AMMI Canada – CACMID Annual Conference
Bibliographic record
Abstract
Objective: PCR assays for detection of C. difficile infection (CDI) in symptomatic patients have been shown to have higher sensitivities than EIAs.The objective of this study was to assess the impact of changing from an EIA to a PCR-based method for C. difficile toxin B gene detection on healthcare-associated CDI (HA-CDI) rates, patient outcomes and CDIrelated isolation days in hospital.MethOds: An observational study was carried out on patients positive for C. difficile toxin by EIA (Oct 2008-Sept 2009) and PCR (Oct 2009-Sept 2011).All patients with a positive test were reviewed to confirm adherence to a case definition for CDI.Patient data collected included demographics, complications, 30-day outcomes, and length of stay (LOS).The number of isolation days for all cases of suspected and confirmed CDI were tracked.HA-CDI rates were reported per 10,000 patient-days.Cases detected by the two methods were compared by t-test and χ 2 analysis.Results: The mean incidence of HA-CDI did not differ between the EIA and PCR test periods (6.4 vs. 6.6/10,000patient-days; p=0.79).A significant decrease was seen in the mean LOS overall (51 vs 32 days; p=0.007), and after confirmation of infection (32 vs 20 days; p=0.011); the mean number of isolation days per patient decreased from 7.7 to 6.3 days (p<0.001) after the introduction of the PCR assay.No significant difference in patient outcomes (ICU admission, colectomy or death at 30 days) was observed.cOnclusiOn: The introduction of PCR testing did not affect HA-CDI rates, but was associated with reduced isolation days and hospital LOS, thereby improving patient care and safety.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.385 | 0.090 |
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".