Body mass index at diagnosis affects disease course in juvenile dermatomyositis
Bibliographic record
Abstract
Institutional Review Board approval was obtained to retrospectively review the charts of 73 patients with JDM seen in pediatric rheumatology clinic at Nationwide Children’s Hospital over the past 23 years. Data on treatment and outcomes were collected up through the last clinic visit, or July 30, 2010, whichever came first. Body mass index (BMI) was calculated using ‘Centers for Disease Control and Prevention - BMI calculator for children and teenagers’. We used the Wilcoxon two-sample test to compare numerical variables between the group of patients who were obese (BMI >85 percentile) and the group who were non-obese (BMI ≤85 percentile) at their initial visit. We used logistic regression to compare categorical variables between obese and non-obese groups in SAS 9.2. Patient age ranged from 0-18 years. Twenty eight patients had age- and sex-specific BMI ≥ 85 percentile, and 45 had < 85 percentile. Average BMI of obese patients was 93 percentile and of non-obese patients was 46 percentile. Comparatively fewer patients in the obese group received corticosteroid pulses at diagnosis (p=0.027) and developed osteonecrosis (p=0.050). Comparatively more patients in the obese group had elevated muscle enzymes at 12 months (p=0.027), developed calcinosis (p=0.047), received methotrexate for longer time (p=0.040), were treated with plaquenil (p=0.04), continued to take steroids at last follow up (p=0.028), and continued to have active disease at 5 years (p=0.006), 8 years (p=0.050) and 10 years (p=0.045) following diagnosis. JDM patients who were obese at diagnosis (BMI > 85 percentile) were less likely to receive pulse corticosteroids and had fewer bone complications. On the other hand, they had a more severe and prolonged disease course. It is not clear if these differences were related treatment choices, or to metabolic differences such as secretion of pro-inflammatory cytokines by adipose tissue, alteration of pharmacokinetics of medications, or altered sensitivity and response of the hypothalamic-pituitary-adrenal axis including response to corticosteroids.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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 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".