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Record W4387230193 · doi:10.1136/emermed-2023-999.56

PP57 Indicators for avoidable emergency medical service calls: mapping of paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada

2023· article· en· W4387230193 on OpenAlexaffabout
Gina Agarwal, A Niroshan Siriwardena, Brent McLeod, Robert Spaight, Gregory Adam Whitley, Richard Ferron, Melissa Pirrie, Ricardo Angeles, Harriet Elizabeth Moore, Mark Gussey

Bibliographic record

Venuenot available
Typearticle
Languageen
FieldHealth Professions
TopicMedical Coding and Health Information
Canadian institutionsMcMaster University
Fundersnot available
KeywordsMental healthService (business)Medical emergencyAmbulatory careHealth careService providerMedicineBusinessPsychiatry

Abstract

fetched live from OpenAlex

<h3>Background</h3> Paramedic assessment data have not been used for research on avoidable calls. Paramedic impression codes are designated by paramedics upon responding to a 911/999 medical emergency after an assessment of the presenting condition. Ambulatory Care Sensitive Conditions (ACSCs) are non-acute health conditions not needing hospital admission when properly managed. <h3>Methods</h3> The current study focused on paramedic impression codes from the East Midlands Region, UK and from Southern Ontario, Canada and mapped them to existing definitions of ambulatory care sensitive conditions (ACSCs) and mental health conditions. Mapping was iterative first identifying the common ACSCs shared between the two countries then identifying the respective clinical impression codes for each country that mapped to those shared ACSCs as well as to mental health conditions. <h3>Results</h3> Experts from the UK-Canada Emergency Calls Data analysis and GEospatial mapping (EDGE) Consortium contributed to both phases and were able to independently match the codes and then compare results. Clinical impression codes for paramedics in the UK were more extensive than those in Ontario. The mapping revealed some interesting inconsistencies between paramedic impression codes, but also demonstrated that it was possible. <h3>Conclusion</h3> This is an important first step in determining the numbers of ASCSs and mental health conditions that paramedics attend to, and in examining the clinical pathways of these individuals across the health system. This work lays the foundation for international comparative health services research on integrated pathways in primary care and EMS.

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)0.003
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.632
Threshold uncertainty score0.932

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
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 head0.138
GPT teacher head0.486
Teacher spread0.348 · 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.

The models applied no category: nothing in the taxonomy fit this work.
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

Citations0
Published2023
Admission routes2
Has abstractyes

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