A surgical algorithm for the management of retrosternal goiters
Bibliographic record
Abstract
Key points: - The heterogeneity of retrosternal goiter size and location, nearby anatomical structures, and evolving surgical techniques means selecting the most appropriate individualised surgical approach remains challenging. - Although most retrosternal goiters can be removed transcervically, a small proportion of patients fulfill anatomical and radiological criteria for concurrent extracervical approaches based on decades of experience at the London Health Sciences Centre. - Anterior goiters above the level of the pericardium were resected using cervical thyroidectomy with either mediastinoscopic-assisted delivery or cervical thyroidectomy with video- assisted thyroidectomy (VATS) - Anterior goiters extending beyond the pericardium require median sternotomy to facilitate sufficient vascular control and exposure. - Posteriorly extending goiters can be managed using trans-thoracic approaches including lateral thoracotomy or VATS.
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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) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".