The change of association between nephrogenic systemic fibrosis and gadolinium-based contrast agents:an updated meta-analysis applying Hill's criteria
Bibliographic record
Abstract
Objective: To examine whether a causal link exists between gadoliniumbased contrast agents(GBCAs) and nephrogenic systemic fi brosis(NSF) and if the link changes over time. Materials and Methods: Studies for analysis were identifi ed by searching the Pub Med,the Wiley Online Library,and the Cochrane Central Register of Controlled Trials up to December 18,2014. Pooled odds ratios(OR) with 95% confi dence intervals(CI) was calculated by using the fi xed-effects model. Statistical heterogeneity was assessed by Cochrane's Q test and I2 statistics. Publication bias was evaluated using peters test,funnel plots and fail-safe N. Quality assessment of included studies using Newcastle-Ottawa Scale(NOS). Infl uence analysis and cumulative meta –analysis were also conducted in this study. All statistical analyses were performed by R software(R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing,Vienna,Austria. URL http://www.R-project.org,2014). Hill's criteria was used to evaluate evidence in support of a potential causal link between GBCAs and NSF. Results: A total of 14 studies including 6398 patients met the inclusion criteria,but 3 was excluded since they reported no NSF events. Metaanalysis of controlled trials indicated the GBCAs exposure may signifi cantly increase the risk of NSF(OR=16. 50,95%CI: 7.46-36.53,P0.01) and gadodiamide exposure may also increase the risk of NSF(OR=20.04,95%CI: 3.72-107.78,P0.01). No heterogeneity(P=0. 819,I2=0%; P=0. 873,I2=0%,respectively) was observed across studies. Hill's criteria suggested a potential causal link between GBCAs and NSF. In addition,the cumulative analysis demonstrated that the pooled ORs for GBCAs and NSF decreased post-2007 compared to pre-2007(OR=26.71; 95%CI: 10.27-69.44). Conclusions: Although this meta-analysis suggests a strong association and potentially causal relation between GBCAs exposure and the incidence of NSF in patients with renal insufficiency,the relation decreased after 2007. More studies are warranted to examine the potential association between GBCAs other than gadodiamide and NSF.
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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 | 0.004 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".