Bibliographic record
Abstract
PURPOSE OF REVIEW: Arthritis and musculoskeletal disorders are highly prevalent and management often involves the use of nonsteroidal antiinflammatory drugs. Cyclooxygenase-2 enzyme inhibitors are newer selective nonsteroidal antiinflammatory drugs that purport to exhibit less gastrointestinal toxicity than traditional nonsteroidal antiinflammatory drugs. Cardiotoxicity has been an adverse outcome of cyclooxygenase-2 inhibitors and this article will critically review the evidence. RECENT FINDINGS: Although there is less than perfect evidence, both traditional nonsteroidal antiinflammatory drugs, with the possible exception of naproxen, and cyclooxygenase-2 inhibitors are associated with increased thrombotic cardiovascular risk. There is strong evidence supporting the cardiotoxicity of rofecoxib and valdecoxib, but less compelling evidence for the other cyclooxygenase-2 inhibitors. Observational studies have been helpful in providing confirmatory and complimentary evidence about this cardiotoxicity. The thrombotic cardiovascular risk begins upon drug introduction, continues throughout exposure and is greatest in patients with a high baseline cardiac risk profile. Cyclooxygenase-2 inhibitors are also associated with other nonthrombotic cardiovascular risks. SUMMARY: The totality of the evidence suggests that all cyclooxygenase-2 inhibitors are associated with increased cardiotoxicity. The cardiovascular risks of the different cyclooxygenase-2 inhibitors are not homogeneous, however, and are likely influenced not only by a class effect, but also by individual drug, dosage and patient characteristics.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
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".