A Descriptive Observational Study of the McGill University Health Centre Capping Trial Protocol in Facilitating Tracheostomy Decannulation
Bibliographic record
Abstract
Background Tracheostomy decannulation improves patient quality of life and reduces healthcare costs. At the McGill University Health Centre (MUHC), a protocol was developed in 2016 to standardize care for adult patients with tracheostomies, preventing complications related to capping techniques. Though based on clinical expertise and evidence, this protocol has not been formally evaluated. This study aimed to assess this protocol in facilitating decannulation. Methods A descriptive observational study was conducted with 44 adult patients who had a tracheostomy tube and were assessed by the tracheostomy team for capping trial eligibility. Patients were placed on a structured protocol, involving set timeframes (e.g., 12 or 24 hour capping periods) on specific days. Patients were monitored for respiratory distress, secretion management, and overall tolerance. Data were collected from patient medical records; variables included age, anxiety levels (using the Spielberger State-Trait Anxiety Inventory (STAI-6) questionnaire), and level of consciousness (Glasgow Coma Scale (GCS)). Patients were categorized as “successfully decannulated” or “not successfully decannulated” based on their trial outcomes. Results Of the 44 patients, 39 (89%) were successfully decannulated within the set timeframe. Among the 39 successful cases, the majority (87%) required only one trial capping attempt. There was no significant difference in age (p=0.494) or anxiety levels (p=0.588) between the two groups. However, a significant difference (p=0.002) was found in GCS scores, with patients who were successfully decannulated having a higher mean GCS score 14.7 (SD= 1.01) compared to those who were not decannulated (mean = 12.6, SD = 3.29). Conclusions The MUHC capping trial protocol demonstrates a high success rate for tracheostomy decannulation, with most patients requiring only one trial attempt. While age and anxiety were not significant, a higher Glasgow Coma Scale score was associated with better outcomes. Further research is needed to explore additional influencing factors and long-term outcomes.
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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 | 0.010 | 0.033 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".