Non-invasive urinary tract infection screening for young infants: A high-value care initiative
Bibliographic record
Abstract
Our aim was to safely decrease unnecessary invasive urinary catheterizations in infants 90 days to <6 months of age by 50% over 24 months in our emergency department without unintended consequences. A multi-professional study team was established, and key stakeholders engaged. Using the Model for Improvement, we implemented a modified 2-step urine bag urinary tract infection (UTI) screening pathway along with reminders and education as our main change ideas. The mean catheterization rate decreased from a baseline of 62.5% to 43.9% during the intervention period, demonstrating special cause variation. Urine cultures also decreased from a mean of 64.7% to 47.3% with special cause variation. There was no increase in length of stay or return visits. There was one potential missed UTI (1/843 patients). Overall, a 2-step non-invasive urine bag UTI screening pathway can be successfully and safely used in the emergency department for young infants aged 90 days and older to improve resource allocation.
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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 | 0.005 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".