Response to ‘Body mass index and the risk of rheumatoid arthritis: a systematic review and dose–response meta-analysis’
Bibliographic record
Abstract
We address the recent paper by Qin et al. [1] evaluating the association between obesity and the development of rheumatoid arthritis (RA). They identified 11 cohort and case–control studies for meta-analysis, and estimated that obese individuals relative to overweight and normal weight individuals have an increased risk of RA (relative risk 1.25, 95 % confidence interval (CI) 1.07 to 1.45). We felt it important to complement their manuscript with a narrative description of results from studies not included in their synthesis, but which we have identified in our own research to be relevant to this discussion. First, we highlight the studies that were not included in the Qin review but that also did not overlap with other cohorts used in the meta-analysis. Hemminki et al. [2] estimated a small but significant increase in RA risk in patients previously hospitalized for obesity relative to those who had not been, with a standardized incidence ratio of 1.37 (95 % CI 1.08 to 1.70). However, in two large cohort studies by Bartfai et al. [3] of an American Kaiser Permanente cohort, and by Vessey et al. [4] of a contraception study, no association between obesity and RA risk was found. Associations between obesity and RA development have now also been studied in patients at high risk for progression to RA. van der Helm-van Mil et al. [5] investigated progression to RA in an undifferentiated arthritis cohort, and there was no evidence of an association with obesity. In a cohort of persons with arthralgias and/or a family history of RA, and with the presence of RA-specific anti-cyclic citrullinated peptide autoantibodies in their serum, de Hair et al. [6] found being overweight, independent of smoking, was associated with RA development (hazards ratio 5.6, 95 % CI 1.3 to 25.0, P = 0.023). Obesity was not studied per se. These findings highlight the importance of a better understanding of the factors contributing to RA development, in particular any modifiable risk factors that we might address to reduce risk in various populations. We feel there is a signal that obesity is an important contributor to RA risk, but that further study is still merited.
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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 | 0.022 | 0.080 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.020 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.015 | 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".