Cannabis in the Treatment of Rheumatic Diseases: Suggestions for a Reasoned Approach
Bibliographic record
Abstract
On April 1, 2014, Health Canada announced a new approach to the permitted use of herbal cannabis as a medication (“medical marijuana”). Physicians are now required to write prescriptions, which the patients must have filled by producers licensed by Health Canada who will sell standard preparations of known purity. Numerous medical organizations, such as the Canadian Medical Association, the College of Family Physicians of Canada, and the Canadian Ophthalmological Society, have expressed their disapproval either of the use of cannabis as a medication, or of the requirement for physicians to write prescriptions for a substance that has not yet been formally approved as a safe and efficacious medication by Health Canada itself. A general assessment of these issues and an appeal for a calm and reasoned approach to the medical uses of cannabis and pure cannabinoids was recently published elsewhere1. However, the debate has not ended, and in this issue of The Journal a further statement of opposition can be found to the new regulations on behalf of the Canadian Rheumatology Association2. The reasons given for opposing the requirement for physicians to write prescriptions for cannabis are essentially the same as those given in the statements by other medical organizations: that the efficacy and safety of cannabis have not yet been demonstrated in well-designed clinical trials in patients with chronic rheumatic and arthritic conditions; that physicians should not be obliged to write prescriptions for a drug that does not yet have defined recommended dosage levels; that the steady increase in potency of contemporary cannabis puts the patients at potentially increased risk; and that the medical prescription of cannabis under these conditions is a violation of the basic principles of good medical practice. These are not trivial concerns, and the medical groups that have raised them have … Address correspondence to Dr. H. Kalant, Department of Pharmacology & Toxicology, Medical Sciences Building, University of Toronto, 1 King’s College Circle, Toronto, Ontario, Canada M5S 1A8., E-mail: harold.kalant{at}utoronto.ca
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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 | 0.087 | 0.077 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.005 | 0.053 |
| Scholarly communication | 0.013 | 0.029 |
| Open science | 0.007 | 0.008 |
| Research integrity | 0.042 | 0.062 |
| Insufficient payload (model declined to judge) | 0.012 | 0.005 |
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".