Bibliographic record
Abstract
The position statement “Advance care planning for paediatric patients”, which was published in the November 2008 issue of Paediatrics & Child Health, includes helpful recommendations for those who care for children with severe chronic conditions. However, the checklist (in the appendix) contains some misleading options for “a limited DNR order” that have the potential to create much difficulty for caregivers who respond to cardiorespiratory arrests (ie, code teams). The attached checklist creates the impression that parents can choose from a ‘menu’ of resuscitation options that include them saying no to bag-mask ventilation, but yes to chest compressions. It makes no sense to leave orders for chest compressions but no assisted ventilation, particularly given that most paediatric arrests result from respiratory failure as a primary cause. Alternatively, it appears that parents could say ‘yes’ to bag-mask ventilation but ‘no’ to intubation, which would leave providers with the dilemma of having to bag-mask ventilate until what end point? The principle of discussing the kinds of interventions that may be helpful and desired in the event of a cardiopulmonary arrest should result in orders that both make sense and respect child and parental wishes. Once the parents and the child understand what is medically possible and what is not possible, it is then up to the physician to write orders that reflect these wishes and then explain to the parents what will happen and why. Limited do not attempt resuscitation orders are certainly possible and are, in fact, common in our institution. However, the attached checklist, as it stands, may do more harm than good.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.087 | 0.018 |
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".