low (<2%), and no newborns had culture-positive EOS. There was no significant association between the readmission rate and initial management (p=0.13). Conclusion Although the rate of non-compliance to the 2017 CPS recommendations was high, no neonates had culture-positive EOS, suggesting that our management strategies may be too aggressive. An initial observational period for newborns at lower EOS risk (groups 3 and 4) may warrant consideration for future quality improvement initiatives.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".