Bibliographic record
Abstract
We thank Drs Racz, Candido, and Helm for their interest in our editorial on epidural adhesiolysis.1 We appreciate the authors’ interest and belief in this procedure. The authors make several comments about statements in our article. We have therefore provided a point-by-point response to their remarks. Regarding the results of the study by Choi et al,2 we maintain that this study had several limitations that we identified in our editorial. The authors also contend that we did not refer to Dr Racz’s more recent work—a nonpeer-reviewed book chapter—on postulated mechanisms of analgesic benefit from neuroplasty that include “hydraulic separation of tissue planes.” However, any attribution of benefit to a particular mechanism is purely speculative in the absence of high-quality preclinical and clinical studies, and one might additionally question how truly different this is from the disruption of scar tissue, the mechanism mentioned in our article. Regarding their question about why outcomes of neuroplasty would be affected by central processing, the answer lies in the fact that persistent pathology (including scarring) in or around the dorsal root ganglion of exiting spinal nerve roots is associated with both peripheral and central sensitization.2 Moreover, conditions characterized by abnormal central pain processing have been shown to be associated with abnormal responses to interventional procedures.3 In response to their comment regarding proof for the incidence of dural puncture quoted by us (4%), Talu and Erdine4 reported an incidence of 4.4% for intrathecal catheter placement during epidural adhesiolysis. Finally, we stand by our statement that the pain community must continue to seek evidence for efficacy and safety of this procedure in large, multicenter trials rather than relying on small trials from centers with interventionalists who have expertise in this procedure. Anuj Bhatia, MBBS, MD, FRCA, FRCPC, FIPP, FFPMRCA, EDRA, CIPSDepartment of Anesthesia and Pain Management and Institute of Health Policy Management and EvaluationUniversity of TorontoUniversity Health Network-Toronto Western HospitalToronto, Ontario, Canada[email protected] Steven P. Cohen, MDDepartments of Anesthesiology and Critical Care Medicine,Neurology, and Physical Medicine and RehabilitationJohns Hopkins School of MedicineBaltimore, MarylandDepartments of Anesthesiology and Physical Medicine and RehabilitationWalter Reed National Military Medical CenterBethesda, Maryland
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.004 | 0.049 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.013 | 0.014 |
| Insufficient payload (model declined to judge) | 0.336 | 0.214 |
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; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
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".