PP222 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: SYSTEMATIC REVIEW AND META-ANALYSIS OF PREVALENCE AND POPULATION-LEVEL FACTORS CONTRIBUTING TO POSTTRAUMATIC STRESS DISORDER IN PEDIATRIC INTENSIVE CARE SURVIVORS
Bibliographic record
Abstract
Aims & Objectives: Pediatric intensive care unit (PICU) admission is a life-threatening event placing survivors at risk for posttraumatic stress disorder (PTSD). This systematic review sought to describe the prevalence of PTSD in PICU survivors and analyze potential risk-factors driving variation in prevalence estimates. Methods: MEDLINE, Embase, CINAHL, and CENTRAL databases were searched from 2000 to August 2022, no language restrictions. Stage one screening of abstract and full text sought to identify studies evaluating PICU survivors post-discharge. Stage two screening identified specific studies reporting on incidence or prevalence of PTSD and/or risk factors. Given the large number of citations, we utilized a validated hybrid model of machine learning and crowdsourcing, recruiting a global community at the WFPICCS 2022 meeting. Random effects meta-analysis calculated pooled PTSD prevalence and evaluated subgroup differences. Results: From the original 15950 citations, 22 met criteria with a median cohort size 59 (IQR 49-76). PTSD prevalence ranged from 3% to 37%, with 529 of the total 1898 survivors reported as having PTSD (I2= 72%). Study factors impacting PTSD variability included months assessed post-PICU (p<0.01) and instrument utilized (n=9, range 4-27%; p=0.03). Patient diagnosis mattered, with lower PTSD (8%) in post-operative cardiac patients (p<0.01). Interestingly, PICU length of stay did not impact PTSD, although heterogeneity was high. Conclusions: 1 in 4 PICU survivors (29%) developed PTSD six months post-PICU. We identified numerous population and study design factors that influence prevalence and heterogeneity. This review demonstrates the need for more standardization in post-PICU PTSD clinical application and research. Trial registration: PROSPERO, CRD42022348997 Keywords: PTSD, Systematic Review, Post PICU
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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 | 0.005 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.009 |
| Bibliometrics | 0.008 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.023 | 0.002 |
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.
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".