Bibliographic record
Abstract
The Lung Health Study (LHS) was a multicenter clinical trial of smoking intervention and inhaled bronchodilator in middleaged smokers with mild to moderate chronic obstructive pulmonary disease (1) that accumulated a large cohort of high-risk individuals and has monitored them for nearly 15 years. This article reviews results of the initial study and subsequent longterm follow-up, and some of the risk factors for rapid decline of lung function in the cohort. At 10 clinical centers in 1986–1988, the LHS recruited 5,887 smokers aged 35–59 years. Entry criteria included evidence of airway obstruction, that is, FEV1/FVC less than 0.70 and FEV1 55–90% of the predicted normal value, and a willingness to enter a smoking cessation program. People with other diseases and those being treated for lung disease were excluded. They were randomized into three groups: usual care (UC) participants were advised to stop smoking and followed; special intervention (SI) participants were enrolled in an intensive smoking cessation program (2), and half (SIA) were prescribed an inhaled bronchodilator (ipratropium bromide) and the other half (SIP) given placebo in a double-blind fashion. All participants were followed with annual spirometry for 5 years and SI participants were seen at least every 4 months to maintain compliance with the interventions. The main outcome measure, spirometry, was assessed with great care in a standardized fashion (3). Methacholine reactivity was measured at baseline and again at the end of 5 years. On entry, participants averaged 48 years of age, and 63% were male. They were heavy smokers, averaging more than 31 cigarettes per day, with more than 40 pack-years. Their FEV1 averaged 75% of the predicted normal (2.64 L) and increased little (0.110 L) with bronchodilator treatment. They demonstrated a surprising degree of methacholine reactivity, in that about one-third had a 20% decline in FEV1 with a methacholine dose of 5 mg/ml. Approximately 11 years after entry efforts were made to reexamine all of the original participants who were not known to be dead (4), and spirometry was repeated when possible.
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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 | 0.052 | 0.121 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.002 | 0.006 |
| Scholarly communication | 0.005 | 0.010 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.006 | 0.015 |
| Insufficient payload (model declined to judge) | 0.009 | 0.004 |
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".