Shifting from a Rheumatologic Point of View toward Patient-centered Care in Rheumatoid Arthritis with an Integrated Management of Comorbidities
Bibliographic record
Abstract
It has been well documented that patients with rheumatoid arthritis (RA) are at higher risk for many comorbidities1, even in early RA2. The concept of comorbidity refers to chronic conditions that coexist with the index disease, such as RA, with potential interactions between RA and comorbidities that may worsen patient global well-being. In fact, this concept does not seem so recent, because a global healthcare approach has always been the gold standard in the management of many chronic diseases. However, specifically regarding RA management, the innovative aspect lies in involving rheumatologists in addressing the field of comorbidities. Thanks to tight control of joint outcomes with targeted disease-modifying antirheumatic drugs (DMARD), the rheumatologists became involved in other dimensions of RA, such as quality of life or comorbidities. Evidenced-based and practical recommendations for screening and managing comorbidities in RA have been developed2,3,4,5,6. Such comorbidities in RA include various conditions such as cardiovascular diseases, hypertension (HTN), diabetes, pulmonary diseases, depression, osteoporosis, and malignancies. Comorbidities appear to be of utmost importance to consider, not only because of their high prevalence but also because of their potential involvement in RA outcome7. Comorbidities affect morbidity, increase mortality, impair quality of life, and affect response to treatment, while increasing the complexity of managing RA and its costs. This is also true in early RA. In the Canadian Early Arthritis cohort, comorbidities were associated with higher disease activity and worse functional status8. Indeed, comorbidities have been reported to be a negative predictor of achieving the treatment target, … Address correspondence to Dr. C. Roubille, Department of Internal Medicine, 371 Avenue du Doyen Gaston Giraud, CHU Montpellier, University of Montpellier, 34295 Montpellier, France. E-mail: c-roubille{at}chu-monpellier.fr
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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 | 0.017 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.007 |
| Scholarly communication | 0.011 | 0.007 |
| Open science | 0.003 | 0.015 |
| Research integrity | 0.006 | 0.015 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
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".