European Association of Endoscopic Surgery Clinical Practice Guideline Protocol: Evidence‐Informed Recommendations on the Management of Cholecystitis With ESAIC and ESR Participation
Bibliographic record
Abstract
ABSTRACT Background Several options exist for the management of acute cholecystitis. However, practice patterns vary widely, and there is a need for high‐quality guidance in areas of controversy. Methods and Analysis We will develop a clinical practice guideline on the management of patients with Tokyo Grades I–III acute cholecystitis. The guideline will answer the following key questions: Should adult patients with Grades I or II acute cholecystitis receive conservative management or emergent laparoscopic cholecystectomy? Should adult patients with Grades II or III acute cholecystitis receive percutaneous drainage or emergent laparoscopic cholecystectomy? Should adult patients with Grades II or III acute cholecystitis receive conservative management or emergent laparoscopic cholecystectomy > 72 h from symptom onset? Our systematic review group will undertake multiple systematic reviews to identify articles addressing each key question. Next, we will appraise the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. An international, expert multidisciplinary panel will then meet to review the evidence and develop recommendations using GRADE's evidence‐to‐decision framework. This panel will consist of four general surgeons, an interventional radiologist, an intensive care specialist, an anaesthetist, and two patient representatives. Panel members will finalize our recommendations by consensus at an in‐person meeting. This guideline will adhere to methodological standards according to GIN, GRADE and AGREE‐S. Ethics and Dissemination All participating members will declare their conflicts of interest, which will be addressed prior to guideline development. This clinical practice guideline will be presented at international scientific meetings, online presentations and social media, and published in full in the journal of Surgical Endoscopy & Other Interventional Techniques .
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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 | 0.070 | 0.175 |
| Meta-epidemiology (narrow) | 0.003 | 0.003 |
| Meta-epidemiology (broad) | 0.008 | 0.014 |
| Bibliometrics | 0.009 | 0.011 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.007 | 0.005 |
| Open science | 0.012 | 0.009 |
| Research integrity | 0.015 | 0.011 |
| Insufficient payload (model declined to judge) | 0.020 | 0.012 |
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".