Continuing alendronate for an additional 5 years maintained bone mineral density in postmenopausal women
Bibliographic record
Abstract
Black DM, Schwartz AV, Ensrud KE, et al. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA 2006;296:2927–38. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q In postmenopausal women with low bone mineral density (BMD) who had been receiving daily alendronate for a mean of 5 years, what is the effect of continuing alendronate treatment for 5 years compared with discontinuing it? Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Endocrine ★★★★★★☆ Rheumatology ★★★★★★☆ Internal medicine ★★★★★☆☆ Surgery—orthopaedics ★★★★★☆☆ ### ![Graphic][5]</img>Design: randomised placebo controlled trial (Fracture Intervention Trial [FIT] Long-term Extension [FLEX]). ### ![Graphic][6]</img>Allocation: unclear allocation concealment.* ### ![Graphic][7]</img>Blinding: blinded (clinicians, participants, data collectors, and outcome assessors).* ### ![Graphic][8]</img>Follow up period: 5 years. ### ![Graphic][9]</img>Setting: 10 clinical centres in the US. ### ![Graphic][10]</img>Patients: 1099 postmenopausal women (mean age 73 y, 97% white) who had had low femoral neck BMD (<0.68 g/cm2) and had been allocated to alendronate (5 mg/d for 2 y and 10 … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.stitle%253DJAMA%26rft.issn%253D0002-9955%26rft.aulast%253DBlack%26rft.auinit1%253DD.%2BM.%26rft.volume%253D296%26rft.issue%253D24%26rft.spage%253D2927%26rft.epage%253D2938%26rft.atitle%253DEffects%2Bof%2BContinuing%2Bor%2BStopping%2BAlendronate%2BAfter%2B5%2BYears%2Bof%2BTreatment%253A%2BThe%2BFracture%2BIntervention%2BTrial%2BLong-term%2BExtension%2B%2528FLEX%2529%253A%2BA%2BRandomized%2BTrial%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.296.24.2927%26rft_id%253Dinfo%253Apmid%252F17190893%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jama.296.24.2927&link_type=DOI [3]: /lookup/external-ref?access_num=17190893&link_type=MED&atom=%2Febmed%2F12%2F3%2F70.atom [4]: /lookup/external-ref?access_num=000243069000024&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif [8]: /embed/inline-graphic-4.gif [9]: /embed/inline-graphic-5.gif [10]: /embed/inline-graphic-6.gif
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Randomized trial | low |
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 | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 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, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
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".