Branch atheromatous disease: prognosis and management. The SPS3 experience
Bibliographic record
Abstract
Stroke due to pathology of small penetrating arteries is common and still remains controversial with respect to mechanisms, prognosis and treatment. Occlusion of small penetrating arteries results in lacunar infarcts which are cavitations not larger than 20 mm and are often located deep in the brain. The pathology of the affected arteries is quite diverse, including; subintimal foam cells, wall disorganization, fibrinoid necrosis and lipohylinosis. Occasionally, obliteration of the parent artery produces giant lacunes. A distinct vascular pathology involving the basilar artery referred as branch atheromatous disease (BAD) is the etiology of a large proportion of pontine infarcts. Both entities (BAD and lipohylinosis) are clinically identical and in addition, it is likely that the prognosis and response to treatment are the same. Therefore, from the practical point of view this differentiation is purely academic. The Secondary Prevention of Small Subcortical Strokes (SPS3) study is the first clinical trial designed to address clinical scientific questions in patients with symptomatic lacunar infarct defined by magnetic-resonance imaging, which are likely due to small vessel disease. Patients are simultaneously randomized in a 2×2 factorial design, to antiplatelet therapy-aspirin plus clopidogrel vs. aspirin and to two levels of blood pressure control“ intensive ” ( < 130 mmHg) vs. “usual” (130-149 mmHg). The primary outcome is recurrent stroke and secondary outcomes include cognitive decline and major vascular events. Recruitment has been completed with 3,020 patients; results are expected by mid 2012.
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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 | 0.002 | 0.002 |
| 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 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".