Impact of systemic lupus erythematosus organ damage on unemployment or disability from a population-based cohort
Bibliographic record
Abstract
Systemic lupus erythematosus (SLE) predominantly develops in younger age groups, when many are establishing themselves in the workforce. The development of a chronic, autoimmune condition during this period can have a devastating impact on employment. The objective was to determine the impact of different organ damage in patients with SLE on employment loss from a large, population-based cohort. The source of data was from the 2011 to 2012 annual patient-reported survey of the Georgians Organized Against Lupus (GOAL) Study, an ongoing population-based cohort of patients with validated SLE in Atlanta, GA assembled primarily from the Georgia Lupus Registry (GLR). The GLR was supported by the Centers for Disease Control and Prevention and designed to more accurately estimate the incidence and prevalence of SLE. In partnership with the state health department, the GLR was able to access protected health information without patient consent. GOAL Study participants were surveyed regarding employment status at the time of survey completion along with other demographic information. Organ damage was measured using the Brief Index of Lupus Damage. Disease activity was measured using the SLE Activity Questionnaire (SLAQ). Logistic regression analysis was used to measure the association between categories of organ damage and unemployment/disability. A total of 459 SLE patients were surveyed with a mean age of 46.5 (SD ± 10), 13.4 (SD ± 8.6) years of disease, and 14.2 (SD ± 2.8) years of education; 93.2% were female, 79.5% were black and 14.4% white. One hundred and ninety-seven (42.9%) were working and 262 (57.1%) were unemployed/disabled. The median duration of loss of employment was 7.1 years (IQR 3.1 to 12.3). See Table 1 . In total, 57.1% of SLE patients were unemployed or disabled at the time of the survey. Organ damage from SLE has a profound association with unemployment/disability. In the multivariate model, low education level and depression were independently associated with unemployment/disability. In line with other studies, cardiovascular and renal damage were associated with unemployment/disability. Previous studies have not reported disease activity (SLAQ) as a mediator and should be considered particularly when evaluating neuropsychiatric damage and its association with employment.
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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 | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".