Letters to the Editor
Bibliographic record
Abstract
Re: Robinson JL, Le Saux N. Preventing Hospitalizations for Respiratory Syncytial Virus (RSV) Infection. Canadian Paediatric Society Infectious Diseases and Immunization Committee. Paediatr Child Health 2015;20(6):321–33. To the Editor; We are a group of paediatricians who wish to express major concerns about this particular Position Statement, published in the August/September 2015 issue of the Journal, and its implications for children and families within our community. Several of the quotes are incorrect, which reflects an incomplete search of the relevant scientific literature. In the United States outcomes registry (2000–2001), 75% of all RSV-related hospitalizations (RSVH) occurred between the first and second injection intervals (1), and the highest RSVH percentage (31%) was also noted in the same time interval in 2000–2004 (2). Palivizumab does prevent intensive care unit admissions, and the Cochrane meta-analysis (n=2789) confirms the same (RR 0.50 [95% CI 0.30 to 0.81]) (3). In a randomized trial, palivizumab recipients also had a statistically lower incidence of medically attended, non-hospitalized RSV infection, suggesting an attenuated effect on disease severity (4). The recommendation for three to five doses is based on low-quality evidence through observational studies without palivizumab levels (5,6). Reports confirm that after three doses, 52% and 85% of infants have palivizumab levels <5th percentile, respectively (7,8). Moreover, the quoted article recommending four doses “emphasizes the importance of testing the regimen in randomized trials before adoption” (9). The key message from the systematic review of observational studies was similarly overlooked (10). The review supports palivizumab for preterms < 33 weeks' gestational age (GA), children with chronic lung (CLD) and hemodynamically significant congenital heart disease (HSCHD) (10). Finally, healthy preterms are at greater risk for RSVH than term infants and the magnitude of difference is two-to threefold higher up to two years of age (11).
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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 | 0.004 | 0.060 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.015 | 0.014 |
| Insufficient payload (model declined to judge) | 0.076 | 0.053 |
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".