Obesity, polycystic ovary syndrome, infertility treatment: Asking obese women to lose weight before treatment increases stigmatisation
Bibliographic record
Abstract
Solution is flawedEditor-Conroy et al offer a challenging solution to advance decisions on cardiopulmonary resuscitation (CPR), but the basis for that solution is fundamentally flawed. 1 They start from the premise that all institutions should provide cardiopulmonary resuscitation unless an overt decision has been made to the contrary. 2 3This is a common position in most UK NHS trusts, but there is no ethical, legal, or clinical demand on professionals that they must provide CPR.Current UK guidelines describe a presumption in favour of CPR in the absence of an advance decision but are equally clear that it would be unreasonable to resuscitate anyone in whom the burdens of treatment clearly outweigh the potential benefits.The presumption in favour of CPR has been interpreted by many health authorities as a default for CPR, but such a position is not supported by the guidelines and runs counter to personalised decision making by removing personal choice.It is also exceptional, since no other medical treatment comes with a default position.Unfortunately, Conroy et al's solution is to suggest an equally unacceptable position, a default against CPR.Conroy et al are right that the current guidelines need to be reviewed, but not for the reasons they state.Current UK guidelines are the source of much confusion among clinicians. 4They contain many contradictions and confusing statements and provide no framework for making clinical decisions.It is possible to make sense of advance decisions on CPR, and had the authors done so they would have arrived at a framework that individualises decisions, involves patients or relatives and partners when appropriate, and does so without placing an unnecessary burden on patients and carers. 4Instead the authors try to work through this confusion, and by offering a default against CPR they fail to reach a caring solution.
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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 | 0.019 | 0.136 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.005 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.005 | 0.009 |
| Insufficient payload (model declined to judge) | 0.017 | 0.002 |
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".