WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study)
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Central venous catheters (CVC) are essential in medicine for monitoring, drug and fluid administration, and renal replacement therapy. Complications such as arrhythmias, endothelial damage, thrombosis, or hemothorax might arise from incorrect positioning. Despite evidence showing their reduction using ultrasound to guide insertion and correct tip positioning, and greater accuracy for tip position assessment vs. chest-X-ray (CXR), ultrasound adoption greatly varies worldwide. This study, conducted by the World Interactive Network Focused On Critical Ultrasound (WINFOCUS) aimed to assess global practices in CVC insertion and tip position confirmation. METHODS: A web-based survey was conducted (April-September 2023) among WINFOCUS members/affiliates across five continents. It assessed clinical backgrounds, CVC insertion and tip position check methods, and reasons for not using ultrasound. Developed by WINFOCUS Research sub-committee, the survey was emailed, with two reminders. Data were analyzed using SPSS 27.0. RESULTS: A total of 1,227 respondents (5.1% response rate) participated, mainly from Europe (33.5%), Asia (28.3%), and the Americas (30.9%), with 95.4% being physicians. Over half (51.3%) had over six years of experience and placed over 200 CVC, mostly using ultrasound guidance (70% of cases). The internal jugular vein (IJV) was the preferred insertion site (74%). Ultrasound was used for pre-insertion assessment (55%) and vessel puncture (57%) but less for guidewire confirmation (44%). CXR remained the primary method for tip position assessment (52%), while only 12% relied solely on bedside ultrasound. Barriers to exclusive ultrasound use included institutional guidelines (33.9%) and medico-legal concerns (13.8%). CONCLUSIONS: Despite evidence favoring ultrasound for CVC insertion and tip position confirmation, its use remains inconsistent, with CXR still widely used. This survey underscores the need for standardized protocols and training to enhance US adoption, improve patient safety, and reduce CXR reliance.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it