Bibliographic record
Abstract
Health disparities in the delivery and outcomes of clinical care exist across the spectrum of patients with rheumatic diseases. In a retrospective analysis of the Corrona registry, patients with rheumatoid arthritis identifying as racial or ethnic minorities achieved lower rates of remission or low disease activity scores and reported poorer functional status compared to White patients.1 Moore and colleagues observed worse pulmonary disease and higher unadjusted mortality rates among Black and African American patients with systemic sclerosis compared to White patients.2 Systemic lupus erythematosus (SLE) may represent the rheumatic disease most burdened with racial disparities, as Black, African American, and Latinx patients suffer more severe disease at earlier ages and have worse outcomes than their White counterparts.3,4,5 Many patient factors contribute to poorer outcomes, including socioeconomic status, educational attainment, and cultural customs or beliefs. The medical community must advocate for patients to achieve equitable health outcomes and must work to reduce any additional contributions to disparity of care, including those created through medical education. Educational materials should depict the appearance of clinical manifestations in patients of all skin tones to equip trainees and practicing clinicians with the skills to care for all patients. These resources should reinforce the recognition of rheumatic diseases across races and ethnicities and highlight the severity and prevalence of rheumatic diseases among patients of color. Inclusive educational materials can enrich the knowledge and clinical practice of learners spanning the continuum of medical education, especially for those who may train or practice in less diverse communities. The benefits of such an approach to medical education carry high impact in the campaign for health equity and enhance the quality of care provided to all patients. Rheumatology educators, authors, and professional societies must accept the responsibility to intentionally represent all patients and … Address correspondence to Dr. B.F. Mandell, Cleveland Clinic Foundation, Rheumatic and Immunologic Disease, 9500 Euclid Ave A50, Cleveland, OH 44022, USA. Email: mandelb{at}ccf.org.
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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 | 0.005 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.007 | 0.002 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.002 | 0.013 |
| Research integrity | 0.007 | 0.008 |
| Insufficient payload (model declined to judge) | 0.143 | 0.020 |
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".