Nonsteroidal antiinflammatory drug use may be protective to cartilage in osteoarthritis of the hip and knee
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Subjects (seen over 2 years at teaching hospitals in London, Ontario) were referred to orthopedic surgeons or rheumatologists, had radiographs available, but had no inflammatory arthritis or evidence of secondary OA. Subjects were divided into mild, moderate (mod) and severe OA by X-ray (worst joint selected). A questionnaire was mailed asking about current/ever use of specific NSAIDs (by generic and trade names) including over the counter and acetylsalicylic acid. Coxibs were not available over the study period. A total of 608 subjects were studied, having mild (71), mod (129) and severe (408) OA, with a disease duration of 10 years in each group (62% were women, who had proportionately more mild disease than men). Those with severe versus mild OA were older (70 versus 61 years), so age was adjusted for. There was an inverse dose–response with use of > 3 NSAIDs being used by mild versus severe OA (odds ratio 3.7), mild versus mod OA (odds ratio 2.5) and mod versus severe OA (odds ratio 1.5) ( P < 0.0001), and the same was found with > 2 NSAIDs ( P < 0.0002); and 7% of mild, 15% of mod and 12% of severe OA had received no NSAIDs ever. Only one NSAID (ever used) was increased in severe OA (sulindac, P < 0.008) compared with naproxen, tiaprofenic acid and diclofenac, more frequently used in mild than mod or severe OA ( P < 0.01). Other NSAID use ever was not different between the groups (including indomethacin, thought to be chondrodestructive), but numbers using indomethacin were small. Limitations may include inability to study accurately the duration of NSAID use, older age in those with severe OA (which could affect NSAID treatment choice), recall bias and unknown confounders. We did not illicit body mass index or pain level in each group. There may be biases for referring to different specialists as the rheumatologists prescribed NSAIDs more often and surgeons treated more subjects with severe OA ( P < 0.0001). When analyses were stratified by specialist type, there were no differences between mild, mod and severe OA for NSAID use in subjects treated by rheumatologists; however, the trend for increased NSAID use with milder OA was evident in those seen by orthopedic surgeons. When stratified by knee and hip OA, the dose–response remained ( P < 0.003 and P < 0.03, respectively). Subjects were followed by general practitioners, so we assumed past NSAIDs should have been prescribed equally in all groups, but this was not the case. Those with more severe OA are more rapidly progressive (having similar disease duration to the other groups) and could be innate NSAID nonresponders. However, one would assume that they should be exposed to more NSAIDs (looking for one to be helpful). We conclude that NSAID use and the number of NSAIDs used was greater in mild radiographic OA and postulate that lowering prostaglandins in the joint with NSAIDs may be protective for cartilage. Prospective studies are needed to confirm observations. Some in vitro models of NSAIDs in OA support our observations.
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.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it