Late-Onset Spondyloarthritis: Subset That Should Not Be Forgotten
Bibliographic record
Abstract
The spondyloarthritis (SpA) complex embraces ankylosing spondylitis (AS), reactive arthritis (ReA), psoriatic arthritis (PsA), arthritis related to inflammatory bowel disease (IBD), and forms that do not fulfil established criteria, which are labelled as undifferentiated SpA (uSpA)1,2. In the early 1990s, 2 sets of classification criteria were suggested to encompass the clinical spectrum of SpA: the Amor criteria1 and the European Spondylarthropathy Study Group (ESSG)2 criteria. Each form of SpA may have a late onset3,4. The onset of AS, as defined by the modified New York criteria5, is unusual after the age of 50 years. In a population-based descriptive study carried out in Rochester, Minnesota, USA, the total incidence rate of AS was 7.3 per 100,000 person-years and the incidence value after age 55 years was 2.2/100,000 per year6. In a survey of a large number of members of the German Ankylosing Spondylitis Society, only 6% had the beginning of symptoms after age 40 years7. Only a few studies have compared the clinical expression of late-onset disease with that of earlier onset. In 2001, Brophy and Calin examined the influence of age at symptom onset on disease expression as measured by BASRI (Bath AS Radiology index), BASDAI (Bath AS Disease Activity Index), BASFI (Bath AS Functional index), percentage undergoing AS-related surgery, and prevalence of extraarticular manifestations (uveitis, psoriasis, IBD) in patients with earlier onset (before 21 years of age) and late onset (after 30 years of age)8. Age at onset had no significant effect on radiological progression, disease activity, need for non-hip surgical intervention, and prevalence of extraarticular manifestations. In contrast, there was a significant … Address correspondence to Dr. Olivieri. E-mail: ignazioolivieri{at}tiscalinet.it
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.002 |
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".