Prevalence of diagnosed pulmonary embolism in patients with chronic obstructive pulmonary disease exacerbation presenting at the emergency department of a large North American academic hospital center
Bibliographic record
Abstract
Background The real prevalence of pulmonary embolism (PE) in patients with chronic obstructive pulmonary disease exacerbation (COPDe) remains largely unknown, especially in North America. Our aim was to evaluate the prevalence of PE in patients with COPDe at a large academic Canadian hospital.Methods This is a retrospective cohort study of all adult patients with COPDe seen at the emergency department (ED) of The Ottawa Hospital, Ontario, Canada (June 2019-January 2022). The primary outcome was the prevalence of PE during the initial assessment and at 3 months. Secondary outcomes included prevalence of venous thromboembolism and mortality. Subgroup analyses based on the type of COPDe and the post-ED clinical setting were conducted.Results Of 1158 patients seen in the ED with COPDe, PE was diagnosed in 13 patients (1.1%; 95%CI 0.6%-1.9%). Five patients (5/1158; 0.4%) had a diagnosis of PE during initial assessment and 8/1141 (0.7%) patients were diagnosed with PE during the 3-month follow-up. The prevalence of PE did not differ based on the type of COPDe (p = 0.27) and was higher in patients admitted to the hospital compared to patients discharged from the ED (1.1% vs 0.0%; p = 0.01). Mortality was clinically but not statistically higher in patients with PE compared to patients without PE (15.4% vs 6.0%; p = 0.19).Conclusion Among patients with COPDe evaluated in the ED, the prevalence of diagnosed PE was low, but more than 60% of the PE were diagnosed during the 3-month follow-up. Further studies are needed to determine an appropriate diagnostic algorithm in this population.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| 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".