Time for Change in the Conduct of Clinical Trials in Patients with Rheumatoid Arthritis
Bibliographic record
Abstract
> What science can there be in a matter in which, as in all practical matters, nothing can be defined and everything depends on innumerable conditions, the significance of which is determined at a particular moment which arrives no one knows when? > > Prince Andrew, War and Peace , Leo Tolstoy Doing clinical research in rheumatology has never been easy. There really wasn’t much going on 30 years ago and a “clinical trialist” was challenged to find something to study. Then came methotrexate (MTX), and for more than 20 years trials of its efficacy, safety, tolerability, pharmacokinetics, and mechanism of action dominated the scene. It’s difficult for young clinical investigators to appreciate a therapeutic epoch that was so entirely dominated by a single drug. Back then, many were frightened by MTX and those misgivings were often transferred to patients as well as other physicians and pharmacists. We really weren’t very sure about this drug. The present clinical climate could not be more different. Nine new biologic drugs have been approved in the United States in the last 13 years, and several other new agents are almost there. While this is definitely good for patients, it has become challenging to remain an ethical trialist while succeeding in North America. That is, if a patient has insurance and can access a variety of new drugs, why would they want to participate in a study of an unproven agent in which they might get nothing more than a sugar … Address correspondence to Dr. Kremer. E-mail: jkremer{at}joint-docs.com
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 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 | 0.018 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| 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".