A246 BALLOON-OCCLUDED RETROGRADE TRANSVENOUS OBLITERATION FOR PRIMARY PROPHYLAXIS OF GASTRIC VARICEAL BLEEDING: A SYSTEMATIC REVIEW
Bibliographic record
Abstract
Abstract Background Gastric variceal (GV) bleeding is an infrequent but serioous complication of cirrhosis that is associated with high mortality. Balloon-occluded retrograde transvenous obliteration (BRTO) is an effective treatment to prevent rebleeding from GV. The role of BRTO for primary prophylaxis of GV bleeding has not been established. Purpose The aim of the current study is to establish the efficacy and safety of BRTO for primary prophylaxis of GV bleeding. Method We searched EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials from inception to November 2021. Randomized controlled trials and observational studies involving adults with cirrhosis related GV that had never bled and were treated with BRTO were included. Studies without clinical outcomes or those not reporting primary prophylaxis outcomes separately were excluded. Risk of bias was assessed using the Newcastle-Ottawa scale. Result(s) We identified 791 unique citations with 9 eligible studies after a full-text review. A total of 577 patients were included from 9 observational studies (1 prospective, 8 retrospective). Technical success after the first procedure ranged from 82.4-100% (7 studies) and GV eradication on follow-up endoscopy ranged from 88.2-100% (4 studies). GV bleeding occurred in 0-7.3% of patients with follow-up ranging from 15.8-66.2 months (9 studies). Eight studies were considered at high risk of bias due to the lack of a control group or poor comparability between the cohorts. Conclusion(s) BRTO appears to be effective for primary prophylaxis of GV bleeding. Further controlled studies are needed before BRTO can be routinely performed for primary prevention of gastric variceal bleeding. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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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 | 0.007 | 0.028 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.007 |
| Bibliometrics | 0.012 | 0.014 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 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".