Immunotherapy improves health‐related quality of life of adult patients with dermal reactions following yellow jacket stings
Bibliographic record
Abstract
BACKGROUND: In many European centers insect venom allergic patients with a reaction confined to the skin are only offered an epinephrine auto-injector and not venom immunotherapy (VIT). Previously we showed that VIT improves health-related quality of life (HRQL) of yellow jacket allergic patients with more than dermal reactions. OBJECTIVE: To examine whether HRQL of dermal reactors is impaired and to examine the influence of VIT on HRQL in comparison with the EpiPen. METHODS: Patients with solely dermal reactions were asked if they were willing to be randomized either to VIT or EpiPen, after receiving patient information. Before and 1 year after enrollment, patients completed the Vespid allergy Quality of Life Questionnaire (VQLQ), Burden of Treatment and Expectation of Outcome. RESULTS: Of 55 patients eligible for the study, 29 consented to randomization: 15 to VIT, 14 to EpiPen. The remaining 26 patients preferred to choose their treatment: 11 VIT and 15 EpiPen. The VQLQ score of patients randomized to VIT improved (mean change 0.83 (SD 0.87), in contrast to patients randomized to the EpiPen whose scores deteriorated (mean change -0.42 (SD 0.64), P < 0.0001), resulting in an overall difference of 1.25 [95% confidence interval (CI): 0.63-1.87]. With a minimal important difference of 0.5 indicating a clinically significant improvement, VIT generated an number needed to treat (NNT) of 1.7. Dermal reactors did not consider VIT burdensome and rated this treatment as being superior to the EpiPen. CONCLUSION: VIT results in a clinically significant improvement of HRQL in most patients with reactions limited to the skin following yellow jacket stings. Prescription of an EpiPen in patients not choosing this treatment is associated with deterioration in HRQL and should therefore be avoided as definitive treatment in these patients.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.002 | 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".