A shared care program for the management of patients with chronic hepatitis B in a Canadian primary care refugee clinic
Bibliographic record
Abstract
OBJECTIVES: Refugees in Canada are disproportionately affected by chronic hepatitis B (CHB) and its complications due to healthcare barriers and resettlement challenges. In 2011 the Mosaic Refugee Health Clinic (MRHC) in Calgary, Canada began a shared care model for CHB. Family physicians identify and monitor chronically infected patients, reviewing cases with hepatology. STUDY DESIGN: A cohort of all adult patients (≥18 years old) with a positive hepatitis B surface antigen result (HBsAg) between January 1, 2011 and December 31, 2020 was assessed through retrospective chart review. METHODS: Variables collected included basic demographics and disease characterization, monitoring parameters, and follow-up intervals. These were analyzed using descriptive statistics. RESULTS: A total of 171 cases were managed during the study time frame, representing 2.6 % of the total number of adult patients (6511) taken into the clinic. Of the cohort, 139 patients (81.0 %) were followed for more than a year. Nearly all patients (98 %) completed a full panel of recommended baseline lab testing, 88 % met ongoing ALT lab surveillance targets, and 70 % ultrasound surveillance. The majority (83 %) were reviewed by the hepatologist within 6 months. CONCLUSIONS: This unique model is the first example of a registry of CHB patients in a longitudinal program at a refugee primary care clinic. The observed high rates of adherence were likely achieved by empowering a primary health care interdisciplinary team with specialty support. No funding was utilized for this study.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".