Discontinuation of Antiresorptive Therapies: A Comparison between 1998–2001 and 2002–2004 among Osteoporotic Women
Bibliographic record
Abstract
CONTEXT: Studies having reported high rates of discontinuation of antiresorptive therapies (ART) may not reflect their actual use. OBJECTIVES: We compared probability of discontinuation among women aged 70 yr or older with a diagnosis of osteoporosis or recent osteoporotic fracture having started ART (alendronate, risedronate, cyclical etidronate, raloxifene, nasal calcitonin) between 1998-2001 or 2002-2004. PATIENTS AND METHODS: We constructed two cohorts of women using Régie de l'Assurance Maladie du Québec databases. Discontinuation was defined as a lapse of 30 d or longer after completion of a refill. Switching from one ART to another was allowed. Probability of discontinuation was estimated using Kaplan-Meier analysis. Multivariate Cox models were used to identify potential determinants of ART discontinuation over 1 yr. RESULTS: After 1 yr, probability of discontinuation was slightly lower in the 2002-2004 cohort than the 1998-2001 cohort (52.2 vs. 57.5%; P < 0.001). This difference remained significant after adjusting for determinants [adjusted rate ratio (RR) 0.92, 95% confidence interval (CI) 0.87-0.98]. Significant determinants of ART discontinuation within 1 yr included bone mineral density testing (RR 0.77; CI 0.73-0.82) performed within 2 yr prior to initiation of therapy and having consulted more than two pharmacies (RR 1.15; CI 1.06-1.25) in the year before starting therapy. In the 2002-2004 cohort, when switching was allowed, women initiating a once-weekly regimen of alendronate or risedronate did not show a 1-yr risk of discontinuation different from women initiating daily regimens of the same drugs (RR 0.90; CI 0.82-1.00). CONCLUSIONS: Even if new dosing regimens were introduced, discontinuation of ART among osteoporotic women remains high.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".