Guía de práctica clínica para la evaluación, tratamiento y seguimiento de niños contacto de pacientes con tuberculosis pulmonar en Colombia
Bibliographic record
Abstract
Introduction: The available clinical practice guidelines on tuberculosis infection are not exclusive to the pediatric population. Objective: To formulate evidence-based recommendations for the evaluation, treatment, and follow-up of children in contact with patients with pulmonary tuberculosis in Colombia. Methods: A multidisciplinary development panel (composed by clinical and field experts, researchers, and methodologists who declared conflicts of interests), including patient representatives, and decision-makers formulated 10 questions and prioritized outcomes related to diagnosis (clinical evaluation, chest X-ray, and interferon-gamma release assays-IGRA), treatment (efficacy of regimens in different clinical scenarios), and follow-up (monitoring and strategies to increase adherence) for children exposed to tuberculosis. We conducted systematic literature reviews to identify guidelines, systematic reviews, and primary studies. We assessed these sources' quality and risk of bias with specific tools. We synthesized the evidence narratively and, in some cases, performed de novo meta-analyses (diagnostic and network meta-analyses). We evaluated the certainty of evidence using the GRADE system. We used the GRADE evidence-to-recommendation framework to formulate the recommendations. Results: We recommend 1) the use of IGRA tests to identify tuberculosis infection and chest X-rays to screen for active tuberculosis in children exposed to tuberculosis, 2) short instead of extended regimens for children with and without immunosuppression, 3) levofloxacin or susceptibility-guided regimens in cases of contact with drug-resistant tuberculosis, 4) monthly clinical follow-up during the treatment, 5) the implementation of comprehensive approaches to identify barriers to encourage treatment adherence. Conclusions: The guideline panel provides context-specific, evidence-based recommendations for assessing and treating children exposed to tuberculosis in Colombia.
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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 | 0.040 | 0.092 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.009 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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".