The Survival of Patients With Alveolar Hemorrhage Secondary to Antineutrophil Cytoplasmic Antibody–associated Vasculitis
Bibliographic record
Abstract
Diffuse alveolar hemorrhage (DAH) is a clinical syndrome that can be caused by a variety of nonimmune-mediated and immune-mediated etiologies, including antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). DAH is one of the most severe and life-threatening manifestations of AAV, occurring in up to 25% of patients with AAV1. Some studies have suggested that DAH may be more common in microscopic polyangiitis (MPA) than in granulomatosis with polyangiitis (GPA), but reported frequencies may be affected by factors including variable epidemiology of MPA versus GPA in different regions of the world, applied disease definitions, and local referral patterns to tertiary care centers2,3,4,5. Preexisting airway disease has been reported as an independent risk factor for the development of DAH in AAV3. Irrespective of the frequency and severity of DAH in AAV, there is only a limited number of studies addressing the prognosis of DAH in patients with AAV (Table 1). The combination of glucocorticoids (GC) with cyclophosphamide (CYC) or rituximab (RTX), variably combined with plasma exchange (PLEX), is usually effective to induce remission of the disease in the majority of patients, and the main causes of death are infections or cardiovascular complications rather than vasculitis activity2,6,7,8,9,10. View this table: Table 1. The published cohorts of DAH occurring in patients with AAV (only studies with ≥ 20 patients are reported). In this issue of The Journal , Tang and colleagues11 report on their analysis of clinical features at presentation and the main prognostic factors of DAH in a single-center cohort of 92 patients with MPA. This is the largest cohort of DAH in patients with MPA published so far. Interestingly, in this cohort, the mortality was the highest reported for DAH in patients with … Address correspondence to Dr. A. Berti, Rheumatology Department, Santa Chiara Hospital, Largo Medaglie D’Oro 9, 38121, Trento, Trentino, Italy. Email: alvise.berti{at}apss.tn.it.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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 | 0.001 |
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".