Hypovitaminosis D in Orthopaedic Trauma: Which Guidelines Should Be Followed?
Bibliographic record
Abstract
OBJECTIVE: To evaluate the risk factors for hypovitaminosis D and to determine the baseline vitamin D supplementation associated with normal vitamin D levels at presentation. DESIGN: Prospective observational study. SETTING: Level I trauma center. PATIENTS: This study included 259 adult patients undergoing operative treatment for orthopaedic trauma (OTA 11-15, 21-23, 31-34, 41-44, 61-62, 70C, 81-82, 87) between January 1, 2014, and December 31, 2014. INTERVENTION: Prospective, observational study. MAIN OUTCOMES: Association of hypovitaminosis D with patient characteristics, injury factors, and vitamin D supplementation. RESULTS: Univariate predictors of hypovitaminosis D included a lack of preinjury supplementation, non-white race, younger age, female sex, non-Medicare insurance, smoking, obesity, Charlson Comorbidity Index <2, and high-energy mechanism. On multivariate analysis, preinjury supplementation was associated with a lower risk (odds ratio: 0.31, 95% confidence interval: 0.15-0.63, P = 0.001) and non-white race was associated with a higher risk (odds ratio: 3.63, 95% confidence interval: 1.58-8.37, P = 0.001) of hypovitaminosis D. Logistic regression analysis found a dose-dependent relationship between vitamin D supplementation and hypovitaminosis D. Each 100-IU increase in vitamin D supplementation was associated with an 8% decrease in the risk of hypovitaminosis D. CONCLUSIONS: A lack of preinjury supplementation and non-white race were independently associated with hypovitaminosis D. Baseline supplementation consistent with Endocrine Society guidelines (2000 IU daily) was more effective than that consistent with Institute of Medicine guidelines (400 IU daily) in maintaining 25-hydroxyvitamin D above 30 ng/mL in this population. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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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 | 0.006 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.004 | 0.006 |
| 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".