Analyse descriptive de l’efficacité et de la toxicité de la dose de charge intraveineuse de digoxine à l’Institut universitaire de cardiologie et de pneumologie de Québec–Université Laval
Bibliographic record
Abstract
Objectifs : Les objectifs de l’étude sont de déterminer la proportion de dose de charge de digoxine par voie intraveineuse associée à un contrôle satisfaisant de la fréquence cardiaque en contexte de fibrillation auriculaire ou de flutter auriculaire, d’identifier les doses de charge suivies d’une digoxinémie et de déterminer les facteurs associés à l’efficacité et à la toxicité de la digoxine. Méthode : Étude rétrospective descriptive de population longitudinale menée entre le 1er mai 2019 et le 1er mai 2023. Les variables comprenaient des données relatives au patient, à la prescription, ainsi qu’à l’innocuité et à l’efficacité de la digoxine. Résultats : Des 170 doses de charge de digoxine par voie intraveineuse répertoriées, 38 ont été considérées efficaces. Près de la moitié d’entre elles ont été suivies d’une digoxinémie dans un délai moyen de 25,2 heures après la dernière administration. Les variables associées à l’efficacité étaient la fréquence cardiaque, la saturation en oxygène, la fréquence respiratoire et l’hospitalisation aux soins intensifs. Celles retenues pour la toxicité comprennent la pression artérielle systolique et l’hypermagnésémie avant l’administration ainsi qu’une hospitalisation aux soins intensifs. Conclusion : Cette étude a permis de souligner une réponse modeste à une dose de charge de digoxine, soit un taux de contrôle satisfaisant d’environ 25 %. Les digoxinémies n’étaient pas effectuées de manière systématique et étaient faites trop tardivement après la dernière administration. Il a été possible d’établir des facteurs associés à l’efficacité et à la toxicité. Summary Objectives: To determine the proportion of cases of digoxin intravenous loading dose associated with satisfactory rate control in patients with atrial fibrillation or atrial flutter, to identify cases where digoxin levels were drawn following loading, and to determine factors associated with digoxin effectiveness and toxicity. Method: Longitudinal population-based descriptive retrospective study conducted between May 1, 2019, and May 1, 2023. Variables included data related to patient, prescribing, and digoxin safety and effectiveness data. Results: Of the 170 intravenous digoxin loading doses identified, 38 were considered effective. In nearly half of these cases, digoxin levels were drawn within a mean time of 25.2 hours after the last dose. Variables associated with effectiveness were heart rate, oxygen saturation, respiratory rate, and admission to intensive care. Toxicity associated variables included systolic blood pressure and hypermagnesemia prior to digoxin administration as well as admission to intensive care. Conclusion: This study demonstrated a modest response to a digoxin intravenous loading dose, with a satisfactory rate control of around 25%. Digoxin levels were not routinely drawn and were performed too late after the last dose. Factors associated with effectiveness and toxicity were identified.
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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 | 0.004 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 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".