Are smoking and COPD associated with ILD onset in rheumatoid arthritis?
Bibliographic record
Abstract
Backgound: Rheumatoid arthritis (RA) is associated with various respiratory manifestations including COPD and ILD. Our goal was to determine whether preexisting COPD and smoking status were associated with RA-ILD onset. Methods: The development of new ILD in incident RA patients was assessed in the MarketScan Commercial Claims database (2011-2018) based on physician and/or hospitalization claim diagnostic codes. Data on smoking (current, past, and never) was available for a subset of subjects that completed a health risk assessment questionnaire. Multivariate Cox regression models were performed to evaluate the hazard ratios (HR) for ILD onset adjusted for age, sex, smoking, and immunosuppression use after RA onset. Results: Among 373,940 new RA subjects, 6343 (1.7%) developed ILD. ILD was more common in patients with prior COPD. After adjusting for age, sex, and immunosuppression use, the HR=2.10 (95% CI 1.89, 2.32) for ILD onset in those with pre-existing COPD. In the subset of subjects with smoking status information, 288 (1.5%) developed ILD and there was no association with smoking. After adjustment including smoking status, HR=1.64 (0.93, 2.89) for ILD onset in those with pre-existing COPD. Conclusion: Pre-existing COPD in incident RA patients was associated with a higher risk of future ILD. While a trend persisted after adjusting for smoking, we were limited by reduced sample size. Further studies of ILD onset in RA are needed to also assess the potentially complicated relationships between smoking, COPD, and other factors in RA-associated ILD.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 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".