643: ESTIMATING THE GLOBAL PREVALENCE OF PEDIATRIC ACUTE CRITICAL ILLNESS IN RESOURCE-LIMITED SETTINGS
Bibliographic record
Abstract
Introduction: Globally, Most pediatric critical illness is managed outside of formal intensive care units, as such we lack an understanding of the true prevalence of pediatric critical illness. Global PARITY (Pediatric Acute cRitical Illness point prevalence sTudY) is a prospective, observational, international study designed to measure prevalence of and outcomes associated with pediatric acute critical illness in resource-limited settings. We hypothesized that availability of pediatric critical care resources (formal and informal) impacts clinical outcomes. Data collection completes in Sep 2022; here we describe preliminary findings. Methods: Children 29 days-14 years with acute illness or injury presenting to a hospital in RLS settings were enrolled during 4 sampling periods over 12 months. Participating centers were not required to have a dedicated pediatric ICU. Admitted children were followed for clinical outcomes and critical care resource utilization. The primary outcome was prevalence of acute critical illness, defined as death within 48 hrs of presentation, need for a higher level of care, or requiring intensive care resources (e.g., Vasoactive). Results: study launched in July 2021 with 63 centers; 47 centers completed >3 data collection periods and over 7000 subjects were enrolled. Data completion and quality review for the 4 sampling periods are underway. A subset of data showed the availability of intensive care units: Pediatric high dependency/intermediate care unit (33, 52.4%), PICU (45, 71.4%), Pediatric beds in adult ICU (8, 12.7%), another subset of data showed patient utilization; Invasive Mechanical Ventilation requirement (N=8055): Yes (48, 0.6%), Vasoactives use: Yes (83, 1.0%). admission location (N=885): Inpatient Ward (600, 67.8%), High-Dependency Unit (266, 30.1%), Intermediate Care Unit (6, 0.7%), Intensive Care Unit (6, 0.7%). Conclusions: The majority of sites reported having a formal PICU. However, resource availability varies significantly between PICUs and this analysis, as well as the association between resources and outcomes, is in process. Global PARITY is a necessary step in determining the global burden of pediatric critical illness and availability of critical care resources; it will provide important insights regarding future resource investment and allocation.
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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 | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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.
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".