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Diagnosis and Treatment of Pediatric Moderate Aplastic Anemia: A survey of the North American Pediatric Aplastic Anemia Consortium

2025· preprint· en· W4411420933 on OpenAlexaff
Paul Castillo, Linah Omer, Nicholas J. Gloude, Catherine McGuinn, Taizo A. Nakano, Kathleen Overholt, Elizabeth Ogando‐Rivas, Kasiani C. Myers, Larisa Broglie, Kirsty Hillier, Edo Schaefer, Jennifer Rothman, Sasidhar Goteti, Yigal Dror, Maria Cancio, Gloria Contreras Yametti, Michaela Cada, Kristin A. Shimano, S. W. Allen, Jeffrey M. Lipton, Peter Kurre, Jill L. O. de Jong

Bibliographic record

Venuenot available
Typepreprint
Languageen
FieldMedicine
TopicErythrocyte Function and Pathophysiology
Canadian institutionsHospital for Sick Children
Fundersnot available
KeywordsAplastic anemiaMedicinePediatricsAnemiaInternal medicineBone marrow

Abstract

fetched live from OpenAlex

Pediatric moderate aplastic anemia (MAA) lacks defined diagnostic criteria and a clear standard-of-care due to the limited knowledge of its pathophysiology and natural history. The approach to MAA has been historically inconsistent as the proposed survey demonstrates. To understand current diagnostic and management practices for patients with MAA, a survey was conducted among members of the North American Pediatric Aplastic Anemia Consortium (NAPAAC), including 104 providers across 57 institutions. The survey demonstrates broad variability regarding the working definition, diagnostic work-up, and therapeutic management of children with MAA. The diagnostic work-up and treatment options for children with MAA are largely driven by management guidelines for pediatric severe aplastic anemia (SAA). Treatment triggers, type of therapy, and outcomes varied widely among respondents. Curated next generation sequencing panels and whole exome/whole genome sequencing were included by only 55% and 9% of respondents, respectively which suggests the need to more broadly consider inherited bone marrow failure syndromes in the differential diagnosis for these patients. Effective and risk-adapted treatment for MAA requires a better understanding of the biology, natural history, and treatment outcomes for this heterogeneous population.

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 distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.019
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.033
GPT teacher head0.277
Teacher spread0.244 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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