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Record W2907723261 · doi:10.3899/jrheum.181046

Too Little of a Good Thing: Hydroxychloroquine in Pregnancy

2019· letter· en· W2907723261 on OpenAlexvenueno aff
Bonnie L. Bermas

Bibliographic record

VenueThe Journal of Rheumatology · 2019
Typeletter
Languageen
FieldMedicine
TopicPregnancy and Medication Impact
Canadian institutionsnot available
Fundersnot available
KeywordsHydroxychloroquineMedicinePregnancyGestationDiseaseInflammatory arthritisInternal medicineObstetricsCoronavirus disease 2019 (COVID-19)

Abstract

fetched live from OpenAlex

Women with rheumatic diseases, including inflammatory arthritis and systemic lupus erythematosus (SLE), fare better in pregnancy when their disease is under good control1,2. The role of hydroxychloroquine (HCQ) for achieving this control is now recognized. Several studies demonstrate that patients with SLE who continue HCQ during pregnancy have decreased flares and improved pregnancy outcomes, including longer fetal gestation and infants with higher birth weight3,4. Reassuringly, antimalarials are compatible with pregnancy, with no signals for safety concerns, and professional society guidelines recommend continuation of HCQ during pregnancy5. In support of this approach, a survey of North American rheumatologists found that over 69% of rheumatologists continued HCQ in their pregnant patients6. Despite the recognition that HCQ is a key component of SLE disease management in both nonpregnant and pregnant patients, adherence to HCQ remains abysmally low. Feldman, et al used claims data to show that 79% of nonpregnant patients with SLE are nonadherent7. Although claims data have also showed that overall use of HCQ during pregnancy has improved from 12.4% in 2004 to 37.7% in 2015, these rates are far from optimal8. Thus, low adherence to HCQ confounds conclusions regarding this drug’s effect on disease control and pregnancy outcome in SLE. To circumvent the possible effect of medication nonadherence on the understanding of the role of HCQ in rheumatic disease management, literature has focused on the measurement of either whole blood or serum drug levels and correlating these levels to disease activity. Costedoat-Chalumeau, et al were among the … Address correspondence to Dr. B.L. Bermas, UT Southwestern Medical Center, Rheumatic Diseases, 2001 Inwood Road, Dallas, Texas 75390, USA. E-mail: Bonnie.Bermas{at}UTSouthwestern.edu

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

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.013
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: none
GenreCandidate signal: Commentary · Consensus signal: none
Teacher disagreement score0.004
Threshold uncertainty score0.011

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0020.013
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.001
Science and technology studies0.0010.001
Scholarly communication0.0020.002
Open science0.0010.001
Research integrity0.0030.004
Insufficient payload (model declined to judge)0.0030.001

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 head0.020
GPT teacher head0.280
Teacher spread0.261 · 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

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designCase report
Domainnot available
GenreCommentary

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

Citations4
Published2019
Admission routes1
Has abstractyes

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