Bibliographic record
Abstract
• Delirium: an acute impairment in cognitive ability together with impaired consciousness. • Dementia: a chronic, progressive impairment in cognitive ability but with intact consciousness. Note that this is different from delirium and that you cannot diagnose dementia from a single mental status assessment. • Mental impairment: a permanent impairment in cognitive ability. • Psychosis: the patient may not be confused, but have a disorder of thought content/perception (e.g. delusions and/or hallucinations). • Receptive dysphasia: the patient may have difficulties comprehending your questions (e.g. due to damage to Wernicke’s area of the brain). • Expressive dysphasia: the patient may be cognitively intact but have difficulties verbalizing an answer to your questions (e.g. due to damage to Broca’s area of the brain). Note that these syndromes may coexist in patients, particularly delirium and dementia which are both very common. Remember to start by checking the patient’s airway, breathing, and circulation (ABC) and whether they are in any pain that requires analgesia. To work out what type of confusion this is, you should start by conducting a quick screen of confusion because if the patient does poorly in your screen, taking a conventional history may prove unhelpful. For example, you may ask: • Are they oriented to time, place, and person? Can they tell you why they are here? The Abbreviated Mental Test Score (AMTS; see Box 2.1) is a simple 10-question screening tool for assessing confusion where a score of less than 6/10 indicates cognitive impairment. An alternative is the 30-question Mini Mental State Exam (MMSE), where a score of less than 26/30 indicates cognitive impairment. Be aware that there are many other scoring systems in routine use, such as the Confusion Assessment Method (CAM), Montreal Cognitive Assessment (MoCA), etc. • If their ability to converse is impaired, can they follow a three-step command? Can they name three common objects? These questions test for receptive and expressive dysphasia respectively. It will be fairly obvious early in your interaction with the patient whether either of these questions is relevant (they do not need to be asked routinely). • Other symptoms? Are they in pain? (even the most confused patient will complain of pain). You should also ask about breathlessness, cough, and urinary symptoms as a chest or urinary tract infection (UTI) is often the cause of confusion.
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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 | 0.011 |
| 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 | 0.003 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.244 | 0.160 |
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".