Brauchen wir eine Spezialsprechstunde? Wie Innovationen Interdisziplinarität in der Amputationsmedizin fördern
Bibliographic record
Abstract
Amputation of a limb is often a necessary, yet irreversible surgical procedure with complex functional, psychosocial, and medical consequences. Comorbidities and concomitant injuries frequently complicate both treatment and rehabilitation. At the same time, modern surgical and technological advances offer new possibilities, while also increasing the demands on comprehensive care. In response, we established an interdisciplinary consultation service to support the multiprofessional care of amputees at our university hospital.A specialized interdisciplinary clinic was established at a German tertiary university medical centre. Its objectives include the structured assessment of amputation indications, quality assurance of orthopaedic-plastic surgical procedures, and holistic post-amputation care addressing functional, psychosocial, and prosthetic aspects. Over a 12-month observation period, we systematically recorded and analysed consultation parameters such as the number of visits, reasons for presentation, and patient and amputation demographics.A total of 474 consultations involving 183 individual patients were documented. Most cases concerned the lower extremity (86.25%), with 13.75% involving the upper extremity. The patient cohort consisted of 63.9% male (n=117) and 36.1% female patients (n=66), with a median age of 55.2±20 years. The most frequent causes of amputation were acute trauma (n=74; 45.7%), vascular diseases (n=24; 14.8%), and infections/sepsis (n=22; 13.6%). The main reasons for presentation were standard follow-up assessments (n=49; 23.1%), postoperative wound checks (n=39; 18.4%), and prosthetic counselling (n=30; 14.2%).The irreversible and multifaceted consequences of amputation require a high level of medical, therapeutic, and socio-medical coordination. Interdisciplinary care models are well established in the management of complex chronic diseases. This approach to amputee care represents a necessary paradigm shift, enabling us to meet the multidimensional needs of this patient population through integrated, patient-centred treatment.
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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 | 0.012 | 0.034 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.007 | 0.007 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
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".