Bibliographic record
Abstract
To present on the benefits and challenges of an expanded musculoskeletal central intake, a virtual center that consolidates referrals for orthopedic consult regarding various appropriate chronic musculoskeletal conditions to a centralized location. Referrals can then be directed to a specific Rapid Access Clinic, a specific surgeon or the first available surgeon as quickly as possible. This allows for fair, equitable and timely distribution of referrals and improved access to care for patients. Prior to a central intake model access to specialists was challenging, resulting in prolonged wait times for consultation. The region already had in place, an established a Rapid Assessment Clinic (RAC) for Hips and Knees. The MSK Expandd central intake scope of referrals was restricted to Shoulder, Spine, Knee Arthroscopy (Knee condititon) and Foot and Ankle as these referrals had prolonged patient wait times for consultations by orthorpedic surgeons. This resulted in many patients being placed on excessively long wait lists for years. All referrals sent to central intake center (CIC) are reviewed to ensure they are appropriate complete and accurate. Referrals are reviewed to ensure that the diagnostic imaging reports accompanying the referral comply with best practice guidelines and clinical expert consensus. If the condition for which the patient is referred is appropriate for a Rapid Assessment Clinic, the referral will be forwarded to the site closest to their home. All other referrals will be forwarded to the most suitable surgeon based on the clinical information provided. Alternatively, a specific surgeon can be requested. Will discuss limitations in the variation of service providers and methods and ongoing challenges of lack of services offered in other regions. Results provided will be an overall number of referrals into the MSK central intake program including the number of declined referrals. Initial results pre- pandemic demonstrated a decrease in wait time 1- time from referral to assessor, and the number of referrals deemed to be non-surgical by the assessor. Data will include the number of referrals being sent to first available surgeon. An expanded regional musculoskeletal central intake model is beneficial in addressing a greater scope of referrals for chronic orthopaedic conditions. It provides patients a means to timely access to care and services. It enables primary care providers to send one referral to a central location rather than sending multiple referrals to multiple specialists of the same discipline in an effort to access care for their patient, leading to duplicate referrals throughout the region.
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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 | 0.004 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.003 | 0.010 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.447 | 0.147 |
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".