PP220 Topic: AS21–Post-PICU: Patient and Family Outcomes/Chronic Critical Illness/Post Intensive Care Syndrome in Pediatrics (PICS-p)/Post-discharge Care Delivery Models/Other: FUNCTIONAL OUTCOME ASSESSMENT IN CRITICALLY ILL CHILDREN, A CLINICIAN-REPORTED VS. PATIENT-REPORTED OUTCOMES STUDY
Bibliographic record
Abstract
Aims & Objectives: Functional assessment using PROM tools is recommended as a core outcome in PICU studies1. Function is currently most commonly assessed by the Functional status scale (FSS), a clinician-applied tool. Aim is to evaluate the agreement between the clinician-applied tool (FSS), and patient-reported outcome measure of functioning, the Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT). Methods: In the “PICULiber8” sub-study (NCT03573479), PEDI-CAT and FSS were evaluated in critically ill children at PICU admission, discharge, and 1-3 months post-discharge. Investigators (SA and MK) retrospectively scored FSS from health records. Both tools were compared, collapsing functioning domains into 3: daily living, motor, and social/cognitive. The primary outcomes were agreement on categorical scores (normal/abnormal) and levels of functioning (normal, mild, moderate, severe disability). Cohen’s kappa statistic determined agreement (poor <0.20, fair 0.21-0.40, moderate 0.41-0.60, good 0.61-0.80, very good >0.80). Results: Agreement between FSS and PEDI-CAT to distinguish between normal and abnormal functioning: •Fair for activities of daily living •Fair to moderate for mobility function •Poor to fair for social/cognitive function Agreement between FSS and PEDI-CAT distinguishing level of function (normal, mildly impaired, moderately impaired, or severely impaired): •Poor to fair for activities of daily living •Poor to fair for mobility function Poor for social/cognitive function Conclusions: FSS does not correlate well with PEDI-CAT. This study provides evidence that patient-centered outcomes such as functioning should be measured through PROMs in critically ill children. Further studies are needed to evaluate the feasibility of integrating PROMs in the Clinical setting in PICU2. Keywords: PEDI-CAT, function, rehabilitation, morbidity, impairment
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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 | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.098 | 0.013 |
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".