A6 TREATMENT TRIAL RESULTS FROM COMMUNITY H. PYLORI PROJECTS IN ARCTIC CANADA
Bibliographic record
Abstract
Helicobacter pylori (Hp) infection is a health concern in Arctic Canada, where prevalence of Hp and gastric cancer rates are high. The Canadian North Helicobacter pylori (CANHelp) Working Group conducts community projects to address public concerns, describe the disease burden, and inform regional health policy. Projects were launched projects during 2007–2017 in Aklavik, Tuktoyaktuk, Fort McPherson, and Inuvik in the Northwest Territories and Old Crow, Teslin, Ross River, Carmacks, and Pelly Crossing in Yukon. To provide summary data on success of anti-Hp therapies in the NWT and Yukon In each community, a planning committee guided the research design and conduct. Projects included UBT screening, upper GI endoscopy, treatment, and knowledge exchange. All Hp-positive participants ≥15 years old could enroll in a series of randomized treatment trials to one of the following anti-Hp therapies: - CA: 10-day combination of proton pump inhibitor (PPI), clarithromycin and amoxicillin - Sequential therapy (ST) 10 day: PPI and amoxicillin for days 1–5, followed by PPI, clarithromycin and metronidazole for days 6–10 - BMT quadruple (BMT): 10–14 day bismuth quadruple therapy with PPI, bismuth, metronidazole, and tetracycline - CAM 14 day quadruple therapy with PPI, clarithromycin, amoxicillin, and metronidazole - AL: 14 day PPI, amoxicillin and levofloxacin Treatment adjustments: CA therapy was discontinued in 2008 after initial results showed poor effectiveness. Based on ST results and new Canadian guidelines ST was replaced by CAM in 2015 and treatment duration became 14 days. Treatment success is defined as a negative UBT at >=10 weeks post treatment. To date, of 1421 community Hp project participants, 1305 were tested for Hp by UBT (positivity=52%), 398 had endoscopy with gastric biopsy, 268 enrolled in the treatment trial, and 225 had a post-treatment UBT. In 5 patients the UBT was equivocal and these were excluded. Of trial participants with a follow-up UBT, the proportion with treatment success was: PPI-CA 62% (29/47; 95%CI 46–75%); ST 72% (70/97; 95%CI 62–81%); BMT 92% (56/61; 95%CI 82–97%) and 100% (15/15; 95%CI 82–100%) of those randomized to CAM. Of 68 participants treated outside the clinical trial with a follow-up UBT, the proportion with treatment success was: PPI-CA 41% (7/17; 95%CI 18–67%); ST 47% (8/17; 95%CI 23–72%); BMT 92% (15/18; 95%CI 59–96%), CAM 67% (2/3; 95%CI 9–99%)and AL 3/3(100%, 95%CI 37–100%), In 10 patients the treatment was unknown. While treatment success estimates from this treatment trial in Canadian Arctic communities are somewhat imprecise, results demonstrate superiority of bismuth based quadruple and non-bismuth quadruple (CAM) therapies to sequential or triple therapy. Compliance with follow up UBT testing is suboptimal. CIHRInuvialuit Regional Corporation, Alberta Innovates Health Solutions, ArcticNet
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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 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.012 | 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".