Bibliographic record
Abstract
To the Editor: In their review article, McCrory and Lindahl state that “although …animal data suggest that COX-2 inhibition may worsen myocardial performance in the presence of ischemia, there now is evidence that COX-2 inhibition reduces atherosclerosis.”(1) The authors conclude their review by suggesting that “…selective COX-2 inhibitors…may represent a safer alternative to nonselective NSAIDs in the treatment of postoperative pain.” However, no data is available from large randomized controlled trials to conclusively demonstrate that COX-2 inhibitors, administered for postoperative analgesia or other indications, produce a reduction in cardiovascular or overall serious adverse events in humans. McCrory and Lindahl do not include in their article the recent evidence from two large and widely discussed trials with over 16,000 patients that show the contrary. Analysis of the safety data of the CLASS trial [celecoxib compared to non-COX-2 selective NSAIDs, 8059 patients (2); complete data set not included in the original publication but published later by the Food and Drug Administration (3)] showed that celecoxib had no advantage over non-selective NSAIDs in terms of either cardiovascular events or overall safety. In the VIGOR trial [rofecoxib vs. naproxen, 8076 patients (4)], patients treated with rofecoxib had a relative risk of 2.36 (95% confidence interval [CI], 1.38–4.02;P = 0.002) to encounter a thrombotic cardiovascular adverse event, and a relative risk of 1.19 (95% CI, 1.04–1.38;P = 0.016) to experience a serious adverse event [complete safety data published by the Food and Drug Administration (5)]. The potential of COX-2 inhibitors to increase cardiovascular risk has subsequently been subject of review in the literature (6,7). On the basis of the best evidence available to date, it would seem reasonable to treat claims that COX-2 inhibitors are safer agents for postoperative analgesia than non-COX-2 selective NSAIDs with caution. Stephan K.W. Schwarz, MD, Dr med, PhD
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.005 | 0.020 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.009 | 0.018 |
| Insufficient payload (model declined to judge) | 0.007 | 0.007 |
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".