HLA-B*5801 Should Be Used to Screen for Risk of Stevens-Johnson Syndrome in Family Members of Han Chinese Patients Commencing Allopurinol Therapy
Bibliographic record
Abstract
To the Editor: Allopurinol is the major drug used in the treatment of gout and hyperuricemia. Generally, the drug is well tolerated, although a minority of people, about 2%, develop a hypersensitivity reaction with rash or, less frequently, Stevens-Johnson syndrome (SJS)1. A multinational study reported that allopurinol is the most common drug associated with SJS and toxic epidermal necrolysis2. Genomic studies have shown that the HLA-B*5801 allele is a strong risk factor (OR 34–348) for developing allopurinol-induced SJS3,4,5,6,7,8. However, the clinical utility of HLA-B*5801 is unclear. We conducted an observational study in the immediate family members of a male patient who experienced allopurinol-induced SJS in 1997 (index case). The patient, now 72 years old, was diagnosed with SJS by a dermatologist when he developed a generalized blistering rash, fever, and internal organ failure … Address correspondence to Dr. R.O. Day, Clinical Pharmacology, St. Vincent’s Hospital Sydney, Darlinghurst, New South Wales 2010, Australia. E-mail: R.Day{at}unsw.edu.au
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 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".