Impact of different preferred functional outcomes on the results of the pre-hospital antifibrinolytics for traumatic coagulopathy and hemorrhage (PATCH-trauma) trial
Bibliographic record
Abstract
RATIONALE: Ordinal endpoints offer more detailed outcome assessment than mortality, though some disabilities may be considered worse than death by patients. OBJECTIVES: To evaluate how different Glasgow Outcome Scale - Extended (GOS-E) hierarchical structures affect effect estimation in the PATCH-Trauma trial. METHODS: This post-hoc analysis of the PATCH-Trauma trial compared pre-hospital tranexamic acid (TXA) to placebo in severely injured patients at risk of acute traumatic coagulopathy. The study included patients with complete 6-month outcomes. Using generalized pairwise comparisons, researchers analyzed the 8-point GOS-E, ICU length-of-stay, and thromboembolic complications. Results were reported using win ratio (WR) statistics, with values above one favoring TXA. The analysis explored GOS-E with mortality rankings adjusted based on different outcomes being considered worse than death. MAIN RESULTS: The study included 1107 patients (546 placebo, 561 TXA). Original GOS-E results showed a neutral WR (1.03; 95 % CI 0.90-1.19). When death was considered preferable to progressively less impaired functionality (from vegetative state to upper moderate disability), the WR decreased to 0.86 (95 % CI 0.75-1.00). CONCLUSION: The assessment of TXA therapy's efficacy and safety may vary depending on scenarios where certain functional outcomes are considered worse than death. This analytical approach could inform functional outcome assessment in future acute care trials.
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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 | 0.049 | 0.054 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.005 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".