Transition of Pediatric Patient with Congenital Heart Disease to Adult Specialty Care in the United States
Bibliographic record
Abstract
Patients with congenital heart disease (CHD) require uninterrupted lifelong specialized cardiac care, yet the transition years are a vulnerable time for these patients. Transition programs offer structured support to patients with CHD with the aim of improving CHD knowledge, independence in care, and providing an uninterrupted transfer process and integration into accredited adult congenital heart disease (ACHD) programs. Transition has three components: preparation, transfer and integration. The main barriers to successful transition program implementation are time and resources to complete transition practices and there is no best model for transition programs. Patients with CHD in the United States (US) have a lower occurrence of transfer to ACHD programs, and they experience more gaps in care during the transition years compared with Canada and Europe. Structured transfer processes to ACHD programs are common in Europe, but these, and overall transition practices in the US are not well understood. The purpose of this dissertation was to test a low resource intervention to facilitate patient preparation, identify factors that improve effective transfer, and evaluate transition practices in the US.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".