ESD, not EMR, should be the first-line therapy for early gastric neoplasia
Bibliographic record
Abstract
With interest, we read the insightful recommendations by Banks et al 1 and the British Society of Gastroenterology on the management of precancerous conditions and lesions in the stomach. They rightly identify that the management of these conditions lacks consistency not only in the UK but also in the majority of Western societies.2 With a growing appreciation for quality indicators in upper GI endoscopy,3 these guidelines are an essential resource for both general endoscopists and tissue resection specialists. Nevertheless, despite the increasing expertise in endoscopic submucosal dissection (ESD) outside of Japan,4 we were surprised that endoscopic mucosal resection (EMR) was recommended for lesions ≤10 mm. This is in contrast to recommendations by the Japan Gastroenterological Endoscopy Society (JGES)5 and the European Society of Gastrointestinal Endoscopy (ESGE).6 Three systematic reviews7–9 have compared ESD versus EMR for early gastric cancer (EGC). In …
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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 | 0.000 | 0.000 |
| 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 | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".