A60 PATIENT KNOWLEDGE-GAPS IN HEPATOTOXIC EFFECTS OF ACETAMINOPHEN FORMULATIONS
Bibliographic record
Abstract
Acetaminophen (APAP) is an immensely popular analgesic agent that is sold in Canada without prescription. The incidence of APAP toxicity leading to acute liver failure has increased over the past two decades. Recent data from a US cohort study demonstrates that up to 46% of acute liver failure cases are due to APAP. Published data suggest that accidental hepatotoxicity related to therapeutic misuse of APAP is a relatively common occurrence, especially when APAP is combined with alcohol. It is unclear if patients are aware of differences in dosage formats of APAP and increased potential for hepatotoxicity when APAP is combined with alcohol. The aim of this study was to assess patient understanding of APAP, dosage formats, combination with alcohol, and potential for toxicity. A survey was given to consecutive patients aged ≥ 18 attending a general gastroenterology clinic in Vancouver, BC. Data collection for this study began in September 2018 and is ongoing. Fisher’s exact test was used to compare categorical variables. P-values were calculated as 2-tailed and a value of ≤ 0.05 was interpreted as significant. This preliminary analysis included 95 respondents, some did not answer all questions. The majority of respondents were female (n=52/94, 54.7%). A majority identified as having university-level education (n=63/94, 67.0%) and Caucasian ethnicity (n=69/94, 73.4%). A minority reported using “regular-strength (RS)” APAP (325mg PO) more than one day per week (n=23/94, 24.5%). A similar number of respondents reported used “extra-strength (ES)” APAP (650mg PO) more than one day per week (n=21/93, 22.6%). Respondents more commonly reported using both RS and ES APAP together over a given stretch of time (n=14/92, 15.2%), than RS APAP alone (n=8/92, 8.7%) or ES APAP alone (n=6/92, 6.5%) (p<0.01). Most recognized that APAP toxicity is harmful to the liver (n=76/91, 83.5%). A majority (n=50/86, 58.1%) misunderstood the distinction between RS and ES APAP – believing that the ES formula included the addition of a separate analgesic agent (n=36/86, 41.9%) or was a different drug altogether than RS APAP (n=14/86, 16.3 %). A minority identified that APAP in combination with alcohol leads to increased toxicity (n=42/89, 47.2%). Patients seen in an outpatient GI clinic have a general understanding that APAP may lead to liver toxicity. Concerningly, however, those who frequently use APAP products seem to use both regular and extra-strength formulations together. Additionally, there is a low-level of understanding regarding the differences in these formulations. Data collection is ongoing, and we will seek to stratify those patients at risk for misunderstanding APAP dosage formats. None
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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 | 0.008 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 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".