Lack of clinically useful response predictors for treating aggression and agitation in Alzheimer's disease with citalopram
Bibliographic record
Abstract
ABSTRACT FROM: Schneider LS, Frangakis, C, Drye LT, et al . Heterogeneity of treatment response to citalopram for patients with Alzheimer's disease with aggression or agitation: the CitAD randomized clinical trial. Am J Psychiatry 2016;173:465–72. Neuropsychiatric symptoms (NPS) associated with Alzheimer's disease (AD) include depression, apathy, hallucinations, delusions, wandering and anxiety. Of all the NPS, agitation and aggression are among the most problematic and are associated with increased risk of mortality, earlier institutionalisation, increased cost of care and markedly increased caregiver burden. Over two dozen randomised placebo-controlled trials with a variety of atypical antipsychotics have demonstrated modest efficacy for agitation and aggression, with and without psychotic symptoms. Unfortunately, the use of atypical antipsychotics in patients with dementia is associated with an increased risk of cerebrovascular adverse events and mortality.1 As a result, clinical practice guidelines recommend their use only after environmental and behavioural interventions have been tried, and only when the behaviours represent a risk for harm to the patient and others.2 Because of this unfavourable risk/benefit ratio, …
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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 | 0.005 | 0.044 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.008 | 0.007 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
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".