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Record W2306838107 · doi:10.24966/pda-0150/100002

Perils of Pragmatic Psychiatry: How We Can Do Better

2016· article· en· W2306838107 on OpenAlexfundno aff
Maju Mathew Koola

Bibliographic record

VenuePsychiatry Depression & Anxiety · 2016
Typearticle
Languageen
FieldMedicine
TopicSchizophrenia research and treatment
Canadian institutionsnot available
FundersNational Institute of Mental HealthUniversity of Alberta
KeywordsSchizoaffective disorderMedical diagnosisObservational studySchizophrenia (object-oriented programming)PsychiatryPsychologyRandomized controlled trialBipolar disorderDiagnosis of schizophreniaGold standard (test)Clinical PracticeMEDLINEPsychotherapistMedicinePsychosisCognitionFamily medicine

Abstract

fetched live from OpenAlex

other meaningful clinical observations may never be subject to high quality Randomized Controlled Trials (RCTs) or other large-scale higher quality evidence-based medicine.As such, current psychiatric practice relies on too few evidence-based treatments of modest effectiveness; rather than those, if further explored, would be more effective treatments.Facing these realities, pragmatic psychiatric practice today requires optimal use of the resources available.This means more accurate applications of adequately studied diagnostic concepts, more widespread use of the evidence-based approved practices, and increased familiarity with novel and potentially helpful treatments.Granted however, that such treatments should themselves be based on available pre-clinical and lower quality clinical evidence (observational case reports, case series, open label trials, small RCTs) as shown in figure 1.The purpose of this paper is to highlight some common pitfalls encountered in the practice of psychiatry, as well as to relay potential issues in making correct diagnoses.Some important, pragmatic, psychopharmacological "pearls" are also included; to potentially aid in the improvement of psychiatric practice. Common Imprecision in Assessment and Diagnosis Schizophrenia and related psychosesClinicians often record both the diagnoses of schizophrenia and schizoaffective disorder, and schizoaffective disorder, bipolar type and bipolar I with psychosis concurrently in the same patient.Assuming that further evaluation is needed to clarify between the two, the differential diagnosis should be added as a rule out diagnosis.Having both diagnoses documented together may reflect imprecise thinking or at least, imprecise record keeping.The diagnosis of schizoaffective disorder is often made incorrectly because it lacks diagnostic reliability and stability [1].One of the criteria for schizoaffective disorder is that a major mood episode be present for the majority

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.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.108
metaresearch head score (Gemma)0.158
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: Theoretical or conceptual
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.108
Threshold uncertainty score0.573

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.1080.158
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0030.003
Bibliometrics0.0040.002
Science and technology studies0.0120.058
Scholarly communication0.0240.056
Open science0.0050.019
Research integrity0.0200.039
Insufficient payload (model declined to judge)0.0270.008

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.

Opus teacher head0.011
GPT teacher head0.274
Teacher spread0.263 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designTheoretical or conceptual
Domainnot available
GenreCommentary

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".

Quick stats

Citations1
Published2016
Admission routes1
Has abstractyes

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