Reply to obstructive sleep apnoea in obese aboriginal and torres strait islander children
Bibliographic record
Abstract
The authors would like to thank Dr Banda for his letter1 expressing an interest in our retrospective study on obstructive sleep apnoea (OSA) in children with obesity.2 Our study showed that ethnicity was statistically significant: of the six Aboriginal and Torres Strait Islander (ATSI) children, three children had severe OSA while the other three had mild-moderate OSA. The children with severe OSA had polysomnography within 3 to 12 months of referral. Five of the ATSI children were from South East Queensland and one from Northern New South Wales. As Dr Banda has pointed out, only one of six Pacific Islander/Maori children had OSA (which was mild). Our study had a small sample size and was possibly not powered enough to detect the previously identified relationships between Pacific Islander/Maori ethnicity and OSA in adult men. We are not aware of any similar studies conducted in Australia looking into OSA in this paediatric population. We are aware of the Canadian study that Dr Banda referenced, which looked at neck-to-waist ratios being predictive of OSA in children with obesity. Our study was retrospective, and these data were not recorded. Prospective studies in Australia will be useful. Despite being a small retrospective study, our results may be relevant. Assessment and management of all children with obesity and possible OSA, including ATSI children, needs to be supported in rural and remote areas. We acknowledge that rural health services in most, if not all, rural and regional areas of Australia lack multidisciplinary clinical teams for overweight and obese children. Even tertiary paediatric centres have, until recently, had no or limited clinical services for obese children, especially those from lower socio-economic areas.3 Until an adequately funded co-ordinated national approach is adopted addressing community prevention, as well as primary and tertiary care management of childhood and adolescent obesity, and its complications, as per the National Health and Medical Research Council guidelines,4 this major public child health crisis will continue to grow and impact adversely on the health, well-being and future of all the nation's children and their families. Unfortunately, we agree that the greatest impact will occur particularly on those children from ATSI background making ‘Closing the Gap’ even more challenging.
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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 | 0.003 | 0.025 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.018 | 0.018 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".