Abstract 347: Experimental use of a Pediatric Fluid Resuscitation Model: Evaluating Test-retest Reliability and Inter-subject Variability
Bibliographic record
Abstract
Introduction: Health Care Providers (HCPs) report that manual techniques of intravascular fluid resuscitation are commonly used to deliver isotonic fluid to young children. At present, it is unclear how manual fluid resuscitation is optimally performed by HCPs. A non-clinical experimental setting can be used to evaluate HCP fluid resuscitation performance outcomes, however test-retest reliability is unknown. Objectives: To determine HCP test-retest reliability (repeatability) and inter-subject variability of fluid resuscitation performance outcomes to inform the design of future studies. Hypothesis: We hypothesized that good test-retest reliability would be demonstrated, but that significant inter-subject variability would exist. Methods: We conducted an interventional study involving 15 consenting HCP subjects from McMaster Children’s Hospital in Hamilton, Canada. Subjects were oriented to a non-clinical model of a 15 kg toddler. The model incorporated a 22-gauge IV catheter and extension tubing affixed to the hand in typical clinical fashion. Following a standardization procedure, subjects were asked to rapidly administer 600 mL (40 mL/kg) of 0.9% normal saline to the model using prefilled 60 mL syringes. Subjects were advised to consider that this was urgently required treatment for decompensated septic shock. Each subject repeated the intervention 5 times with a 10-minute washout period between trials. All testing was video recorded, with fluid administration time outcome data (in seconds) extracted from trial videos by two blinded outcome assessors. The primary outcome of fluid administration time test-retest reliability was analyzed by one-way ANOVA and ICC as per our a priori plan. Results: Differences in HCP fluid administration times are attributable to inter-subject variability rather than intra-subject variability based on one-way ANOVA analysis, F(14,60)=43.125 (p<0.001). Test-retest reliability of subjects was excellent, with ICC=0.97 [95% CI 0.95; 0.99] (p<0.001). Conclusions: Our findings demonstrate excellent test-retest reliability of HCP fluid resuscitation performance in an experimental setting involving a non-clinical model. Use of a single HCP trial in future comparative studies is justified.
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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 | 0.011 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".