Notice bibliographique
Résumé
Evolution of GERD over 5 years: author's replyWe appreciate the highly pertinent questions and comments by Drs Aro and Ronkainen 1 concerning our observations made on disease evolution in patients with gastrooesophageal reflux disease under routine care, over a follow-up period of 5 years.As to the number of endoscopists from 1253 participating centres who enrolled a total of 6215 patients with erosive reflux disease (ERD) and non-erosive reflux disease (NERD), we cannot provide the exact figure.However, the majority of participating centres were each invited to include four consecutive patients with GERD, and most of these were out-patient services led by one individual specialist performing the endoscopy.All participating endoscopists were educated in the adoption of the Los Angeles classification for the description of oesophageal erosions as well as in the accurate endoscopic description of any detectable columnar lined epithelium (Barrett's oesophagus).This was the best we could do, considering the pragmatic nature of the study that intended to follow-up patients with ERD and NERD under routine medical care.Inter-observer validation was impossible to do, but the standard of education provided and training in endoscopy is high in our country.Concerning the healing rate of 74% of patients with Barrett's oesophagus (BO) on regular PPI medication, as pointed out by Dr Aro and Dr Ronkainen, intended healing of erosions, if they were present, or complete symptom relief in patients who had no erosions.We have indicated with an asterisk in table 1 of the manuscript 2 that healing referred to erosions in the group with ERD and complete symptom relief in the group with NERD in the initial healing phase on PPI, 3 and this does also apply to the subset of 240 patients with additional BO at baseline, but does not imply regression of BO.Thank you, for allowing us to make this clarification.Patients were also allowed to be included if they were found to have BO (either suspected endoscopically or confirmed by histology) at the index endoscopy, and they were assigned to one of the two categories ERD or NERD.Patients with BO at baseline have been excluded from the analysis in this follow-up study 2 as their evolution will be addressed in a separate report.Concerning progression of BO during follow-up, in spite of the regular use of PPI, may result from inadequate dosing of PPI in the specific subset of patients.Beyond this hypothesis a definitive explanation cannot be given due to the observational nature of our study.The definition of BO in the follow-up cohort was either by endoscopy alone, if the detection of columnar lined epithelium was not corroborated by histology, or was 'confirmed' if combined with positive histology.According to the proposal of the Montreal classification of gastro-oesophageal reflux disease, we considered the histology to be positive for BO if the columnar lined epithelium contained either specialized intestinal metaplasia (IM) or gastric metaplasia.4 An important finding in this context was that in the newly developed BO segments >3 cm IM had been described in 100%, whereas in BO segments shorter than 1 cm IM was detected only in 50% of patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,051 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,002 | 0,005 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,019 | 0,025 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,004 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».