SCAI Technical Review on Management of Chronic Venous Disease
Bibliographic record
Abstract
Background: Chronic venous disease (CVD) impacts more than 25 million adults in the United States and is associated with a host of symptoms that can adversely affect quality of life (QoL), such as leg discomfort, edema, and ulceration. Treatments for CVD range from conservative therapy centered around use of compression to more invasive approaches, such as ablation, sclerotherapy, phlebectomy, venoplasty, and stenting. Methods: A systematic review was conducted to address 8 questions on the management of CVD that were formulated by the Society for Cardiovascular Angiography & Interventions (SCAI) Guideline Panel using the patient, intervention, comparator, outcome (PICO) format. Medical literature from January 1, 2008, through May 15, 2023, was searched using PubMed, Embase, and the Cochrane Central Register of Controlled Trials, except where an existing systematic review on compression therapy versus no intervention was updated with evidence from May 1, 2020, to May 15, 2023. Study selection was performed in duplicate; data extraction and risk of bias assessment were performed by 1 reviewer and reviewed by a second reviewer. Pooled effect estimates were calculated when applicable, and overall certainty in the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Our combined searches identified 3648 titles and abstracts, of which 19 met eligibility criteria and informed the technical review. Studies reported on healing rate and time to healing, disease recurrence, symptom severity, and QoL among patients who were treated with compression therapy, ablation, sclerotherapy, phlebectomy, and venoplasty or stenting. Compression therapy probably results in slightly faster and more complete venous ulcer healing compared with no compression. Ablation of the great saphenous vein ± small saphenous vein may improve healing rate and symptoms over conservative therapy alone, particularly for ulcer disease. Evidence is very uncertain for any effect on healing rate, symptom score, QoL, and disease recurrence associated with perforator vein ablation, venoplasty, and stenting for iliocaval obstruction, sclerotherapy, and phlebectomy of symptomatic varicose veins. Conclusions: Data from this technical review will inform the Society for Cardiovascular Angiography and Interventions Guideline on Management of Chronic Venous Disease. The panel also identified research priorities based on areas where evidence to guide clinical practice is lacking or very uncertain.
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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 | 0.013 | 0.045 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.007 |
| Bibliometrics | 0.020 | 0.015 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.017 | 0.003 |
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".