P-928. The Second Heart Program: A Peer-focused, Multidisciplinary Harm Reduction Intervention to Improve Outcomes for People Who Inject Drugs After Admission for Infective Endocarditis
Bibliographic record
Abstract
Abstract Background Infective endocarditis (IE) is a severe and highly prevalent injection-related infection among people who inject drugs (PWID). IE is estimated to account for 5-10% of deaths among PWID. The long-term outcomes among PWID with infective endocarditis are poor, with 5-year mortality rates over 50%. Most long-term complications are related to ongoing drug use (re-infection). However, most PWID with IE are not offered treatment for their underlying substance use disorder while in hospital. The Second Heart (SH) program is the first interdisciplinary team in Canada designed specifically to meet the unique needs of PWID with IE and which transitions with patients from the hospital into the community. The six components of the SH team are: peer support worker, systems navigator, addiction medicine physician, infectious disease physician, cardiologist/cardiac surgeon, and family physician. Methods The Second Heart Program was a non-randomized clinical trial enrolling PWID with infective endocarditis at three tertiary care hospitals in Hamilton. It was a mixed methods study utilizing both qualitative and quantitative methods. Five quantitative surveys, two qualitative interviews, and chart review were completed over the 12-month study period. Results Participants felt that their involvement with SH supported their physical, mental, and social recovery from IE, improved their trust in the healthcare system, and increased their engagement with their care. Out of 20 enrolled participants, all were consulted with an addictions medicine provider during initial hospitalization, 16/20 were set up with a family doctor post-discharge, 9/20 completed their 1-month follow-up survey, one participant died within 12 months of enrolment, and 12/19 completed their 12-month follow-up survey. Conclusion The early success in this pilot project has led to the successful application of funding for an expanded version of the multidisciplinary intervention for people who have any injection-related infection, including Hepatitis and HIV. Disclosures All Authors: No reported disclosures
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.020 | 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".