1355 A Systematic Transition for Complex Pediatric Sleep Patients to Adult Services
Bibliographic record
Abstract
Abstract Introduction Patients in pediatric sleep clinics can be medically complex, making the transition from pediatric to adult sleep medicine daunting for both patients and health care providers. In Calgary, Canada, a transition clinic was established to facilitate the transfer to new providers while mitigating disruption in care and poor outcomes. The purpose of this study was to describe the model’s key structures and processes. Methods We conducted a retrospective chart review of all patients attending the transition sleep clinic. Data sources included electronic medical records and paper charting. We used Donabedian’s structure-process-outcome framework to describe core elements of the transition clinic model. Results From 2017 to 2024, 30 patients (14 female) participated in the clinic. The most common diagnoses were obstructive sleep apnea (n=23, 77%), and narcolepsy (n=4, 13%). Patients with narcolepsy were included until 2022 when pediatric and adult patients were transferred to a sleep neurologist. The mean age at the first pediatric sleep encounter was 8.4 years, and mean age at transition was 17.8 years. 26 patients used NIV with 18/26 using BPAP, 6/26 using CPAP and 2/26 using AVAPS. Prior to transition, mean diagnostic AHI was 39 events/hour and mean oxygen saturation of 91.6%. The average number of comorbidities at transition was 5. Structure: Transition clinics were held at the pediatric sleep center in Alberta Children’s Hospital. Health care providers (HCPs) included the pediatric sleep physician, adult sleep physician, and NIV coordinators from both centers. Process:. A pre- and post-clinic discussion was conducted for each patient amongst the HCPs. Transition summaries were prepared by the pediatric team for the EMR. Within each summary, a discussion between the HCPs was documented in 90% of visits, and a discussion with the patient about transition was documented in 87% of visits. Conclusion Preliminary findings suggest that a strong foundation of structures and processes can enable safe and effective transition from pediatric to adult sleep care. Further analysis of outcomes can support the rationale for establishing similar transition clinics in other jurisdictions. Support (if any) This study is unfunded.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".