Bibliographic record
Abstract
Background and Objective(s): Spinal fusion surgery for children with medical complexity (CMC) is a procedure that is associated with a high rate of complications, adverse events, prolonged recovery and hospital readmissions.This single group case study describes a collaborative posterior spinal fusion surgical planning initiative between a pediatric orthopedic surgery group and a complex care medical home for CMC with the objective of improving outcomes.The Comprehensive Care Clinic (CCC) is a dedicated medical home for over 800 CMC and is a hub of the child's healthcare.Central Texas Pediatric Orthopedics is a tertiary orthopedic surgery group with four surgeons with expertise in neuromuscular scoliosis repair performing 30 neuromuscular scoliosis repairs annually. Study Participants & Setting:Patients in this study were identified for their need for neuromuscular scoliosis surgery in the following 6 months and were active patients at the CCC.A total of 22 patients presented from 2019 to 2023 subsequently had neuromuscular scoliosis surgery.Demographic data is presented.Materials/Methods: Data was collected over 4 years.Contemporaneous notes were taken during the quarterly meetings and reviewed.Demographic data was drawn from the PCP notes manually.Outcomes data was drawn from the hospital notes manually.Data was combined and examined using descriptive statistical analysis.Results: 22 patients completed the process of presurgical planning and posterior spinal fusion.Primary outcomes measured included postoperative Infection rate, intensive care unit (ICU) length of stay (LOS), total postoperative LOS, 30 Day and 90 Day all cause hospital readmission rate, and 90 Day reoperation rate.Conclusions/Significance: This initiative describes a population of CMC who underwent a quarterly case review preoperative process of planning in coordination with a complex care primary provider.This described intervention achieved a median post-op LOS of 5 days and a 90-day readmission rate of 18.2%, similar to a large study benchmark reported by Berry et al. (PMID 28899986).Collaboration between complex PCPs and orthopedic surgeons for preoperative preparation for posterior spinal fusions is integral to coordinated care for this at risk population.This collaborative effort demonstrated the feasibility and benefit to improve quality of care.We hope that this initiative will provide further evidence of the value of communication and interdisciplinary integration to optimize care for CMC receiving posterior spinal fusions.
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 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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.635 | 0.362 |
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".