Fusion versus Non-fusion Surgery for Pediatric Idiopathic Scoliosis: Preferences of Patients, Caregivers, and Patient-Caregiver Dyads
Bibliographic record
Abstract
Study DesignOriginal research, cross-sectional study.ObjectivesEvaluate preferences of patients, caregivers, and patient-caregiver dyads for non-fusion vs fusion surgery.MethodsA survey-based discrete choice experiment included patients 12-15 years of age with idiopathic scoliosis and their caregivers. Preference weights were estimated for 2 types of attributes that differed between fusion and non-fusion surgery: treatment outcomes (ie, appearance, confidence in planned correction, spinal motion, device failure, reoperation, and recovery period) and procedure-type requirements associated with each surgery type. Correlations between preference weights for patients, caregivers, and dyads were calculated to assess preference concordance between cohorts.ResultsA total of 344 respondents (124 patients, 92 caregivers, and 128 patient/caregiver dyads) completed the survey. Appearance was the most important treatment outcome for the average respondent in all cohorts. For patients, the least important treatment outcome was recovery time, whereas reoperation rate was the least important treatment outcome for caregivers and dyads. After controlling for treatment outcomes, patients and patient-caregiver dyads preferred the procedure-type requirements associated with fusion surgery, while caregivers preferred the procedure-type requirements associated with non-fusion surgery. Preferences of respondents who completed the survey prior to surgery were similar to those who completed the survey after surgery. Patient and caregiver preferences were more similar to the preferences of dyads than to each other.ConclusionsPatients and patient-caregiver dyads preferred the procedure-type requirements associated with fusion surgery, while caregivers preferred the procedure-type requirements associated with non-fusion surgery. Appearance was the most important treatment outcome for patients, caregivers, and patient-caregiver dyads.
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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 | 0.006 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".