14 Preventing damage and reducing mortality in lupus: how are we doing?
Bibliographic record
Abstract
Introduction: Malignant pleural effusions (MPEs) can be treated by indwelling pleural catheter (IPC) or chest drain and talc pleurodesis (usual care). This is the first direct, randomised comparison of these techniques as initial therapy assessing patient reported outcomes. Methods: Randomised trial of IPC versus usual care (1:1) in patients with symptomatic MPE. IPCs were inserted as day cases, followed by patient education and home drainage. Usual care was admission for chest drain and talc pleurodesis in patients with good lung re-expansion. The primary outcomes were daily visual analogue scale (VAS) scores of breathlessness and chest pain over 42 days (100mm line, 0mm = no breathlessness/chest pain, 100mm = maximum breathlessness/pain). Results: 106 patients were randomised. Dyspnoea improved in both arms, with no significant difference in intensity (mean VAS: IPC 24.7mm (SD 18.9), usual care 24.4mm (SD 17.0), difference 0.16mm, 95% CI -6.82 to 7.15, p=0.96). Dyspnoea decreased by mean 37mm (SD 27.1) IPC arm and 30.2mm (SD 27.7) usual care arm. Chest pain decreased from baseline in both arms (mean VAS: IPC 20.5mm (SD 18.2), usual care 17.6mm (SD 16.0), difference 5.4mm, 95% CI -3.0 to 13.8, p=0.21). Preliminary analysis demonstrated lower initial hospital stay in the IPC group (median days 0 (IQR 0-1) versus 4 (IQR 2-6)). Discussion: IPC and usual care are comparably effective treatments for the relief of breathlessness in patients with MPE. The pain profile of IPC and usual care is similar over 6 weeks.
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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 | 0.015 | 0.029 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.018 | 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".