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Record W4401951431 · doi:10.3138/canlivj-2023-0037

Risk evaluation and recipient selection in adult liver transplantation: A mixed-methods survey

2024· article· en· W4401951431 on OpenAlex
Christian Vincelette, Philémon Mulongo, Jeanne‐Marie Giard, Éva Amzallag, Adrienne Carr, Prosanto Chaudhury, Khaled Dajani, René Fugère, Nelson Gonzalez-Valencia, Alexandre Joosten, Stanislas Kandelman, Constantine Karvellas, Stuart A. McCluskey, Timur Özelsel, Jeieung Park, Ève Simoneau, Helen Trottier, Michaël Chassé, François Martin Carrier

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
venuePublished in a venue whose home country is Canada.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueCanadian Liver Journal · 2024
Typearticle
Languageen
FieldMedicine
TopicLiver Disease and Transplantation
Canadian institutionsVancouver General HospitalLondon Health Sciences CentreUniversity of TorontoWestern UniversityUniversity of British ColumbiaTranslational Research in OncologyToronto General HospitalDalhousie UniversityUniversité de MontréalUniversity of AlbertaMcGill University Health CentreCentre Hospitalier de l’Université de Montréal
Fundersnot available
KeywordsMedicineLiver transplantationComorbidityRisk assessmentVignetteKidney diseaseIntensive care medicineTransplantationLiver diseaseIncidence (geometry)Emergency medicineInternal medicine

Abstract

fetched live from OpenAlex

Background: Liver transplant (LT) is the definitive treatment for end-stage liver disease. Limited resources and important post-operative implications for recipients compel judicious risk stratification and patient selection. However, little is known about the factors influencing physicians' assessment regarding patient selection for LT and risk evaluation. Methods: We conducted a mixed-methods, cross-sectional survey involving Canadian hepatologists, anesthesiologists, LT surgeons, and French anesthesiologists. The survey contained quantitative questions and a vignette-based qualitative substudy about risk assessment and patient selection for LT. Descriptive statistics and qualitative content analyses were used. Results: We obtained answers from 129 physicians, and 63 participated in the qualitative substudy. We observed considerable variability in risk assessment prior to LT and identified many factors perceived to increase the risk of complications. Clinicians reported that the acceptable incidence of at least 1 severe post-operative complication for a LT program was 20% (95% CI: 20-30%). They identified the presence of any comorbidity as increasing the risk of different post-operative complications, especially acute kidney injury and cardiovascular complications. Frailty and functional disorders, severity of the liver disease, renal failure and cardiovascular comorbidities prior to LT emerged as important risk factors for post-operative morbidity. Most respondents were willing to pursue LT in patients with grade III acute-on-chronic liver failure but were less often willing to do so when faced with the uncertainty of a clinical example. Conclusions: Clinicians had a heterogeneous appraisal of the post-operative risk of complications following LT, as well as factors considered in risk assessment.

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.

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)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.463
Threshold uncertainty score0.949

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
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 head0.022
GPT teacher head0.321
Teacher spread0.299 · 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