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
BACKGROUND: Chronic opioid use has been associated with the development of sleep-disordered breathing (SDB) such as central sleep apnea (CSA). Patients receiving chronic opioids may suffer from unrecognized sleep apnea that contributes to opioid-overdose death. Currently, information regarding the perioperative management of patients with chronic opioid-associated CSA is limited. The objectives of this review are to define the clinical manifestations of SDB associated with chronic opioid therapy, especially CSA, and to highlight their prevalence, mechanisms, risk factors, and perioperative management. METHODS: We searched Medline (1983-2014), Medline In-Process and other nonindexed citations (July 2014), EMBASE (1983-2014), the Cochrane Database of Systematic Reviews (January 2005-2014), the Cochrane Central Registry of Controlled Trials (July 2014), and PubMed basic search for new materials (1983-2014). Anesthesia and Sleep Medicine meeting abstracts were also searched for relevant articles. We included all prospective, retrospective studies and case reports in which CSA and chronic opioid use was confirmed by polysomnography. CSA was defined as the absence of airflow for ≥ 10 seconds with the absence of breathing efforts. A Central Apnea Index ≥ 5 events/h was considered significant. RESULTS: The search strategy yielded 8 studies which included 560 patients. The overall prevalence of CSA in patients taking chronic opioids was high (24%). The morphine equivalent daily dose (MEDD) was strongly associated with the severity of the SDB, predominantly CSA, with an MEDD of >200 mg being a threshold of particular concern. Concurrent use of benzodiazepines or hypnotics was associated with the severity of CSA in one study. Body mass index was inversely related to the severity of SDB. There were various recommendations regarding the best type of positive airway pressure therapy for the treatment of opioid-associated CSA. Continuous positive airway pressure may be ineffective in eliminating, or may even increase, CSA. Adaptive servoventilation and bilevel positive airway pressure ventilation were effective according to some reports. CONCLUSIONS: The overall prevalence of CSA in patients taking chronic opioids was 24%. The most important risk factors for severity of CSA were an MEDD >200 mg, and low or normal body mass index. Continuous positive airway pressure is often ineffective for treating CSA. Limited data are available on the perioperative management of patients with CSA associated with chronic opioid use. Further prospective studies on the perioperative risks and management of these patients are needed.
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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