The Training Program as a Catalyst for Clinical Trials in Cardiac Critical Care: The DOREMI Experience
Bibliographic record
Abstract
The morbidity and mortality rates associated with cardiogenic shock remain unacceptably high; physicians caring for these patients need to use novel and innovative methods to identify evidence-based therapies to improve their care. Trainee-led pragmatic clinical trials are one strategy that can overcome many of the identified obstacles faced when undertaking clinical trials in the cardiac intensive care unit. We present our approach to executing the CAPITAL DOREMI (Dobutamine as compared to Milrinone in the Treatment of Cardiogenic Shock) trial as an example of how a trainee-led prospective randomized controlled trial can be successfully implemented in this high-risk cohort of patients, can serve as a model for future studies and for building a culture of mentorship within the growing area of critical-care cardiology.
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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 | 0.150 | 0.116 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.010 |
| Scholarly communication | 0.010 | 0.007 |
| Open science | 0.003 | 0.018 |
| Research integrity | 0.005 | 0.019 |
| 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".