Screening in Frail Older People: An Ounce of Prevention or a Pound of Trouble?
Bibliographic record
Abstract
Screening for subclinical disease has provided benefit to many asymptomatic patients, especially those who are relatively young and otherwise healthy. However, frail older people do not always profit from such maneuvers, for several reasons. First, older individuals usually have less physiological reserve and greater comorbidity and resultant polypharmacy than their younger counterparts. As such, they may tolerate the invasive interventions called for after a positive screening test less easily. In addition, shorter natural life expectancy shifts the focus to quality of life improvement after screening tests rather than simply offering a promise of "more years." Lack of education and cognitive decline may also interfere with the older person's ability to give truly informed consent to these maneuvers. Thus, on the whole, in this rapidly growing subpopulation, screening programs may tilt the balance toward the likelihood of causing more harm than good. For many frail older patients, an individualized approach to screening is recommended, adjusted to comorbidity, life expectancy, and patient preference. One size does not fit all.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".