MétaCan
Menu
Back to cohort
Record W2953950239 · doi:10.3899/jrheum.181249

Is It Time for Gout Flare Treatment to Move into the 21st Century?

2019· letter· en· W2953950239 on OpenAlexvenueno aff
Robert T. Keenan

Bibliographic record

VenueThe Journal of Rheumatology · 2019
Typeletter
Languageen
FieldMedicine
TopicGout, Hyperuricemia, Uric Acid
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineAnakinraGoutPopulationIntensive care medicineCanakinumabAdverse effectInternal medicineDisease

Abstract

fetched live from OpenAlex

Advances in science have offered opportunities to develop targeted therapies for multiple disease states. Physicians and patients are becoming accustomed, and even expect, to use targeted therapies, avoiding any “shotgun approaches.” The discovery of biologics has revolutionized the treatment of rheumatological diseases. The benefits have greatly outweighed the risks with biologic therapy, and have subsequently reduced tender and swollen joints, improved quality of life, decreased morbidity, and slowed disease progression in this population as a whole1. But despite our greater understanding of the physiology of the inflammatory process of gout, our approach to treatment has remained antiquated. The approved US Food and Drug Administration (FDA) therapies for gout flares include indomethacin, naproxen, sulindac, corticosteroids, and colchicine2,3,4,5. Nonsteroidal antiinflammatory drugs (NSAID) have been used to treat gout flares since the 1960s, corticosteroids since the 1950s, and documented use of colchicine goes back to 17632,6. The efficacy of all these medications for the treatment of gout flares is well documented, but not all patients respond adequately; and in a population that is likely to have 1 or more comorbid conditions, these FDA-approved medications can carry significant risks and adverse effects7. In this issue of The Journal , Desmarais and Chu evaluate the efficacy and safety of anakinra, a biologic therapy that targets interleukin (IL)-1 receptors, thereby blocking IL-1 activity, a major driver of inflammation in an acute gout flare8. The authors used retrospective data spanning almost 9 years from the Oregon Health & Science University (OHSU) Hospital and the Veteran’s Administration Portland Health Care System (VAPORHCS) to identify hospitalized patients who carried a diagnosis of gout or calcium pyrophosphate (CPP) deposition, who flared, and who had received at least one 100-mg dose of anakinra … Address correspondence to Dr. R.T. Keenan, Duke University School of Medicine, 200 Trent Drive, DUMC 3544, Durham, North Carolina 27710, USA. E-mail: Robert.keenan{at}duke.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)0.006
metaresearch head score (Gemma)0.023
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.030
Threshold uncertainty score0.099

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0060.023
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0020.001
Bibliometrics0.0010.001
Science and technology studies0.0030.003
Scholarly communication0.0090.009
Open science0.0020.003
Research integrity0.0100.015
Insufficient payload (model declined to judge)0.0300.008

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 head0.018
GPT teacher head0.279
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 designNot applicable
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

Citations0
Published2019
Admission routes1
Has abstractyes

Explore more

Same venueThe Journal of RheumatologySame topicGout, Hyperuricemia, Uric AcidFrench-language works237,207