1A SIMPLE, EFFECTIVE AND CONVENIENT REGIME FOR TREATMENT OF VITAMIN D DEFICIENCY IN OLDER PEOPLE
Bibliographic record
Abstract
Vitamin D (VitD) deficiency increases risk of falls and osteoporotic fractures in older people. Population studies have also shown a correlation with diabetes, cancer, hypertension, myocardial events, infections, and there is now a consensus on the importance of treating VitD deficiency. A variety of treatment strategies have been recommended but no agreement as to which intervention is best suited for older patients. Regardless of severity, recent guidelines recommend weekly loading regimes for 6 to 12 weeks followed by daily maintenance 800-2000 IU. Our null hypothesis was that a short course of intensive VitD replacement would be quicker, more convenient, and equally effective in replenishing depleted stores. We conducted an audit of our local guideline, looking at our practice and its effectiveness as an easy, short, effective, and compliant regime of treating VitD deficiency in older patients. On an acute geriatric ward, patients with VitD deficiency/insufficiency were prescribed a 2 week course of ergocalciferol 50,000 IU/day. A daily maintenance dose of calcium/VitD (1.5gm/400IU) was also started. Levels were checked within 4 week of completion. Demographics including age, gender, renal function, pre and post vitD levels were recorded. Patients in CKD stage 4 were excluded. 54 patients were included. 12 were lost to follow up. Mean age was 82 years. 72% were female. The median level of VitD was 30.7 nmol/L (range 8-67) [normal >80]. Renal function, determined by eGFR, was abnormal in 78% (16 CKD stage II, 17 in stage III). Following 14 days treatment, all patients demonstrated significant improvement in VitD levels. The median change was 265%. No side effects were noted and none reached overdose levels (≥ 380 nmol/L). Our results show that this regimen of VitD replacement is effective in replenishing stores in older people. Compared to recommended strategies which span over 6-12 weeks, this protocol ensures rapid replacement, is effective and safe with no side-effects. The short duration should also increase compliance, as intermittent dosing is less easily adhered to by patients and staff, and therefore less effective. Although a small study, the results also suggest that for patients with VitD levels below 20 nmol/L, a 2 week course is probably not sufficient and may be worth considering 3 weeks of treatment at the same dose.
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How this classification was reachedexpand
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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, unvalidatedMachine predicted; a candidate call from one teacher head, 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".