Determinants of in-hospital death in patients with a thrombus straddling a patent foramen ovale: protocol of a systematic review
Bibliographic record
Abstract
<ns4:p> <ns4:bold>Background:</ns4:bold> Thrombi identified on echocardiography at the time of straddling a patent foramen ovale (PFO) constitute a medical emergency with an associated imminent risk of death. Ischemic stroke (IS) and myocardial infarction (MI) occurring in patients with a thrombus straddling a PFO (TSPFO) may be associated with increased risk of in-hospital death. Variables associated with increased risk of death in women and men may be different. We will perform a systematic review of case reports and cases series of patients with a TSPFO to assess if IS and MI are associated with increased risk of in-hospital death and we will further stratify analyses by sex. </ns4:p> <ns4:p> <ns4:bold>Methods:</ns4:bold> This systematic review will include all case reports and case series of adult patients (18-year-old or older) with echocardiographic or pathological (e.g. at autopsy for older reports) evidence of a TSPFO published between inception and June 30, 2020, in any language. We will search in PubMed and Embase databases. Two reviewers will independently screen titles and abstracts, retrieve full texts, and extract the data in a predesigned form. We will apply a multivariable logistic regression analysis to estimate the association of IS and MI with in-hospital mortality. We will stratify analyses by sex. </ns4:p> <ns4:p> <ns4:bold>Discussion:</ns4:bold> IS and MI in patients with TSPFO could potentially be associated with worse outcomes if they are not timely identified or left untreated. Both acute IS and MI require specific treatment (e.g. thrombolysis, primary coronary intervention, or mechanical thrombectomy) that may be influenced by the therapy instituted for the TSPFO. Knowing the incidence of acute IS and MI among patients diagnosed with TSPFO and whether they are associated with an increased risk of death would help to improve the management of this medical emergency. </ns4:p> <ns4:p> <ns4:bold>Protocol registration</ns4:bold> : CRD42020216118, PROSPERO. </ns4:p>
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".