Oral Corticosteroids for Induction of Remission in Ulcerative Colitis
Bibliographic record
Abstract
Purpose: Despite extensive use over many decades, regimens of steroids vary between clinicians. There is a lack of clarity of initial dosing, tapering pattern and duration of steroid treatment. Although most clinicians use once a day dosing, split dosing has been studied (Powell-Tuck 1987). Thus there is a need to clearly establish an evidence-based use of corticosteroids not only to maximise benefit but also reduce serious complications. In order to define its role further a Cochrane review will be undertaken. Methods: We included randomized controlled trials (RCTs) comparing oral corticosteroids versus placebo, administered to patients with confirmed ulcerative colitis. We searched 4 electronic databases and examined multiple sources of grey literature for eligible trials. Two independent investigators assessed trial eligibility and abstracted data. For each RCT we calculated the relative risk (RR) for each outcome and used a random effects model to pool the RRs. Results: Our search identified 9 citations that met our eligibility criteria. There were significantly greater rates of clinical (9 trials; 927 patients; RR 2.27; 95% CI 1.52-3.39; p=0.0001) and endoscopic (7 trials; 436 patients; RR 2.47; 95% CI 1.50-4.04; p=0.0003) remission with corticosteroids. Notably there was no significance increase in the occurrence of adverse events (3 trials, 218 patients; RR 2.74; 95% CI 0.31-23.85; p=0.36) and the withdrawal of patients due to adverse events (5 trials; 377 patients; RR 0.60; 95% CI 0.14-2.55; p=0.49). Conclusion: Our meta-analysis showed a significantly higher rates of clinical and endoscopic remission. There was no significant increase in the occurrence of adverse events and the withdrawal of patients secondary to adverse events.
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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 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 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".