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Record W2809086820 · doi:10.1136/bmjebm-2018-110979

Essential medicines and the challenges in the Evidence-Based Manifesto

2018· editorial· en· W2809086820 on OpenAlexaff
Nav Persaud

Bibliographic record

VenueBMJ evidence-based medicine · 2018
Typeeditorial
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsUniversity of TorontoSt. Michael's Hospital
Fundersnot available
KeywordsManifestoData scienceComputer sciencePolitical scienceLaw

Abstract

fetched live from OpenAlex

The Evidence-Based Medicine Manifesto aptly identifies massive ‘too much’ problems: too much hidden information, too much bias, too much research waste and too much overtreatment.1 2 One potential solution is to focus efforts on a small number of needed treatments while allowing all the excess to fall by the wayside. Here I explore the potential role of the essential medicines list (EML) in meeting some of the big challenges posed in the Manifesto. EMLs usually include around 300 medicines that meet the priority needs of a population.3 4 The WHO created its Model EML in 1977, and since then more than 100 countries have adapted the WHO’s Model EML to their own circumstances.3 4 Today more than five billion people live in a country with an EML. Ultimately we need to know which treatments should be used and EMLs are ‘positive lists’ that can help direct people to effective treatments (as opposed to ‘negative lists’ of medicines to avoid). Given all the clinical research that has been done over the decades, we ought to be able to write down a list of medicines that were proven to have important benefits without excessive harms in studies that were properly done and reported. The fact that it is …

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

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 armCategoriesStudy designConfidence
gemmano category
Domain: not available · Genre: Editorial
About the Canadian research system: no · About a Canadian topic: no
Not applicablehigh
gptno category
Domain: not available · Genre: Editorial
About the Canadian research system: no · About a Canadian topic: no
Not applicablehigh
models agreeAgreement compares identical category sets and study designs across arms.

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.149
metaresearch head score (Gemma)0.191
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow)
Consensus categoriesMetaresearch
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Editorial · Consensus signal: none
Teacher disagreement score0.639
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.1490.191
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0030.000
Bibliometrics0.0010.001
Science and technology studies0.0000.003
Scholarly communication0.0000.001
Open science0.0020.000
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0010.001

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.

Opus teacher head0.517
GPT teacher head0.488
Teacher spread0.030 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Labeled directly by 2 models reading the full record.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEditorial

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".

Quick stats

Citations1
Published2018
Admission routes1
Has abstractyes

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