Knee osteoarthritis clinical practice guidelines -- how are we doing?
Bibliographic record
Abstract
OBJECTIVE: To determine the degree to which documented knee osteoarthritis (OA) care in a teaching rheumatology clinic corresponds to evidence-based treatment guidelines. METHODS: The charts of 105 randomly selected patients meeting criteria for knee OA were reviewed. The patients received care from 3 rheumatologists working in a major Canadian teaching center between 2002 and 2005. The chart abstraction tool was based on European League Against Rheumatism, American College of Rheumatology, and The Arthritis Society guidelines for OA treatment. Descriptive statistics were used for patient demographics and the proportion of patients receiving recommended care. RESULTS: The most frequently recommended nonpharmacologic treatments were any kind of exercise (58.1%), weight loss in those overweight (50.0%), physiotherapy (42.9%), and strengthening exercise (40.0%). Other nonpharmacologic treatments were documented in less than 30% of patient charts. The most frequently prescribed pharmacologic treatments were acetaminophen (68.6%), intraarticular (IA) corticosteroids (65.7%), nonsteroidal antiinflammatory drugs/cyclooxygenase-2-selective inhibitors (COXIB; 50.5%), and IA hyaluronans (43.8%). Topical pharmaceuticals, glucosamine/chondroitin, and opioid analgesics were recommended to less than 20% of the patients. Exploratory analyses suggested the following factors may be associated with increased documentation of recommended care: female sex, younger age, overweight, more clinic visits, decreased symptom length, and the individual rheumatologist. CONCLUSION: Nonpharmacologic knee OA treatments currently recommended by practice guidelines were seldom documented in patients' charts in this Canadian rheumatology teaching center. These findings are similar to studies conducted before the practice guidelines became available and to results reported from general practices. This suggests the need for reminder systems or other strategies to promote physician adherence to current guidelines.
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 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 | 0.036 | 0.155 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.008 | 0.007 |
| Open science | 0.005 | 0.003 |
| Research integrity | 0.005 | 0.006 |
| Insufficient payload (model declined to judge) | 0.005 | 0.003 |
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 source (direct Gemma or distilled Codex), 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".