Management of Malignant Pleural Effusions with Indwelling Pleural Catheters or Talc Pleurodesis
Bibliographic record
Abstract
BACKGROUND: Management of malignant pleural effusion typically involves insertion of an indwelling pleural catheter (IPC) or chemical pleurodesis with agents such as talc. OBJECTIVES: To compare these management strategies with regard to success of pleural effusion management. METHODS: A retrospective cohort study was designed comparing patients with malignant and paramalignant pleural effusions and Eastern Cooperative Oncology Group performance status <4 managed with IPC insertion or talc pleurodesis (TP) through tube thoracostomy during noncontemporary three-year periods at a single centre. RESULTS: The IPC and TP groups comprised 193 and 167 patients, respectively. The pleural effusion control rate at six months was higher in the IPC group (52.7% versus 34.4% in the TP group; P<0.01), but the rate of freedom from catheter at 90 days and pleural effusion at 180 days was not significantly different (IPC 25.8% versus TP 34.4% [P=0.17]). Median effusion-free survival from the date of catheter insertion was significantly longer in the IPC group (101 days versus 58 days in the TP group; log-rank P=0.025). Both procedures were safe. DISCUSSION: While the results suggest better pleural effusion control and longer effusion-free survival with IPC insertion compared with TP, the present study had several limitations. Other recent studies have not shown one strategy to be clearly superior to the other. CONCLUSION: Both IPC insertion and TP remain acceptable options for the management of malignant pleural effusions.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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) | 0.001 | 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".