Development of Patient-Specific 3-Dimensional Graphical Entry-Point Maps for External Ventricular Drain Insertion
Bibliographic record
Abstract
OBJECTIVE: External ventricular drains (EVDs) are mainly inserted free-hand perpendicular to the skull through known entry points, but only 40%-50% of cases result in acceptable position. Nonideal trajectories increase the risk of complications. METHODS: Using 90 patient cases, we developed a visualization method to identify regions on the skull that result in successful EVD insertion, while incorporating precalculated uncertainties in the trajectory. Feasibility of the method was evaluated by determining the number of possible trajectories. RESULTS: There was a significant difference in hit rate between hydrocephalic or trauma and asymptomatic patients. Overall, the average catheter length calculated was concordant with ranges reported in prior EVD studies (maximum average = 51.4 ± 6.4 mm). CONCLUSIONS: A new patient-specific visualization paradigm was developed to optimize the insertion point for EVD. The visualization tool identifies new insertion sites but also confirms the validity of existing ones used in the current standard of care.
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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 | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 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".