Case 216: Hypertrophic Spinal Pachymeningitis
Bibliographic record
Abstract
History A 58-year-old woman presented for evaluation of gradually progressive lower extremity pain and paresthesia. She initially experienced interscapular pain that developed while gardening. After 1 month, she started to feel numbness in her feet. This numbness ascended over the next few days to involve her lower breast margin. There were no exacerbating or alleviating factors. She had no history of trauma, and she denied having fevers, weight change, or night sweats. Her past medical history was noncontributory. On examination, there was hyperreflexia and clonus of her lower extremities, with no clear sensory level to pinprick testing. Otherwise, her general physical examination results were normal. She underwent magnetic resonance (MR) and computed tomographic (CT) imaging of her spine. Surgery was considered at this time; however, given the preservation of strength and sensation in her legs, it was deemed to be of limited benefit. Five months passed, and her numbness and pain persisted. In the interim, her left foot had begun to drag, requiring her to use a cane. She also had developed delayed bladder emptying. She underwent a second spine MR imaging examination, which was followed by a posterior decompressive laminectomy. Her symptoms resolved after surgery. One year later, her symptoms returned and repeat MR imaging was performed at that time.
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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 | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 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".