Night-time intra-oesophageal bile and acid exposure in GERD patients failing PPI therapy
Bibliographic record
Abstract
Sirs, We read with great interest the publication by Hershcovici et al. comparing gastro-oesophageal reflux disease (GERD) patients who failed proton pump inhibitor (PPI) therapy vs. those who fully responded to PPI with regard to night-time intra-oesophageal bile and acid exposure.1 This publication provides very interesting pathophysiological information. Nevertheless, in our opinion, the results should be interpreted with caution. The decision to split the twenty-four hour study period into night- and day-time was a logical one; however, the remaining data, i.e. the results for day-time as well as the entire twenty-four hour period, should also have been reported, along with testing for statistical significance, to help readers put current findings into perspective. Of note is that the investigators have previously published a similar study where they found no significant differences in intra-oesophageal bile and acid exposure, between the PPI success and the PPI failure group over a twenty-four hour period.2 If the study population of the previous study does not overlap with the current one, it would be interesting to split (as a post hoc analysis) the results of the previous study into night-time and day-time, as a comparison to the findings of the current study. Furthermore, the current study is under powered (although, admittedly, it would have been difficult to recruit more patients due to the invasive nature of the interventions). The apparent discrepancy between acid- and bile-exposure of the oesophagus during night-time may merely represent a type II error. Indeed, the difference in means between the two groups (PPI failure and PPI success) regarding night-time exposure (duration and percentage) was proportionally similar for acid exposure and bile exposure, although it reached statistical significance only for the former. Finally, within the PPI failure group, it would be interesting to know whether or not the presence of erosive oesophagitis is associated with oesophageal acid and/or bile-exposure indexes. Declaration of personal interests: GL has served as a consultant for AstraZeneca. Declaration of funding interests: None.
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.
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 | 0.003 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".