Pediatric Rheumatology Care in the Canadian Context: A Qualitative Analysis of Care Providers
Bibliographic record
Abstract
OBJECTIVE: Previous work highlighted a national deficit in pediatric rheumatologists and allied health professionals (AHPs), with a geographic maldistribution in Canada. The aim of this current study was to further evaluate the clinical care structures and processes in place within Canadian pediatric rheumatology centers that promote or impede care delivery from the perspective of pediatric rheumatology healthcare providers. METHODS: Data were collected through semistructured interviews with pediatric rheumatologists and Advanced Clinician Practitioners in Arthritis Care (ACPACs) across Canada. Analysis was performed by 2 investigators following the 4 stages of qualitative content analysis: decontextualization, recontextualization, categorization, and compilation. Data were analyzed through latent analysis due to the informal nature of interviews, and themes were identified iteratively. RESULTS: Twelve individuals (9 pediatric rheumatologists, 3 AHPs) agreed to participate in the study. Interviewees practiced across Canada with a range of career experience. The following themes emerged: (1) geographic barriers negatively affect access to care; (2) ACPAC practitioners and community pediatric rheumatologists improve access to care; and (3) there is inconsistent access to physiotherapists, social workers, and occupational therapists who are knowledgeable about pediatric rheumatology care and disease. CONCLUSION: Although there was variation in pediatric rheumatology practice across Canada, there were common themes of supports and barriers to clinical care. The description of these themes can (1) help guide pediatric rheumatology practice by highlighting thriving practice patterns, and (2) concomitantly emphasize the deficits in resources and functioning, both of which can advise future advocacy work.
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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 | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".