Clinical Outcomes of Children Meeting the At‐Risk for PARDS Criteria Before PICU Admission: A Single‐Center Study
Bibliographic record
Abstract
OBJECTIVE: To evaluate the ability of the criteria "At-risk for PARDS" to identify patients with acute respiratory infection hospitalized outside the pediatric intensive care unit (PICU) who are at high risk of developing pediatric acute respiratory distress syndrome (PARDS) and describe the timing for the identification. The secondary aim was to explore clinical outcome differences between patients with and without risk for PARDS. METHODS: We conducted an observational prospective cohort study from June to August 2019. Children under 15 years old hospitalized in a pediatric ward due to an acute respiratory tract infection were included. MAIN RESULTS: A total of 177 patients with a median age of 12 (IQR 5; 25) months were included. Registered data included demographics, respiratory support, at-risk for PARDS and PARDS diagnosis according to PALICC consensus. PICU admission, hospital length of stay (LOS) and intrahospital mortality were the outcomes compared between children with and without risk for PARDS. The at-risk criteria, within 48 h of admission, showed an overall accuracy, sensitivity, and specificity of 82.5%, 100%, and 81.9% respectively, to detect patients that progress to PARDS. The at-risk for PARDS criteria was met in 37 cases (20.9%), which also were more likely to developed PARDS (6/37 [16.2%] vs. 0/140 [0%]; p < 0.001), had higher admission to PICU (16/37 [43.2%] vs. 0 [0%]; p < 0.001) and hospital LOS (7 [6; 12] days vs. 5 [3-6] days; p < 0.001), compared with the group without at-risk for PARDS. CONCLUSIONS: The at-risk for PARDS criteria within 48 h of admission demonstrated an adequate ability to identify patients with a respiratory infection at increased risk of developing PARDS. Patients who met the at-risk for PARDS criteria before PICU admission presented with unfavorable clinical outcomes compared with those without risk.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".