Abnormal vaginal bleeding after epidural steroid injection: is there a cause for concern?
Bibliographic record
Abstract
Commentary on: Suh-Burgmann E, Hung YY, Mura J. Abnormal vaginal bleeding after epidural steroid injection: a paired observation cohort study. Am J Obstet Gynecol 2013;209:206.e1–6.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Epidural steroid injections (ESI) are the most commonly performed intervention for chronic axial pain. In the USA alone, the number of ESIs administered to Medicare recipients almost doubled between 2000 and 2004 (from 740 845 to 1 437 962 procedures/year).1 A recent systematic review found high-quality evidence that ESI for sciatica results in small, short-term (>2 weeks but ≤3 months) improvements in pain and disability; however, neither effects remained significant at ≥12 months of follow-up.1 ESI are associated with adverse effects that may be related to the technical approach or due to the effect of the steroids themselves,2 but there is very limited … [1]: {openurl}?query=rft.jtitle%253DAm%2BJ%2BObstet%2BGynecol%26rft.volume%253D157%26rft.spage%253D865%26rft_id%253Dinfo%253Adoi%252F10.7326%252F0003-4819-157-12-201212180-00564%26rft_id%253Dinfo%253Apmid%252F23362516%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.7326/0003-4819-157-12-201212180-00564&link_type=DOI [3]: /lookup/external-ref?access_num=23362516&link_type=MED&atom=%2Febmed%2F19%2F2%2Fe16.atom [4]: /lookup/external-ref?access_num=000312583200016&link_type=ISI
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
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Case report | low |
| gpt | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Case report | low |
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 | 0.005 | 0.079 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.004 | 0.001 |
| Research integrity | 0.022 | 0.011 |
| Insufficient payload (model declined to judge) | 0.024 | 0.009 |
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, unvalidatedLabeled directly by 2 models reading the full record.
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".