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Record W4402860063 · doi:10.1183/13993003.00470-2024

Multidisciplinary management of adult patients with chylothorax: a consensus statement

2024· article· en· W4402860063 on OpenAlexaff
Abhinav Agrawal, Udit Chaddha, Samira Shojaee, G. Nadolski, Moïshe Liberman, Gary Lee, Najib M. Rahman, Janani Reisenauer, Mark K. Ferguson, Malcolm M. DeCamp, Erin A. Gillaspie, Eihab O. Bedawi, Brian Currie, David Feller‐Kopman, Ajinkya Desai, Kazuhiro Yasufuku, V. Bishay, Yaron Gesthalter, Horiana B. Grosu, Jeffrey Forris Beecham Chick, Robert J. Lentz, K. Kolli, Andrew Kaufman, Ravindra Mehta, Kush Desai, Heather Davis, Uzair Ghori, Fabien Maldonado

Bibliographic record

VenueEuropean Respiratory Journal · 2024
Typearticle
Languageen
FieldMedicine
TopicLymphatic Disorders and Treatments
Canadian institutionsUniversity of TorontoUniversity Health NetworkToronto General HospitalUniversité de Montréal
Fundersnot available
KeywordsMedicineChylothoraxDelphi methodStatement (logic)Multidisciplinary approachDelphiBest practiceMEDLINEEvidence-based medicineIntensive care medicineMedical educationMedical physicsSurgeryAlternative medicinePathologyManagement

Abstract

fetched live from OpenAlex

The management of chylothorax remains challenging given the limited evidence and significant heterogeneity in practice. In addition, there are no practical guidelines on the optimal approach to manage this complex condition. We convened an international group of 27 experts from 20 institutions across five countries and four specialties (pulmonary, interventional radiology, thoracic surgery and nutrition) with experience and expertise in managing adult patients with chylothorax. We performed a literature and internet search for reports addressing seven clinically relevant PICO (Patient, Intervention, Comparison and Outcome) questions pertaining to the management of adult patients with chylothorax. This consensus statement, consisting of best practice statements based on expert consensus addressing these seven PICO questions, was formulated by a systematic and rigorous process involving the evaluation of published evidence, augmented with provider experience. Panel members participated in the development of the final best practice statements using the modified Delphi technique. Our consensus statement aims to offer guidance in clinical decision making when managing patients with chylothorax while also identifying gaps in knowledge and informing future research.

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 machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.126
metaresearch head score (Gemma)0.132
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.126
Threshold uncertainty score0.664

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.1260.132
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0020.003
Bibliometrics0.0050.003
Science and technology studies0.0040.003
Scholarly communication0.0040.005
Open science0.0040.008
Research integrity0.0080.008
Insufficient payload (model declined to judge)0.0030.002

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 head0.016
GPT teacher head0.280
Teacher spread0.263 · 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 source (direct Gemma or distilled Codex), not a consensus.

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

Citations8
Published2024
Admission routes1
Has abstractyes

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