Composite Measures of Impact and Activity in Psoriatic Arthritis: A Conceptual Framework
Bibliographic record
Abstract
Considerable progress has been made in recent years to improve outcome measurement in psoriatic arthritis (PsA). The Outcome Measures in Rheumatology (OMERACT) initiative has recently endorsed an updated “core outcome set” of disease domains that should be measured in clinical trials and observational studies of PsA1. There are also a range of clinical, patient-reported, and composite clinical measures of disease that have been validated for use in PsA2. In this setting the Psoriatic Arthritis Impact of Disease (PsAID) measure3 has been developed, and a validation study of the PsAID in an Italian cohort of patients has been undertaken. Results of that study are published in this issue of The Journal . Which measures should clinicians use for the assessment of PsA and where does the PsAID fit into the existing collection of measurement tools? It is first helpful to remind ourselves of what should be measured to adequately identify the clinical spectrum of PsA. It is well established that PsA is a heterogeneous disease affecting multiple disease domains including joints, skin, entheses, spine, nails, eyes, and axial skeleton4. Further, we know the disease phenotype varies (polyarthritis, oligoarthritis, spondyloarthritis, mutilans, and distal interphalangeal arthritis), and patients can transition between phenotype during disease course5,6. It is, therefore, a challenge to assess this heterogeneous disease and, historically, assessing only peripheral articular disease has underrepresented the totality of disease burden, thus leading to an incomplete understanding of treatment effect on extraarticular domains of disease. There have, therefore, been efforts to develop a composite disease activity measure that identified the wide range of PsA disease expression: and several measures are now available. These candidate composite measures include, but are not limited to, the Disease Activity in Psoriatic Arthritis (DAPSA)7, the Psoriatic Arthritis … Address correspondence to Dr. W. Tillett, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, BA1 1RL, UK. E-mail: w.tillett{at}nhs.net
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 | 0.039 | 0.038 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.011 | 0.008 |
| Science and technology studies | 0.002 | 0.012 |
| Scholarly communication | 0.007 | 0.008 |
| Open science | 0.006 | 0.005 |
| Research integrity | 0.004 | 0.009 |
| 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".