P2–088: <i>Suffering syndrome</i> a new pathological entity in end–stage dementia
Bibliographic record
Abstract
Patient suffering is a pathological syndrome traditionally viewed as a state encompassing psychological distress, spiritual concerns and various aspects of physical pain. There is insufficient clinical evidence of suffering in dying dementia patients and key criterions for irreversible medical conditions, which may lead to inappropriate evaluation and insufficient palliative treatment. To evaluate the suffering of terminal dementia patients (MMSE=0/30, FIM=18/126) using the Mini Suffering State Examination (MSSE) scale over time, from admission to a geriatric ward and during a 6–months follow–up period. A prospective study of consecutive end–stage dementia (ESD) patients admitted to a general geriatric department of a tertiary hospital. Patients were evaluated weekly by the MSSE that was developed by us and presented at world and regional congresses in Berlin (1999), Jerusalem (2000), Vancouver (2001), Stockholm (2002), Tokyo (2003), Las Vegas (2004), Rio de Janeiro (2005), the Committee for Labor, Social Services and Health of the Israeli Knesset (Parliament) (2005). Two hundred patients were studied. After 6 months' follow–up of ESD patients who admitted to a geriatric department, 88 (44%) had survived and 112 (56%) had died. The MSSE scale score of the surviving ESD patients was low. The total score on the day of admission was MSSE=3.41±2.02, and decreased to MSSE=2.77±1.90, (P=0.003) during 6 months follow–up. Conversely, the MSSE scale score of the ESD patients who died was high – the total score was MSSE =4.97±2.46 on the day of admission to a geriatric department, and increased to MSSE=5.93±2.39 on the last day of life with a significant difference (P≤0.0001). Suffering syndrome in terminal dementia is the new proposal pathological symptomatology and entity that is characterized by a high MSSE scale score, <6 months survival, irreversible and intractable aggravation of suffering and medical condition until demise. Suffering syndrome may be the key criterion for enrolling ESD patients for palliative and hospice treatment, and for the development of new alternative setting approaches, such as “Suffering Relief Units” for end–stage and dying dementia patients.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".