Pilotstudie zur Messung der mechanischen Berührungs-,Druckschmerz- und Vibrationsempfindungsschwellebei Therapie der Gonarthrose mit Hirudo medicinalis
Bibliographic record
Abstract
Purpose: Osteoarthritis of the knee (KOA) leads to severe and often debilitating symptoms such as pain, constrained movement, immobility, and reduced quality of life and the incidence is still increasing. Previous randomized controlled trials (RCT) have shown a significant pain reduction using leeches for the treatment of KOA. The way how leeching improves the symptoms of KOA is still unclear. The aim of this study was to pilot if the measurement of somatosensory function is a way to investigate the mechanism of action of leech therapy treating KOA. Methods: 42 patients with bilateral KOA participated in the case series pilot study. Neurophysiological measures of local pain perception at the knee were subtests obtained from the QST (Quantitative sensory testing) protocol: MDT (mechanical detection threshold), VDT (Vibration detection threshold) and PPT (Pressure pain threshold). All QST subtests were obtained at defined areas of both knees and at the hands as a control area for systematic treatment effects. Moreover, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was obtained before and seven days after therapy in addition to pain measured by a visual analogue scale (VAS, day 0 and day 7). Based on the QST results a case number was calculated. Results: MDT was generally lowered after treatment indicating a better discrimination of mechanical stimuli. The effect was significant (p=0.008) for the area close to the pain. In order to prove the standardized difference with a statistical power of β=80% in a following RCT 170 patients are needed. Whereas a statistical power of β=80% requires 228 patients. There was a general significant treatment effect for VDT resulting in less vibration discrimination for all sites (p<0.05) with the exception of the most affected knee. No consistent effects were seen for PPT. Clinical pain improved significantly (WOMAC global, pain, function, and VAS: p<0.001). Discussion: Due to the study design it can not be concluded that leeching improves somatosensory function. However, there are essential findings concerning feasibility, methodologies and results along with the corresponding case number calculation. These findings can then be implemented in a following RCT.
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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 | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".