Reducing fall risk while managing pain and insomnia
Bibliographic record
Abstract
As people age, the effects of medications (particularly in causing side effects like orthostatic hypotension and impaired balance) can become more pronounced. The potential for medications to contribute to symptoms must always be considered. During admissions to the Bruyere Geriatric Day Hospital (GDH), medication reviews focus on reducing polypharmacy and optimizing medication appropriateness by minimizing medications that may be contributing to symptoms or that are no longer required, while maximizing effective therapy. This case illustrates how medications, including a tricyclic antidepressant, beta blocker, calcium channel blocker and diuretic, can potentially contribute to orthostatic hypotension, dizziness and falls. We describe how some of these medications were successfully tapered and/or discontinued. We also highlight the importance of monitoring for adverse drug withdrawal events as changes are made and of reducing medications contributing to prescribing cascades, which are possibly no longer needed. A description of the GDH processes and, in particular, communication about medication-related care can be found in Appendix 1 (available online at www.cpjournal.ca).
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.003 |
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".