Risks of Intravenous Immunoglobulin in Sepsis Affect Trial Design
Bibliographic record
Abstract
Letters4 December 2007Risks of Intravenous Immunoglobulin in Sepsis Affect Trial DesignAlexis F. Turgeon, MD, MSc, Dean A. Fergusson, MHA, PhD, D. William Cameron, MD, Paul C. Hébert, MD, MSc, Lauralyn McIntyre, MD, MSc, and Alan A. Tinmouth, MD, MScAlexis F. Turgeon, MD, MScFrom Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Search for more papers by this author, Dean A. Fergusson, MHA, PhDFrom Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Search for more papers by this author, D. William Cameron, MDFrom Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Search for more papers by this author, Paul C. Hébert, MD, MScFrom Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Search for more papers by this author, Lauralyn McIntyre, MD, MScFrom Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Search for more papers by this author, and Alan A. Tinmouth, MD, MScFrom Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-11-200712040-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Drs. Khan and Sewell for their interest and relevant comments regarding our study. As pointed out in their letter, adverse reactions after IVIG administration have been observed in patients with severe infections. However, these severe adverse effects were described in patients with hypogammaglobulinemia who received their usual replacement treatment of IVIG during an intercurrent infection, who differ from the broad population of patients with sepsis of our study. Moreover, in the same observational study of more than 13 500 IVIG infusions, the incidence of adverse events was 0.8%, and none of these reactions were reported as severe ...References1. Brennan VM, Salomé-Bentley NJ, Chapel HM. Prospective audit of adverse reactions occurring in 459 primary antibody-deficient patients receiving intravenous immunoglobulin. Clin Exp Immunol. 2003;133:247-51. [PMID: 12869031] CrossrefMedlineGoogle Scholar2. Chen C, Danekas LH, Ratko TA, Vlasses PH, Matuszewski KA. A multicenter drug use surveillance of intravenous immunoglobulin utilization in US academic health centers. Ann Pharmacother. 2000;34:295-9. [PMID: 10917372] CrossrefMedlineGoogle Scholar3. Pendergrast JM, Sher GD, Callum JL. Changes in intravenous immunoglobulin prescribing patterns during a period of severe product shortages, 1995-2000. Vox Sang. 2005;89:150-60. [PMID: 16146507] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Intravenous Immunoglobulin in Critically Ill Adult Patients with Sepsis Alexis F. Turgeon , Brian Hutton , Dean A. Fergusson , Lauralyn McIntyre , Alan A. Tinmouth , D. William Cameron , and Paul C. Hébert Risks of Intravenous Immunoglobulin in Sepsis Affect Trial Design Sujoy Khan and W. A.C. Sewell Metrics 4 December 2007Volume 147, Issue 11Page: 813-814KeywordsAdverse eventsAdverse reactionsNeutropeniaObservational studiesProteinsQuality of lifeSafetySepsis ePublished: 4 December 2007 Issue Published: 4 December 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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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 | 0.148 | 0.453 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.006 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.008 | 0.004 |
| Insufficient payload (model declined to judge) | 0.040 | 0.006 |
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".