Characterization of Chronic Pain and Opioid Usage in Adult Sickle Cell Disease Patients Referred to a Comprehensive Pain Clinic
Bibliographic record
Abstract
Dear Editor, The adult Sickle Cell Disease (SCD) program at our tertiary academic hospital network developed a collaborative approach with the Comprehensive Pain Program to better assess and manage pain in their SCD population. We followed 16 consecutive SCD patients referred to our pain program due to poor pain control over a 4-year period (2010–2013). Data collected included demographics, types and doses of opioids prescribed, use of other than opioid drugs, and verbal pain ratings on a numerical rating scale (NRS) ranging from 0 to 10. The average prescribed daily dose (in milligrams) of oral morphine or equivalent was calculated for each patient in Morphine Equivalent Dose (MED). Opioid users were classified as HOU (High Opioid Users) or LOU (Low Opioid Users), depending on whether the exceeded 200 mg of morphine equivalent per day the “watchful dose” recommended by the Canadian Guideline for Safe and Effective Use of Opioids in Chronic Non-Cancer Pain. At this dose, the Guideline recommends reconsideration of effectiveness of opioid treatment in a given patient if he/she has failed to respond adequately [1]. In terms of demographics, 62.5% of the patients were Canadian born primarily of African or Caribbean decent, female/male ratio …
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How this classification was reachedexpand
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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".