Notice bibliographique
Résumé
To the Editor: We would like to thank Drs Rovner and Zamel for their valued comments. We agree that there are several limitations to our study, as identified in the discussion (1) and accompanying editorial (2). Although several adult studies suggest that self-reporting on fractures is reasonably accurate (3,4), this has not, to our knowledge, been validated in children. Other data dependent on recall, including age at time of fracture, weight, height, and estimated level of physical activity at time of fracture occurrence, were not obtained. These are well-known risk factors for fractures and would be best estimated in a prospective multicenter study. Because this is a retrospective study, the data available are obviously limited. None of the sibling controls had dual-energy x-ray absorptiometry scans; therefore, we are not able to comment on bone mass density (BMD) in controls. When we looked at those patients with inflammatory bowel disease (IBD) who had sustained a fracture in their lifetime, 17 (58.6%) had abnormal BMD; however, when we reviewed the patients with abnormal BMD among our patients with IBD, only 17 of 70 (24%) had sustained fractures. This was not statistically significant when compared with the non-IBD group. Furthermore, we recognized in our discussion that the numbers were relatively small and therefore limited the value of subgroup analysis. There are clearly many ways to statistically evaluate data. We felt that our simple approach was sufficient to demonstrate the prevalence of fractures among children with IBD and to identify the lack of association with abnormal BMD. As Drs Rovner and Zamel point out, the data collected may have a time lag factor. If the variables collected can change with time (eg, BMD), then interpretation may be difficult (5). It is important to recognize that bone densitometry is a routine investigation in many tertiary centers that care for children with IBD. Children who are identified as having low BMD are often asked to take calcium and vitamin D supplements, despite a lack of evidence that doing so changes outcome. In this group of children who are already taking several medications including 5-ASA, immunosuppressants, antibiotics, iron, and others, the risk of noncompliance increases. The clinical significance of these measurements as defined by lifetime fracture occurrence is unknown. In adult studies there appears to be some discrepancy, with a modest increase in fracture rate identified (6–8). Our study is 1 of the first in children with IBD. A well-designed prospective study will likely be required to clarify the issues raised by Drs Rovner and Zamel.
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 | 0,006 | 0,060 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,003 |
| Communication savante | 0,005 | 0,004 |
| Science ouverte | 0,004 | 0,002 |
| Intégrité de la recherche | 0,033 | 0,033 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,030 | 0,023 |
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 ».