Diagnosis and treatment of Paget's disease of bone
Bibliographic record
Abstract
Paget's disease of bone (PDB) is a metabolic bone disease characterized by increased bone resorption followed by excessive unregulated bone formation. This results in weakened, deformed bones of increased mass in which the collagen fibres assume a haphazard irregular mosaic pattern instead of the normal parallel symmetry. PDB rarely occurs before middle age and its prevalence increases steadily with age. The overall prevalence in Caucasians is approximately 3%; although it appears to be declining. There is a geographic variation in prevalence, with highest rates found in the UK. PDB affects both men and women, with a slight predominance in men. PDB may be asymptomatic or symptomatic, depending on the bones involved; the most common symptom is pain in the affected bone. While its aetiology remains elusive, genetic factors and environmental influences are implicated. In 2002, guidelines for PDB management were developed in Great Britain and have gained worldwide acceptance. In this position paper, an Expert Panel of Canadian endocrinologists and rheumatologists examines current evidence on the diagnosis and treatment of PDB to provide Canadian recommendations. In general, diagnosis may be confirmed both by X-ray and by the biochemical marker serum alkaline phosphatase, which is elevated in 85% of individuals with untreated active PDB. Treatment is indicated for all patients with symptoms and for asymptomatic patients with active PDB in areas of the skeleton with the potential to produce complications of clinical importance. The Panel recommends treating PDB with bisphosphonates that have demonstrated superior efficacy and remission rates.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".