How strong is the evidence for the use of perioperative β blockers in non-cardiac surgery? Systematic review and meta-analysis of randomised controlled trials
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
<h3>Introduction</h3> Little is published on the health impact of irritable bowel syndrome with diarrhoea (IBS-D) on patients. We aimed to assess the gastrointestinal and wider health burden of IBS-D, including medications used for symptom relief and perceived care shortfalls. <h3>Method</h3> A 30 min online survey was completed in France, Germany, Italy, Spain, UK, Canada and Australia. Target sample size was 80 patients per country. Screening criteria included: age 18–65 years, being diagnosed with IBS-D by a doctor, having symptoms present within the past 12 months, and currently using prescription or over-the-counter (OTC) medicines for IBS-D. The maximum quota was 30% male and 25% of patients who had never seen a gastroenterologist for their IBS. Attitudes to IBS-D and its management were scored using a 7-point scale (Table). <h3>Results</h3> 513 eligible patients completed the survey; 357 (70%) were female and mean age was 40.9 (range 18–65) years. As well as stomach pain and diarrhoea, 269 (52%) patients had bloating before treatment, 204 (40%) had urgency and 88 (17%) had faecal incontinence. Mean duration of symptoms was 9.8 years. The most troublesome current symptom was urgency in 136 (27%) patients. In the past 3 months, symptoms were intermittent in 390 (76%) patients and continual in 123 (24%). The most common comorbidities were anxiety in 189 (37%) patients, depression in 137 (27%) and migraine in 133 (26%). OTC drugs were used by 372 (73%) patients (214 [42%] OTC only, 158 [31%] OTC + prescription). The most commonly used agents were antidiarrhoeals in 416 (81%) patients and antispasmodics in 300 (58%); notably, 91 (18%) used codeine-based painkillers and 79 (15%) used antidepressants. Antidiarrhoeals were used daily by 63 (12%) patients and 58 (11%) used daily antispasmodics; 178/384 (46%) and 99/217 (46%) were not satisfied with these agents. Patients had mixed attitudes towards their condition (Table: score 6–7): 216 (42%) reported having learned to live with their IBS but 189 (37%) were constantly worried about when their symptoms would return, and 58 (11%) agreed with the statement “When my IBS is bad, I wish I was dead”. A substantial proportion (170; 33%) wanted doctors to listen and support more and 165 (32%) agreed that healthcare professionals do not take IBS seriously. The majority of patients (296; 58%) wanted treatment to significantly improve their quality of life and 237 (46%) were willing to try anything to help manage their IBS. <h3>Conclusion</h3> We report the substantial impact of IBS-D on quality of life, medication use and the desire for more services in this patient population. There is a distinct opportunity for improved pharmacological and supportive management of IBS-D patients. <h3>Disclosure of Interest</h3> H. Törnblom Conflict with: Almirall, Allergan and Shire, Conflict with: Shire, Almirall, Probi, Tillotts, A Emmanuel Conflict with: Allergan, Kyowa Kirin, Shionogi, Shire, Takeda, R Goosey Conflict with: Kantar Health, paid consultants to Allergan plc, G Wiseman Conflict with: Allergan plc, S Baker Conflict with: Allergan plc
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.
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 | 0.029 | 0.050 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.063 | 0.036 |
| 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 | 0.000 |
| 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 it