Primary versus Secondary Sjögren Syndrome: Is It Time To Reconsider These Terms?
Bibliographic record
Abstract
Classification of systemic autoimmune diseases on the basis of clinical, serological, and genetic characteristics has long been considered a necessary approach to determine disease prognosis and institute appropriate therapeutic strategies1. Has this, however, truly been pursued by the scientific community? Probably not, because similar disease-modifying agents and several immunosuppressants are implemented as baseline therapy for combating arthritis, pleurisy, or nephritis, irrespective of the character of the underlying disease. Despite our better understanding of molecular patho-biology, which eventually led to development of targeted therapies, seropositive and seronegative arthritis are still similarly treated with tumor necrosis factor inhibitors, while certain vasculitic syndromes are managed with B cell depletion therapy in the same way as rheumatoid arthritis (RA). The responses, even to those new therapies, are not uniform because these syndromes are highly polymorphic in both clinical phenotypes and underlying pathogenetic pathways. A prototype autoimmune disorder characterized by a wide spectrum of clinical, serological, and genetic features is Sjögren syndrome (SS). It may extend from sicca symptoms and complications of mucosal dryness as a result of exocrine gland involvement, to a systemic disease or to malignant B cell lymphoproliferation in about one-fourth and one-tenth of patients, respectively. Nevertheless, sicca manifestations may also occur in several other systemic autoimmune disorders at variable frequencies ranging from 8.3% … Address correspondence to Dr. C.P. Mavaragani, Department of Physiology, 75 Mikras Asias St., 11527 Athens, Greece. E-mail: kmauragan{at}med.uoa.gr
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.003 |
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; both teacher heads agree on what is shown here.
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".