06 Eating disorder toolkit 2023: Standards of practice in the primary care setting
Bibliographic record
Abstract
Abstract Background Throughout the COVID 19 pandemic, physicians across Canada began to see a 'shadow pandemic' unfold as new diagnosis of eating disorders and hospital admissions for patients with medically unstable eating disorders increased exponentially. As these rates remain high, specialists stressed the importance of the role primary care physicians play in the early recognition, assessment, and diagnosis of eating disorders as a way to improve prognosis. Further, the high volume of patients has resulted in the need to manage patients in the community or engage in collaborative care between the eating disorder specialist and primary care physician. This Eating Disorder Toolkit was created as a knowledge mobilization resource to provide primary care and community providers with Standards of Practice and improve care for eating disorder patients. Objectives 1. Provide an updated and easily readable evidence-based reference tool for PCPs 2. Clarify PCPs role in working with, monitoring, and treating EDs in a shared care model 3. Strive for early diagnosis and connection to care for improved prognosis and decreased morbidity 4. Highlight unique considerations for specific populations 5. Align with the upcoming Eating Disorders Pathway project Design/Methods The first edition of the ED Toolkit was reviewed and based on feedback sought and provided by key partners including PCPs already using the Toolkit, areas of improvement were identified. These included formatting to improve accessibility in the primary care setting, updating the guidelines, and including unique considerations for specific populations. A literature review of current guidelines and practices internationally was completed. Experienced paediatric and adult ED specialists reviewed the material to ensure it was appropriate for clinical practice. Key partners contacted for feedback and collaboration included the Provincial ED Steering Committee, Provincial ED Pathway Project Committee, UBC Continuing Professional Development, and Primary Care physicians. This ensured the resource was meeting PCPs identified needs and was usable in the primary care setting. Edits were made to reflect the feedback received. Finally, the resource was reviewed to ensure alignment with the upcoming Provincial ED Pathway Project. Results The Eating Disorder Toolkit 2023: Standards of Practice in the Primary Care Setting is now available and has been distributed widely across British Columbia. In addition, Kelty Mental Health and Compass, leading resource hubs in the province, host the live document on their sites. Finally, the toolkit is also provided to any health providers upon request to their regional ED clinic. While we have not formally studied the outcome of this resources, anecdotal reports via email and verbal feedback from nurse practitioners, paediatricians, and ED specialists across the province has been positive. Conclusion Eating disorders are complex illnesses associated with significant medical and psychiatric complications. Early recognition and management improves prognosis. Community providers play a crucial role in recognizing and managing these patients, however many do not have expertise in this area. It is hoped that this resource will support PCPs in managing ED patients in British Columbia and there may be a potential scope for use across Canada with adaptations to local guidelines and resources.
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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 | 0.114 | 0.228 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.009 | 0.006 |
| Open science | 0.006 | 0.013 |
| Research integrity | 0.004 | 0.007 |
| Insufficient payload (model declined to judge) | 0.023 | 0.016 |
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".