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Record W2416570510 · doi:10.1093/joneph/21.1.6

Lessons for dialysis investigators from the Steno-2 Study

2008· article· en· W2416570510 on OpenAlexaff
Philip A. McFarlane

Bibliographic record

VenueJournal of Nephrology · 2008
Typearticle
Languageen
FieldComputer Science
TopicMachine Learning in Healthcare
Canadian institutionsUniversity of TorontoSt. Michael's Hospital
Fundersnot available
KeywordsMedicineDialysisIntensive care medicineClinical trialRandomized controlled trialDiabetes mellitusInternal medicine

Abstract

fetched live from OpenAlex

People undergoing dialysis have a substantially shortened survival and a high rate of cardiovascular events. Recent clinical trials have failed to demonstrate a survival benefit of reducing traditional or dialysis-specific cardiovascular risk factors. The reasons for the failure of these clinical trials are unclear. One candidate explanation is that they lacked sufficient statistical power to detect important outcome differences. Several errors in trial design or execution can lead to trials being underpowered. An overestimation of the attributable risk of the condition of interest is a common error. Statistical models that partition attributable risk can be invalid when multiple risk factors are present, as is the case in dialysis patients. Diabetes investigators faced similar challenges in their early clinical trials. However, using only 160 people with diabetes, the Steno-2 Study demonstrated a 50% reduction in cardiovascular risk in people. This impressive result was achieved because patients in the experimental arm of the Steno-2 Study underwent reduction of multiple cardiovascular risk factors simultaneously. A Steno-2 Study approach would be an attractive trial design for dialysis investigators. It could be done with fewer resources than conventional randomized trials, and a positive result would strongly argue against therapeutic complacency in the dialysis unit. However, a variety of limitations to this approach exist. Most significantly, if positive, it would not be possible to determine which individual components of the intervention led to the improved outcomes. Despite the limitations, the Steno-2 design should currently be an attractive option for dialysis investigators.

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)0.258
metaresearch head score (Gemma)0.315
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.258
Threshold uncertainty score0.915

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.2580.315
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0040.004
Bibliometrics0.0020.002
Science and technology studies0.0020.006
Scholarly communication0.0080.014
Open science0.0050.005
Research integrity0.0130.025
Insufficient payload (model declined to judge)0.0070.004

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 head0.069
GPT teacher head0.327
Teacher spread0.259 · 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.

Study designObservational
Domainnot available
GenreEmpirical

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

Citations3
Published2008
Admission routes1
Has abstractyes

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