Bibliographic record
Abstract
Introduction: Long-term medical management of benign prostatic hyperplasia (BPH) includes use of 5-alpha reductase inhibitors (5ARI) and alphablockers (AB). Studies have demonstrated an increased risk of comorbidities, including cardiac failure and diabetes mellitus, with use of these medications, raising safety concerns. This study aims to determine the risk of developing diabetes with the use of AB and 5ARI in combination, as well as monotherapy. Methods: This population-based study used administrative databases to look at men over the age of 66 with a diagnosis of BPH between 2005 and 2015. Men were categorized based on exposure to 5ARI or AB. Primary outcome was new cardiac failure and new diagnosis of diabetes. Variables examined included exposure time to medication, age, and comorbidities and logistic regression was used for statistical analysis. Results: There was a total 129 223 men with a BPH diagnosis and no prior history of diabetes mellitus. Of these, 6390 were exposed to 5ARI, 39 592 exposed to AB, and 30 545 exposed to combination therapy. There was a statistically significant association with new onset of diabetes mellitus with these medication regimens compared to no medication use. Men treated with combination therapy of 5ARI and AB (odds ratio [OR] 1.276, 95% confidence interval [CI] 1.226-1.329), 5ARI monotherapy (OR 1.254, 95% CI 1.168-1.345), or AB monotherapy (OR 1.171, 95% CI 1.127-1.217) all showed increased association. When calculating risk of new diagnosis of diabetes measured from start of therapy, AB had a decreased risk in comparison to 5ARI monotherapy (OR 0.887, 95% CI 0.816-0.966). Conclusions: In this study, men with a BPH diagnosis and exposed to both 5ARI and AB therapy had an increased association of developing newonset diabetes mellitus when compared to no medication use. In a direct comparison of those that initiated monotherapy, 5ARI was shown to have an increased risk compared to AB.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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 teacher head, 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".