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Record W4249372515 · doi:10.1213/ane.0000000000002361

In Response

2017· letter· en· W4249372515 on OpenAlexaboutno aff
Ramon Abola, Tong J. Gan

Bibliographic record

VenueAnesthesia & Analgesia · 2017
Typeletter
Languageen
FieldMedicine
TopicEnhanced Recovery After Surgery
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineGuidelineHarmMalpracticeScientific evidenceAmerican society of anesthesiologistsMedical emergencySurgeryLawSocial psychologyPsychology

Abstract

fetched live from OpenAlex

We appreciate the comments by Drs Grocott and Brudney.1 We agree that the specific language used in medical guidelines has the potential to influence the adoption rate by anesthesiologists. In this regard, we applaud the specific language by the American Society of Enhanced Recovery, the European Society of Anaesthesiology, and the Canadian Anesthesiologists Society regarding preoperative fasting guidelines that actively encourage patients to drink clear fluids up to 2 hours before elective surgery. We agree that guideline authors should attempt to be as explicit in their recommendations as the evidence and circumstances allow. But the final language chosen by a guideline committee must reflect a consensus opinion of the group. Thus, recommendations tend to be “watered down” and less explicit. The ambiguous nature of guidelines may also be intentional to hedge against its use during malpractice litigation. We applaud the work by Shiraishi et al2 because it provides evidence that it is safe to allow patients to drink until 2 hours before surgery. Evidence-based research enables authors of practice guidelines to make better and more specific recommendations. The outcome data regarding the benefit of carbohydrate beverages are limited. However, allowing patients to drink clear fluid preoperatively is humane and not associated with any harm. We challenge providers to implement process changes at their hospitals that will encourage their patients to drink clear fluids up to 2 hours before surgery. A decision support system within the electronic medical record can facilitate its implementation. Ramon E. Abola, MDTong J. Gan, MDDepartment of AnesthesiologyStony Brook MedicineStony Brook, New York[email protected]

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Research integrity, Insufficient payload (model declined to judge)
Consensus categoriesResearch integrity
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.165
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0000.001

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.

Opus teacher head0.019
GPT teacher head0.277
Teacher spread0.258 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designNot applicable
Domainnot available
GenreCommentary

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".

Quick stats

Citations0
Published2017
Admission routes1
Has abstractyes

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