The Diagnosis and Management of Asymptomatic Primary Hyperparathyroidism Revisited
Bibliographic record
Abstract
Primaryhyperparathyroidism (PHPT) is a commonendocrinedisease, especially in countries where multichannel bio-chemical screening, including the serumcalciummeasurement, is routinely used. As a result of the introduction of the automated serum screening chemistry panel in the United States in the early 1970s, the prevalence and incidence of the disease was shown to be much higher than previous estimates (1). In addition, the clinical profile had shifted from a symptomatic disorder, with hypercalcemic symptoms, kidney stones, overt bone disease, or a specific syndrome of neuromuscular dysfunction, toward a less symptomatic or even asymptomatic state. The modern clinical profile of asymptomatic PHPT, at least in North America and in many other parts of the world, is best characterized as a disorder in which there are neither signs nor symptoms traditionally as-sociated with hypercalcemia or PTH excess. However, there are clearly different presentations of the disease in different coun-tries. In parts of Europe and in developing nations, disease pre-sentation is more typically reported with overt signs and/or symptoms (2). In light of the shift in the clinical profile of PHPT, it was no longer clear in 1990 whether parathyroid surgery should be rec-ommended for all patients with this disease. Other issues related to medical management, surveillance, and criteria for diagnosis and/or recommendations for surgery all led to the convening of
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".