RUMPOH-1: Descriptive study of conversion ratios between conventional opioids and methadone in pediatric pain, a 13-year retrospective review
Bibliographic record
Abstract
OBJECTIVE: To present the conversion ratios used for transitioning from conventional short-acting opioid (CSO) to methadone in a diverse pediatric population at methadone initiation and steady state. Oral-to-intravenous methadone conversion ratios were measured as an exploratory objective. DESIGN: This study is a retrospective descriptive review that spans a 13-year period from January 1, 2010, to March 31, 2023. SETTING: The study was conducted in a quaternary pediatric university healthcare center and included patients from general and specialized pediatric wards. PATIENTS: All patients who were initially treated with CSO and subsequently switched to methadone for pain, 3 months to 18 years old, were included. Neonates, patients treated with methadone for less than 48 hours, and patients treated with methadone for opioid use disorder were excluded. INTERVENTIONS: Switch from CSO to methadone for treatment of pain. OUTCOME MEASURES: Conversion ratios from CSO to methadone were calculated at initiation, on day 3, and on day 5 after the conversion. RESULTS: Sixty-five patients, aged 10.6 years, were identified, the majority of whom were treated for neuropathic or mixed-type pain. Treatment duration was 184 days on average (median 79 days). Methadone doses ranged from 0.1 to 300 mg/day (0.01-10.72 mg/kg/day). Initial conversion ratios from oral morphine equivalent doses to methadone ranged from 0.64 to 162:1. CONCLUSIONS: Similar to the adult studies, we describe dose-dependent conversion ratios. Progressive titration of methadone was observed with high CSO doses, while low initial CSO doses had stable conversion ratios from the beginning. We have also highlighted the importance of a full 5-day switching period for patients with high CSO doses.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".