Pediatric pulmonary arterial hypertension; is it possible to predict its outcome?
Bibliographic record
Abstract
Objectives: To assess the outcome of pediatric pulmonary arterial hypertension (PAH) and to identify the predictors of morbidity and mortality of this progressive disease. Patients and methods: This prospective observational cohort study was conducted on consecutive pediatric patients with PAH. Medical history was taken with a grading of the WHO functional class as well as the serum N-terminal pro-BNP (NT pro-BNP), 6 min' walk test (6MWT), and echocardiography at the initial assessment and at follow-up. Results: The cohort study included 71 patients; 39 patients had idiopathic and heritable PAH, 27 patients had PH secondary to CHD and five patients had miscellaneous causes. Dyspnea was the most common presenting symptom. The mean initial 6MWT distance was 273.3 ± 139.9 m. The median of the initial NT-proBNP level was 1982 pg/ml with IQR from 373.9 to 5472 pg/ml. Death occurred in 17 patients (23.9%) and 16 (22.5%) had evolving morbidity. The predictors of morbidity were NT-proBNP >1032 pg/ml and its Z score > +3.5, WHO functional class 3 and 4, RV failure and low TAPSE. The predictors of mortality were 6MWD ≤210 m, WHO functional class 4, RV failure, syncope, low TAPSE, NT-proBNP >4734 pg/ml and its Z score >4.57. Conclusion: PAH is a serious disease and reliable predictive outcome is feasible by clinical assessment, echocardiographic parameters. NT pro-BNP is a surrogate biomarker for diagnosis and prognosis of PAH.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".