573 Feasibility of an Unfunded Multicenter Trial Group for Older Adult Burn Patients: A Retrospective Study
Bibliographic record
Abstract
Abstract Introduction Older adults represent a significant portion of the burn patient population, presenting unique physiological challenges and requiring tailored treatment approaches. Yet, comprehensive data specific to this demographic are limited. The relatively small number of older burn patients at each center makes single-center studies insufficient to address key questions about their care. The development of a multicenter trial group focused on older adult burn patients could yield valuable insights into clinical outcomes, yet funding for such initiatives is often restricted. This study explores the feasibility of creating an unfunded multicenter trial group and conducting a retrospective pilot study to examine clinical trends and outcomes for older adult burn patients. Methods Following IRB approval and the creation of data use agreements, a retrospective pilot study was conducted across twelve burn centers in North America. Each center was tasked with collecting standardized data on burn patients aged 60 and older from January 2017 to December 2019. Data included demographic information, burn characteristics (total body surface area burned, type of burn, etc.), treatment interventions, and outcomes such as mortality, length of hospital stay, and complications. Where possible, data were sourced from each center’s submission to the Burn Care Quality Platform (BCQP). BCQP and additional data were manually entered into a centralized REDCap database managed by one institution. Descriptive statistics of the pilot study are presented. Results The study included 1,632 older adult burn patients. Median age was 68 years (interquartile range [IQR] 13); 1,095 patients (67%) were male and 1,187 (73%) were White with a median BMI of 27.5 (IQR 7.87). The median burn size was 3.5% total body surface area (IQR 9, range 0-100%). Patients presented a median of 4.68 hours after injury (IQR 15.35), with a median modified Baux score of 76.21 (IQR 20.5). These patients underwent a median of 1 operation (IQR 1), typically 3 days after injury (IQR 6). The median length of hospital stay was 6 days (IQR 13), with an ICU stay of 1 day (IQR 5). In-hospital mortality was 10.4% and the median time to wound healing was 40 days (IQR 48). Conclusions Creating an unfunded multicenter trial group for older adult burn patients is feasible. The group successfully conducted a retrospective study on care trends for burn-injured older adults. Key factors in the success of this initiative included standardized data collection protocols and strong collaboration between centers. Applicability of Research to Practice Although challenges remain, this project illustrates the potential for establishing a larger, sustainable multicenter trial group aimed at improving clinical practices and outcomes for older burn patients. Funding for the Study No financial compensation or technical support was provided to the participating institutions.
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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 | 0.120 | 0.129 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".