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Record W4372334641 · doi:10.1136/bmjgh-2023-012049

Recommendations for developing effective and safe paediatric and congenital heart disease services in low-income and middle-income countries: a public health framework

2023· article· en· W4372334641 on OpenAlexaff
Babar Hasan, Areesh Bhatti, Shazia Mohsin, Paul Barach, Eltayeb Mohamed Ahmed, Sulafa Ali, Muneer Amanullah, Annette Ansong, Tahmina Banu, Andrea Beaton, R. Morton Bolman, Bruna Cury Borim, John P. Breinholt, Edward Callus, Massimo Caputo, Marcelo Cardarelli, Tomás Chalela Hernández, Ulisses Alexandre Croti, Yayehyirad Ejigu, Kathleen N. Fenton, Anu Gomanju, Ashraf S. Harahsheh, Peter S. Hesslein, Christopher Hugo‐Hamman, Sohail Khan, Jacques Kpodonu, Raman Kumar, Kathy J. Jenkins, Kokila Lakhoo, Mahim Malik, Sanjiv Nichani, William M. Novick, David M. Overman, Alexis Palacios-Macedo Quenot, Ceeya Patton Bolman, Dorothy Pearson, Vijayakumar Raju, Shelagh Ross, Néstor Sandoval, Gary F. Sholler, Rajesh Sharma, Fenny Shidhika, Sivakumar Sivalingam, Amy Verstappen, Dominique Vervoort, Liesl Zühlke, Bistra Zheleva

Bibliographic record

VenueBMJ Global Health · 2023
Typearticle
Languageen
FieldMedicine
TopicCongenital Heart Disease Studies
Canadian institutionsUniversity of Toronto
FundersMedical Research CouncilDepartment for International DevelopmentSouth African Medical Research CouncilNational Research FoundationBritish Heart Foundation
KeywordsMedicinePublic healthHealth careHeart diseaseGlobal healthDeveloping countryQuality managementNursingFamily medicineMedical emergencyOperations managementManagement systemEconomic growthCardiology

Abstract

fetched live from OpenAlex

of paediatric and congenital heart disease (PCHD) is substantial. We propose a novel public health framework with recommendations for developing effective and safe PCHD services in low-income and middle-income countries (LMICs). This framework was created by the Global Initiative for Children's Surgery Cardiac Surgery working group in collaboration with a group of international rexperts in providing paediatric and congenital cardiac care to patients with CHD and rheumatic heart disease (RHD) in LMICs. Effective and safe PCHD care is inaccessible to many, and there is no consensus on the best approaches to provide meaningful access in resource-limited settings, where it is often needed the most. Considering the high inequity in access to care for CHD and RHD, we aimed to create an actionable framework for health practitioners, policy makers and patients that supports treatment and prevention. It was formulated based on rigorous evaluation of available guidelines and standards of care and builds on a consensus process about the competencies needed at each step of the care continuum. We recommend a tier-based framework for PCHD care integrated within existing health systems. Each level of care is expected to meet minimum benchmarks and ensure high-quality and family centred care. We propose that cardiac surgery capabilities should only be developed at the more advanced levels on hospitals that have an established foundation of cardiology and cardiac surgery services, including screening, diagnostics, inpatient and outpatient care, postoperative care and cardiac catheterisation. This approach requires a quality control system and close collaboration between the different levels of care to facilitate the journey and care of every child with heart disease. This effort was designed to guide readers and leaders in taking action, strengthening capacity, evaluating impact, advancing policy and engaging in partnerships to guide facilities providing PCHD care in LMICs.

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 imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.105
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.034
GPT teacher head0.379
Teacher spread0.345 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations57
Published2023
Admission routes1
Has abstractyes

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