Gleason grading controversies: what the chemoprevention trials have taught us
Bibliographic record
Abstract
The recent Prostate Chemoprevention Trial (PCPT), which assessed the efficacy of finasteride in reducing prostate cancer incidence, showed promising results. However, patients who developed cancer had higher Gleason scores than those on placebo. Moreover, recent evidence has shown that the biopsy Gleason scores in patients on finasteride were actually more accurate compared with patients on placebo when matched with the final, radical prostatectomy (RP) scores. This accuracy was due to a reduction in prostate volume induced by the drug, and better performance of prostate-specific antigen correlation for identifying men with high-grade cancer. Re-evaluation of the results based on the pathology of the RP specimens and longer follow-up showed a 30% reduction in cancer incidence with finasteride and no significant differences in Gleason scores compared with placebo.
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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 | 0.113 | 0.211 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.003 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.003 | 0.019 |
| Scholarly communication | 0.010 | 0.026 |
| Open science | 0.006 | 0.004 |
| Research integrity | 0.017 | 0.026 |
| Insufficient payload (model declined to judge) | 0.009 | 0.003 |
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".