Inhaled corticosteroids and fractures in chronic obstructive pulmonary disease
Bibliographic record
Abstract
PURPOSE OF REVIEW: Inhaled corticosteroid (ICS) is commonly used in the management of patients with chronic obstructive pulmonary disease (COPD) for symptom relief and exacerbation prevention; however, there is a growing concern that ICS increases risk of osteoporosis and fractures in patients with COPD. RECENT FINDINGS: Osteoporosis is a major comorbidity of COPD. There is evidence from large observational studies that use of ICS for prolonged period of time (e.g. ≥4 years) is associated with accelerated loss of bone mineral density and increased risk of fractures in a dose-dependent and time-dependent fashion in patients with COPD. The risk of fractures appears increase significantly when high doses of ICS (at least 250 μg/day in fluticasone or equivalents) are used for a long period of time (at least 3 years). SUMMARY: ICS increases risk of bone demineralization and fracture in patients with COPD. It should be generally avoided in patients with previous fractures or significant osteoporosis. If they are used in such patients, close monitoring is recommended for accelerated bone demineralization.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 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".