Expert Perspectives on a Randomized Controlled Trial Comparing Novel Donor Storage Platforms to Cold-static Preservation for Heart Transplantation
Bibliographic record
Abstract
Background: There is a clinical need for randomized evidence to establish the comparative efficacy of organ preservation techniques for heart transplantation in Canada. In this study we used a survey to evaluate the feasibility and value of a randomized trial comparing cold-static preservation with novel donor storage platforms. Methods: A validated survey was distributed to 30 members of the Canadian Cardiac Transplant Network, including adult heart failure cardiologists, pediatric cardiologists, and cardiovascular surgeons. Survey sections addressed demographics, clinical scenarios, perceived benefits, barriers, and willingness to participate in a randomized trial. Results: Twenty-six experts (87%) responded: 65% were adult heart failure cardiologists, 27% were women, and 54% practiced in Ontario. Respondents were evenly distributed across career stages. All expressed interest in participating in a trial, and 88% were comfortable with study blinding. Willingness to randomize declined with anticipated ischemic times: > 80% for < 6 hours, 42% for 6-8 hours, and 31% for > 8 hours. Key benefits identified included improved donor utilization (69%), better outcomes (58%), and enhanced scientific understanding (58%). The major barrier was device cost (73%). Conclusions: Canadian experts reported interest and perceived equipoise for a randomized trial of organ preservation strategies, although cost remains a key barrier. Such a trial could standardize protocols and strengthen the evidence base guiding heart transplantation practice.
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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 | 0.252 | 0.484 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.011 | 0.005 |
| Insufficient payload (model declined to judge) | 0.015 | 0.001 |
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".