Projected hospitalization cost impact of the selective cytopheretic device in pediatric acute kidney injury
Bibliographic record
Abstract
AIMS: The Selective Cytopheretic Device for Pediatrics (SCD-PED) is a cell-directed extracorporeal therapy approved by the Food and Drug Administration through the humanitarian device exemption pathway for patients≥10kg, age≤22 years with acute kidney injury due to sepsis or a septic condition requiring antibiotics and on continuous renal replacement therapy (CRRT). We leveraged the Kids' Inpatient Database (KID) and SCD-PED study data to estimate hospitalization costs with and without SCD-PED therapy. MATERIALS AND METHODS: A cost regression model was built from KID hospitalizations (2019) that included patients aged 1-20 years with AKI receiving CRRT, total parenteral nutrition, KID mortality risk=4, KID severity=4, and hospital length of stay (LOS) ≤60 days. Data assessed as cost predictors included patient age, sex, vasopressor use, mechanical ventilation, sepsis, theoretical SCD-PED cost/number used, LOS, and death at hospital discharge. Differences in mean costs between a matched control cohort from the Prospective Pediatric CRRT registry (ppCRRT) and the SCD-PED study cohort were estimated from the model using SCD-PED study mortality rates and LOS reported in the SCD-PED studies. RESULTS: = 22): 28 days vs. 31 days in the control group, which despite the lower mortality rate, resulted in a lower estimated cost of $320,304, reflecting an estimated savings of $69,146 per hospitalization. LIMITATIONS: The model in the current study compares patients using SCD-PED to an external control cohort with similar characteristics, because controls were not examined in the original clinical studies. This study is not intended to be predictive of costs in other patient types or larger populations. Additional study is needed. CONCLUSIONS: The SCD-PED is likely cost-beneficial in critically ill children with AKI requiring CRRT, including those with sepsis.
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How this classification was reachedexpand
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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".