Clinical course of patients with bloodstream infections enrolled in the BALANCE clinical trial
Bibliographic record
Abstract
OBJECTIVES: There is a lack of data describing the longitudinal clinical trajectories of vital signs and laboratory tests in patients with bloodstream infection (BSI). The BALANCE trial, which randomly assigned patients with BSI to receive 7 or 14 days of antibiotic treatment, provided rich daily data to describe these trajectories. METHODS: As part of the BALANCE trial, we collected several daily parameters (temperature, heart rate, mean arterial pressure, systolic blood pressure, respiratory rate, WBC count, C-reactive protein, platelet count and SOFA score) until Day 14 of illness, discharge or death. In this post hoc descriptive sub-study, we described trajectories of these parameters, stratified by treatment group allocation and by the primary outcome of 90-day all-cause mortality. RESULTS: Among 3608 patients included, median age was 70 years and 46.7% were female. At enrolment, 55.0% were admitted in the ICU and 21.2% required mechanical ventilation. Longitudinal trajectories of vital signs, laboratory tests and SOFA scores were almost identical comparing the two treatment groups, including from Day 7 after treatment divergence. These trajectories were markedly different when comparing survivors (3034 patients; 84.7%) and non-survivors (547 patients; 15.3%), with non-survivors demonstrating a slower recovery course throughout the 14-day period. CONCLUSIONS: Among hospitalized patients with BSI, recovery trajectories were similar in patients assigned to 7- versus 14-day antibiotic treatment durations but were different comparing survivors versus non-survivors. These data could be used to inform daily clinical management, formulate predictive risk scores or clinical decision rules, and guide future research into individualized therapeutic strategies.
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 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".