Close contact casting may result in similar outcomes compared with plate fixation for unstable ankle fractures in patients over 60 years old
Bibliographic record
Abstract
Commentary on: Willett K , Keene DJ , Mistry D , et al . Close contact casting vs surgery for initial treatment of unstable ankle fractures in older adults: a randomized clinical trial. JAMA 2016;316:1455–63.[OpenUrl][1] Surgery has been considered the mainstay of treatment for unstable ankle fractures. Early mobilisation and weight bearing is possible with stable anatomic fracture fixation (open reduction internal fixation (ORIF)). Surgery also increases the risk of wound problems. This study compared outcomes among older adults with ankle fractures who received ORIF versus close contact casting. This study was prospective, powered and randomised to determine the outcomes at 6 months of adults aged 60 years or older using the Olerund-Molander Ankle Score (OMAS). Patients were randomised to casting or surgery (ORIF) in a 1:1 ratio. The surgeons were trained in the casting technique before the study. If casting failed and the patient underwent ORIF, … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.volume%253D316%26rft.spage%253D1455%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Editorial About the Canadian research system: no · About a Canadian topic: no | Non-randomized trial | low |
| gpt | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Not applicable | medium |
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
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".