Early detection and treatment of acute illness in medical patients with novel software: a prospective quality improvement initiative
Bibliographic record
Abstract
OBJECTIVE: An ageing population and rising healthcare costs place healthcare systems at risk of failure. Our goal was to develop a technology that would identify illness early, initiate action and therein improve patient care, outcomes and save healthcare resources. DESIGN: This was a prospective interventional quality improvement study. SETTING: A 40 bed medical floor in a 300 bed Canadian tertiary care regional referral hospital. PARTICIPANTS: General ward patients randomly assigned to control or treatment groups. There was no cross-over or loss to follow-up. INTERVENTION: We designed an algorithm and software programme capable of detecting the sentinel change in a deteriorating patient's clinical condition and once detected direct early investigation and care. Study duration was 1 year. MAIN OUTCOME MEASURES: Primary outcome was patient transfer from the general medical ward to the intensive care unit (ICU). The secondary outcome was the time needed to (1) order investigations (2) contact senior medical staff and (3) senior medical staff intervention. RESULTS: We identified a decrease in the transfer of patients from the medical ward to the ICU. Over the course of the study including 273 patients (110 in the control group and 163 in the treatment group), transfers dropped from 14 to 3 with a relative risk reduction of 85.54% (95% CI 84.96 to 86.1), a number needed to treat of 9.19 (95% CI 9.01 to 9.36) and a absolute risk reduction of 10.89% (95% CI 10.7 to 11.1). We also found a statistically significant reduction in the time required to order investigations (p=0.049), contact senior medical staff (p=0.040) and senior medical staff intervention (p=0.045). CONCLUSION: A novel algorithm and software in the hands of nursing staff identified acute illness with adequate sensitivity and specificity to dramatically reduce ICU transfers and time to clinical intervention on a medical ward.
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 imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".