CSHP Professional Practice Conference 2011: Poster Abstracts / Conférence sur la pratique professionnelle 2011 de la SCHP : Résumés des affiches
Bibliographic record
Abstract
Objective: To compare clinical and economic outcomes in patients receiving traditional meropenem dosing (1 g Q8H) with alternative dosing (500 mg Q6H) before and after the implementation of an autosubstitution policy based on pharmacodynamic evidence of equivalence.Methods: A retrospective chart review of patients prescribed meropenem 5 months prior to (September 2008-February 2009) and 5 months after the implementation of the autosubstitution policy (February -July 2009) for P&T committee approved indications was conducted.Clinical outcomes of proportion of patients afebrile at 72 hours, time to defervescence and clinical failure rate were assessed.A cost minimization analysis was completed to quantify any cost savings accrued through implementation of the policy.Results: 28 patients who received meropenem 1 g Q8H and 29 who patients received 500 mg Q6H met our inclusion criteria.No significant differences in baseline demographics, indication for meropenem use, duration of therapy, and concomitant antibiotic use were observed between groups.The proportion of patients afebrile at 72 hours (61% vs. 79%, p=0.15) and clinical failure rate (39% vs. 24% , p=0.26) was not statistically significantly different in the traditional and alternative dosing regimen, respectively.Of the 9 patients in each treatment group who were febrile upon initiation of therapy, mean time to defervescence did not differ significantly (traditional dosing: 134.4 h, alternative dosing: 89.3 h, p=0.33).Cost minimization analysis revealed significant cost savings as quantified by mean cost per patient ($1262.45 vs. $849.78,p= 0.02) and total drug acquisition cost associated expenditure ($49235.70 vs. $43489.10,p=0.02) in the traditional and alternative dosing groups, respectively).Conclusion: The pharmacodynamically optimized alternative dosing regimen of meropenem revealed similar clinical outcomes with significant economic benefits compared to the traditional dosing in the 5 month pre and post implementation period of the autosubstitution policy.
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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 | 0.007 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.100 | 0.023 |
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".