Intravesical Tranexamic Acid for Patients Requiring Continuous Bladder Irrigation in the ED: A Non-Randomized Feasibility Study
Bibliographic record
Abstract
Objectives Tranexamic Acid (TXA) is a well studied clot stabilizer that may have benefit when used intravesically prior to continuous bladder irrigation (CBI). This study determined the feasibility of conducting a randomized controlled trial using TXA intravesically in patients who present to the emergency department (ED). The study goals were to recruit 20 participants within a six-month time frame and have an 80% recruitment rate. Methods Potential participants were identified at triage if they presented with a complaint of hematuria or urinary retention and were over the age of eighteen. Informed consent was obtained if the patient needed CBI and met inclusion/exclusion criteria. If consented, TXA was instilled intravesically at the start of CBI treatment and the patient was followed until their CBI treatment was complete. Results A total of 14 (out of 18) participants were recruited over eight months. The mean age of participants was 74.5 +/- 7.4 years with only one of the 14 participants identifying as female. For resource management, the study was designed to include support from an on-call nurse. The on-call nurse was called seven out of fourteen times and came into hospital one time. Eight participants did not require hospital admission after the TXA intervention. The mean length of hospital stay for participants was 4.6+/-2.7 days. The mean ED length of stay was 8.1+/-4.9 hours. There were no reported adverse events. Conclusion The recruitment rate of 78% indicated that the study was acceptable to participants, but we were unable to meet our goal of recruiting 20 participants over six months. Study protocol was followed, and no adverse events were found.
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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 | 0.022 | 0.025 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".