Screening for Non-invasive Ventilatory Requirements in Children With Spinal Muscular Atrophy
Bibliographic record
Abstract
Introduction: Despite disease modifying treatments (DMT) in Spinal Muscular Atrophy (SMA), ongoing ventilatory requirements are common. Current guidelines suggest screening with oximetry with transcutaneous carbon dioxide (TcCO2). Aim: To determine the utility of pulse oximetry with TcCO2 as a screening tool for sleep disordered breathing (SDB) and need for Polysomnography(PSG)/Non-invasive ventilation (NIV) in children with SMA. Methods: A prospective cohort study was conducted in Queensland, Australia with diagnostic PSG completed in DMT naïve children. Transcutaneous carbon dioxide and pulse oximetry were recorded and extracted. Apnoea-hypopnoea indices (AHI) criteria, stratified by age, were applied to define normalcy and indication for non-invasive ventilation (NIV). Abnormal was defined as: ≤3 months of age [mo] AHI≥10 events/hour; > 3mo AHI ≥ 5events/hour. Receiver operating characteristic (ROC) curves and clinically meaningful cut-points were calculated for abnormal PSG and a variety of pulse oximetry/TcCO2 variables. Sensitivity, specificity, and predictive values are reported. Results: Total of45 children recruited (see table 1). The odds ratio of an abnormal PSG if the ODI4≥20 events/hour and a McGill score ≥ 2 was10.1 (95% CI 1.1-89.9; p=0.04). Conclusion: This is the first study to assess utility of pulse oximetry/TcCO2 to screen for need for NIV in children with SMA; particularly important where access to gold standard full diagnostic PSG is limited. TcCO2 adds limited information. Advantages of pulse oximetry: tolerated by children; versatile (e.g. ward/home); may avoid need for a diagnostic PSG(positive screen directed to NIV titration PSG) for some children. Findings need to be validated prospectively. Grant Support: Nil. This abstract is funded by: Nil.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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".