Using gastrografin to manage adhesive small bowel obstruction:A nonrandomized controlled study with historical controls
Bibliographic record
Abstract
Background: A standardized protocol for managing adhesive small bowel obstruction using diatrizoate meglumine and diatrizoate sodium (Gastrografin) was implemented at Vancouver General Hospital. Our study assessed whether this protocol improved the quality of patient care. Methods: A nonrandomized controlled study was conducted. Two groups of patients were studied: a preimplementation group (historical control) and a postimplementation group that received the Gastrografin protocol. The primary outcome was length of hospital stay. Secondary outcomes included rate of successful conservative manage-ment, need for surgery, time to resolution of the obstruction, time to surgery, readmission to hospi-tal, rate of complications or mortality, and patient satisfaction. Results: The study included 122 patients (n = 82 preimplementation; n = 40 postimplementation). In the postimplementation group, length of hospital stay was shortened (adjusted mean difference:-3.209 days; 95% CI,-5.772 to-0.645; P = 0.015), successful conservative management was higher (odds ratio: 3.354; 95% CI, 1.129-12.600; P = 0.044), and need for surgery was lower (odds ratio: 0.237; 95% CI, 1.129-12.600; P = 0.034) compared with the preimplementation group. Patients in the post-implementation group were generally satisfied with their care. Conclusions: The implementation of a standardized protocol using Gastrografin for managing adhesive small bowel obstruction was associated with improved quality of patient care.
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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 | 0.007 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 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".