A133 EVALUATION OF DYSPHAGIA IN AN ACADEMIC CENTRE
Bibliographic record
Abstract
Abstract Background Dysphagia is a common referral to gastroenterology with both benign and malignant etiologies. There is a lack of studies regarding its clinical assessment, complications and outcomes in Canada. Aims To evaluate the assessment and outcomes of secondary and tertiary level dysphagia referrals in adult patients. Methods We conducted a retrospective analysis of 98 consecutive adult patients who were initially referred for dysphagia to the Division of Gastroenterology at the Kingston Health Sciences Centre in 2015. Chart reviews were performed to assess demographics, characteristics of dysphagia, time for clinical assessment and outcomes. Results Of the referred patients, 19 did not present for their clinic appointment. The majority of patients (60%) were >60 yrs old with an equal distribution of male and female patients. In the assessed patients, reflux was the most common etiology (55.5%) followed by oropharyngeal causes (13.5%) and motility disorders (12%). Only 3 patients of the cohort were diagnosed with esophageal cancer, 2 of whom had metastasis at the time of presentation. Time from referral to clinical assessment was <4 weeks in just 30% and >12 weeks in 55%. For the patients diagnosed with malignancy, 2 were assessed within of 2 weeks while the third patient was assessed and endoscoped at 12 weeks. In patients sent for endoscopy, 28% had an endoscopy <4 weeks after assessment while 47% had endoscopy > 12 weeks after assessment. Manometry was performed in 18% of the patients assessed. Information was available on the course of the dysphagia in 65 patients. Dysphagia had resolved or improved in 83%, remained unchanged in 14% and worsened in 3%. Conclusions Reflux-related dysphagia was by far the most common cause of dysphagia in this referral cohort. Wait times for clinical assessment greatly exceeded current CAG recommendations in the majority. Given current resource constraints, this highlights the need for improved referral information and patient care pathways in the management of patients referred with dysphagia. Funding Agencies None
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".