Development of consensus best treatment plans for new-onset systemic juvenile idiopathic arthritis
Bibliographic record
Abstract
To develop eligibility criteria and consensus approaches to therapeutic management, the CARRA sJIA Core Workgroup convened regularly for workgroup meetings, hosted a 2-day CARRA consensus conference in April 2010, and conducted surveys of the CARRA membership. The CARRA sJIA Core Workgroup developed formal eligibility criteria for patient enrollment, standardized treatment approaches, and a recommended schedule of visits and monitoring parameters. Entry criteria include age 6m-18y and probable sJIA determined by defined criteria. The treatment regimens include: 1) a corticosteroid based plan, 2) a methotrexate based plan – with/without corticosteroid, and 3) an anti-IL1 (anakinra) based plan – with/without corticosteroid. A survey of the CARRA membership was conducted in December 2010 to assess the acceptability and feasibility of these strategies. There was a 63% response rate (133 of 211 surveyed), of which 92.6% expressed willingness to follow 1 of 3 treatment plans as outlined. 82% concurred that a 4th anti-IL6 based treatment arm should also be offered. Consensus was reached at the 78-85% level for all topics posed (entry criteria, specific details of treatment plans, ability to use plans). A feasibility study estimated that over 250 patients could be enrolled in these plans per year, and that physicians would likely enroll one-third to one-quarter of the patients in each of the original 3 plans. The use of consensus derived standardized treatment plans for new onset SJIA is feasible and acceptable to most North American rheumatologists who are members of CARRA. Four treatment approaches to the first 6 months of treatment will be published as frameworks for use. Coupled with standardized data collection at routine intervals, use of these treatment plans will serve as the basis for rigorous study of comparative effectiveness of the regimens as used in clinical practice.
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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 | 0.061 | 0.073 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.005 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.004 | 0.005 |
| Research integrity | 0.002 | 0.006 |
| Insufficient payload (model declined to judge) | 0.007 | 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".