Another Nasty Effect of Opioids: Attenuating the Benefits of Motivational Interviewing in Fibromyalgia?
Bibliographic record
Abstract
The reasons why fibromyalgia (FM) patients fail to adhere to medical advice are complex and multifactorial, with consequent challenge to effective medical care. While adherence to medication treatments is generally poor, adherence to lifestyle intervention recommendations may be even poorer1,2. FM is a condition without cure at this time and with symptoms expected to be lifelong for most. Current guidelines recommend regular physical activity as a critical and necessary treatment strategy for FM; both short-term and longterm benefits of exercise have been demonstrated, emphasizing the need to promote adherence to these recommendations3,4,5,6. Nevertheless, continued practice of exercise by FM patients remains poor7. Strategies proposed to maintain adherence include patient education and empowerment, encouragement to participate in an activity that is pleasurable and convenient, and psychological interventions that may include cognitive behavioral training or motivational interviewing (MI)8. MI is a patient-centered technique that aims to facilitate patient involvement in maintaining good, health-centered behavior patterns. This psychological strategy, developed in the 1980s, was initially used in the management of substance abuse disorders9. As the popularity of MI increased, along with the appreciation of the importance of active patient/person participation in health care, it was used in various other health-related settings such as prevention programs for smoking and alcohol use in youth, and then to a wider application to promote adherence to treatment recommendations in diverse diseases. The objective of MI is to sufficiently motivate a person to develop a closed loop of achievement, whereby a person is able to set and achieve goals that will continue to provide personal motivation by generating a self-sustaining loop. MI may be delivered in various formats, including face-to-face encounter, telephone contact or online groups, as well … Address correspondence to Dr. M.A. Fitzcharles, Montreal General Hospital, 1650 Cedar Ave., Montreal, Quebec H3G 1A4, Canada. E-mail: mary-ann.fitzcharles{at}muhc.mcgill.ca
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 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, 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".